Partner and Healthcare Department Co-Chair Edo Banach recently spoke with
Hospice News about the rising trend of AI-assisted hospice regulatory enforcement.
In the article, "Human Oversight Lagging in AI-Driven Hospice Fraud Fight", Banach said that providers can have little recourse to respond to AI-generated audit requests.
“I don’t see an appropriate level of human oversight. We can use technology, that’s good and appropriate, but you need human oversight before you accuse someone of committing fraud and before you reject their rebuttal. You can use algorithms to deduce fraud, but it really does require human judgement,” he told the publication.
“We’re seeing responses that clearly contain language that no human being would ever write, and if they saw it, would change it,” Banach continued. “When we get humans involved, there are times that they turn it around and reverse course.”
Read the article in Hospice News here.
