The CMS audits are designed to curb overcharging by Medicare Advantage plans, to which the government pays more than $200 billion a year, but the audits are years behind schedule, largely because of industry opposition.
The idea is that the care management and incentive payments will motivate doctors to better support and engage patients, deliver preventive care and coordinate with other providers.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.