Automated Decision-Making

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January 2, 2026
Federal AI Policy Threatens Prior Authorization Reform
Brit Vanneman Automated Decision-Making, Uncategorized
Automated systems play increasingly important roles in shaping access to health care services. Frequently, insurers use algorithms and artificial intelligence (AI) to route requests and make coverage decisions, fill records and forms, and even make recommendations about medical necessity. While automation can improve speed, relying too heavily on AI…
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May 15, 2025
Big Government Republican Bill Keeps States from Reining in Bad AI: A 10-year License for Unfettered Harm
Elizabeth Edwards and Brit Vanneman Automated Decision-Making, Medicaid Defense 2025
In an era of artificial intelligence (AI) and other forms of automated decision-making systems making decisions about people’s lives, people are rightly worried about how AI may affect their jobs, use their posts, invade their privacy, and affect their access to sound medical care. AI experts and the public…
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October 28, 2024
Unwinding Issues Show Medicaid Eligibility Systems Need Better Oversight to Ensure Coverage
Cassandra LaRose 2025, Automated Decision-Making, Uncategorized
The upcoming November election will have a significant impact on health care nationwide. Policy proposals championed by candidates at the federal and state levels could radically change health law and policy in ways that will reverberate in 2025 and beyond. In this new blog series, the experts at NHeLP will…
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May 1, 2024
1557 Final Rule Protects Against Bias in Health Care Algorithms
Cassandra LaRose and Elizabeth Edwards 1557, Automated Decision-Making, Eligibility & Enrollment, Uncategorized
The 2024 Final Rule implementing § 1557 of the Patient Protection and Affordable Care Act includes an important protection against the use of some algorithms in health care, or as the rule terms it “discriminatory patient care decision support tools.” HHS defined this term to be broad and inclusive,…
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May 16, 2023
NHeLP’s Automated Decision-Making Principles in Medicaid Continuous Coverage Unwinding
Cassandra LaRose Automated Decision-Making, Disability, Eligibility & Enrollment, Health Equity, Uncategorized
NHeLP’s Principles for Fairer, More Responsive Automated Decision-Making Systems outline how to realize the benefits of Automated Decision-Making Systems (ADS) while minimizing drawbacks. Many government agencies use ADS for Medicaid eligibility decisions. During the unwinding of the Medicaid continuous coverage period Medicaid eligibility ADS and related processes will be…
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July 14, 2021
Race-Based Prediction in Pregnancy Algorithm Is Damaging to Maternal Health
Liz McCaman Taylor Automated Decision-Making, Best of 2021 Blogs, Health Equity, SRH Health Equity, Uncategorized
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Federal AI Policy Threatens Prior Authorization Reform

Big Government Republican Bill Keeps States from Reining in Bad AI: A 10-year License for Unfettered Harm

Unwinding Issues Show Medicaid Eligibility Systems Need Better Oversight to Ensure Coverage

1557 Final Rule Protects Against Bias in Health Care Algorithms

NHeLP’s Automated Decision-Making Principles in Medicaid Continuous Coverage Unwinding

Race-Based Prediction in Pregnancy Algorithm Is Damaging to Maternal Health