Study Results from Columbia University in the Area of Managed Care Reported (Ai-generated Denials: Medical Necessity In Medicare Advantage Today): Managed Care

2026 MAY 05 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Current study results on Managed Care have been published. According to news reporting originating in New York City, New York, by NewsRx editors, the research stated, “Medicare Advantage insurers hold vast power over access to care for Medicare beneficiaries enrolled in their plans. Among other things, these insurers make the all-important determination as to whether care is ‘medically necessary’ and thus warrants coverage under Medicare.”

The news reporters obtained a quote from the research from Columbia University, “Recently, these insurers have turned to artificial intelligence to help with these determinations. This trend has yielded concerning results, exacerbating both inaccuracy and opacity in the coverage determination process. This Note describes the current state of determinations. Taking an outcomes-focused approach, it argues that the government must demand greater information sharing from Medicare Advantage insurers and enhance beneficiaries’ access to the appeals process.”

According to the news reporters, the research concluded: “Such reforms are an important first step in ensuring beneficiaries have access to the care they are entitled to.”

This research has been peer-reviewed.

For more information on this research see: Ai-generated Denials: Medical Necessity In Medicare Advantage Today. Columbia Law Review, 2026;126(1):129-168. Columbia Law Review can be contacted at: Columbia Journal Transnational Law Assoc, Columbia Univ, School Law, 435 W 116TH St, New York, NY 10027, USA.

Our news correspondents report that additional information may be obtained by contacting Emma Ziegler, Columbia University, New York, NY 10027, United States.

(Our reports deliver fact-based news of research and discoveries from around the world.)