Author: Simon Barr

URAC Establishes First Formal Health Care AI Accreditation

URAC has unveiled the country’s inaugural Health Care AI Accreditation program, an independent framework that evaluates artificial-intelligence solutions for safety, equity, transparency, and measurable clinical impact. The new credential offers payers and providers a concrete way to vet AI tools, align with emerging regulatory guidance, and advance value-based care objectives while mitigating compliance and reputational risk.

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CMS Releases New Oversight Rules for Medicaid State-Directed Payments

CMS has released new guidance tightening federal oversight of Medicaid state-directed payments (SDPs) in managed care. The update centers on transparency, documentation, and measurable quality outcomes—signaling stronger guardrails on financing, distribution methodologies, and alignment with actuarial soundness and value-based care. Payers, providers, and state agencies should prepare for enhanced monitoring and reporting expectations.

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