Recent years have seen growth in the use of technology, including artificial intelligence (AI), to automate parts of the Medicaid prior authorization process. However, there is little information available today about how automation is used in Medicaid prior authorization and its impact on payers, providers, and Medicaid beneficiaries. To fill this gap in knowledge, staff completed a literature review on the role of automation in the Medicaid prior authorization process. During this session, we summarized the findings from this literature review, including the automation tools that states and managed care organizations use today, existing evidence on the impact of automation on the prior authorization process, and federal and state oversight of automation in prior authorization.
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Medicaid and CHIP Payment and Access Commission