HIMSS Supports CMS protections of Health Equity in Medicare Advantage and Prescription Drug Benefits Programs

HIMSS has reiterated its support for a proposal by the Centers for Medicare and Medicaid Services to clarify that artificial intelligence and other automated tools should, at a minimum, not amplify harmful biases, and at best help to address any biases already inherent in healthcare data.

HIMSS’s responded to the CMS proposed Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly Rule.

Read the full public comments.

HIMSS supported the CMS proposed update to the Part B program to clarify that access to benefits should not be restricted, regardless of if the determination is made by a human, artificial intelligence or some other form of automated decision tree.

The clarification was made as concerns were raised that artificial intelligence could be used to restrict access to benefits for Medicare beneficiaries.

The proposal specifically indicates that benefits can’t be restricted on the basis of having limited English proficiency; people of ethnic, cultural, racial or religious minorities; people with disabilities; people who identify as lesbian, gay, bisexual or other diverse sexual orientations; people who identify as transgender and other diverse gender identities; people living in rural communities; or people otherwise adversely affected by persistent poverty or inequality, regardless of what mechanism was used to make the determination, including artificial intelligence.

As the proposed rule is considered by the new leadership at CMS, HIMSS will continue to advocate for realizing the full health potential of every human everywhere.