More than 130 hospitals have filed a lawsuit against HHS challenging how the agency calculates disproportionate share hospital payments, arguing the policy unlawfully reduces reimbursement for facilities serving low-income patients.  The complaint, filed March 30 in the U.S. District Court for the District of Columbia, centers on the agency’s treatment of Medicare Advantage Part C patient days in DSH payment calculations. 

How Mass General Brigham Decides Which AI Tools Are Worth Scaling

Mass General Brigham evaluates AI tools by carefully monitoring real-world performance before scaling them system-wide. At HIMSS earlier this month, Rebecca Mishuris, the health system’s chief health information officer and vice president of digital, explained what this process looks like.  Once an AI solution is launched, it must be monitored in multiple layers, Mishuris stated. She described three types of monitoring at Mass General: real-time monitoring during patient care to catch potential hallucinations immediately, short-term retrospective monitoring days or weeks later to review model outputs at scale and identify potential issues, and ongoing performance monitoring to ensure tools continue delivering their intended outcomes.

Nonprofit Electronic Frontier Foundation sues CMS over AI prior authorization demonstration

Digital and privacy rights nonprofit Electronic Frontier Foundation is suing the Centers for Medicare & Medicaid Services (CMS) to get more information about a multi-state program that is using artificial intelligence to evaluate requests for medical care.  CMS rolled out the Innovation Center model to test new prior authorization requirements in traditional Medicare. It launched January 1 and will conclude at the end of 2031.  The pilot program uses AI to assess prior authorization requests from Medicare beneficiaries and expands the scope of prior auth in traditional Medicare, which has mostly eschewed prior authorization.