tci Medicare Compliance & Reimbursement - 2024 Issue Q1

Expect AI To Be An Enforcement Tool — And Target

Experts warn about the perils of too much dependency on AI. You may find that the pros outweigh the cons when embracing artificial intelligence (AI) for your practice needs. But as with all technology, it’s important to tread lightly and ensure you’re implementing it with compliance in mind. Why? One of the cornerstones of federally-covered care, prescriptions, and equipment is that they are reasonable and medically necessary — and ordered by providers, not a program or algorithm. You run the risk of violating the False Claims Act (FCA) if AI goes awry, suggest attorneys Brian P. Dunphy...

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