Studies from University of Rhode Island Have Provided New Data on Artificial Intelligence (Who Is Responsible? a Risk-stratified Framework for Pharmacist Accountability In Artificial Intelligence-assisted Managed Care): Artificial Intelligence

2026 SEP 21 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on Artificial Intelligence. According to news reporting originating in Kingston, Rhode Island, by NewsRx journalists, research stated, “Artificial intelligence (AI)-enabled tools are increasingly integrated into managed care pharmacy workflows, particularly in utilization management and prior authorization processes. Although these systems aim to improve operational consistency and efficiency, federal regulatory guidance and professional standards make clear that coverage and medical necessity determinations must remain grounded in human clinical judgment.”

The news reporters obtained a quote from the research from the University of Rhode Island, “As AI tools become part of routine managed care, responsibility for final decisions may become unclear, creating an accountability gap. This article synthesizes federal regulatory guidance and professional pharmacy standards relevant to AI use in health care. We review Centers for Medicare & Medicaid Services requirements, oversight findings from the US Department of Health and Human Services Office of Inspector General, and established pharmacy ethics frameworks. Based on this review, we propose a pharmacist-centered accountability framework for AI-assisted managed care decisions. The framework emphasizes explicit professional responsibility, structured human-in-the-loop review, and documentation practices that support transparency and auditability.”

According to the news reporters, the research concluded: “Clarifying pharmacist accountability in AI-assisted utilization management can strengthen professional stewardship, enhance workforce readiness, and support responsible innovation in managed care pharmacy.”

This research has been peer-reviewed.

For more information on this research see: Who Is Responsible? a Risk-stratified Framework for Pharmacist Accountability In Artificial Intelligence-assisted Managed Care. Journal of Managed Care & Specialty Pharmacy, 2026;32(9):1130-1134. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

Our news correspondents report that additional information may be obtained by contacting Emine Gulce Byers, University of Rhode Island, College of Pharmacy, Dept. of Biomedical and Pharmaceutical Sciences, Kingston, RI 02881, United States.

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