August 31, 2022
DREDF submitted comments in response to CMS request for information on various aspects of care delivery provided by Medicare Advantage plans. We called for special attention to be given to the potential impact of disability bias in algorithms and AI being used in healthcare and services decision-making and recommended steps CMS should take to ensure that these biases are identified and corrected. The goal is to increase equity and fairness and avoid discrimination and inappropriate care decisions for disabled Medicare Advantage beneficiaries. Although research is limited, some scholars have observed that when algorithmic and AI development and testing does not consider the potential for disability bias, certain inequitable outcomes could occur. Moreover, other specific disability status information is not measured or recorded directly within electronic health records (EHRs), yet it is likely that disabled people have a pattern of healthcare services use that might display unique variation based on disability type and might be affected by intersectional and demographic factors including race, ethnicity, gender identity, and age. Thus, any risk assessment algorithm should be designed with explicit attention to disability, not as an outlier or source of skew, but as a common demographic characteristic—an aspect of the human condition.