AU04: Uses and Abuses of Extrapolation and AI Software by Payors and CMS
Joint presentation with Wayne van Halem and Stephen Bittinger regarding current litigation and compliance regarding the use of statistical sampling and extrapolation and AI software tools for auditing and claims review by payors and CMS. The presentation will cover the law, regulation, and guidance, or lack thereof for AI, that suppliers should know in using AI software tools, self-auditing with statistical sampling and extrapolation, and how to challenge both when used by payors or CMS. The presentation will also cover current litigation against payors for use and abuse of AI and extrapolation and DOJ investigations of use and abuse of AI by providers and suppliers.
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