MCG and Telligen to share successful results of ai-enabled Medical Necessity Review at HLTH 2026. Nov 05, 2026, 09:40 ET Industry experts will discuss how evidence-based guidance and artificial intelligence support timely and consistent clinical decisions SEATTLE, Nov. 5, 2026 /PRNewswire/ - MCG Health, part of the Hearst Health network and the industry's source of truth for trusted clinical guidance, today announced its Senior Manager of Product Management, Daniel Cawood, and Senior Manager of Quality Improvement at Telligen, Nancy Johnson, BSN, RN, will be featured speakers at the upcoming HLTH 2026 conference. HLTH is one of the leading healthcare industry events focused on innovation, collaboration, and technological transformation. The 2026 conference will take place November 15-18 in Las Vegas, Nevada, at the Venetian Expo Center. Mr. Cawood and Ms. Johnson will present "Smarter Medical Necessity Review with AI" on Tuesday, November 17, from 11:45 a.m.-12:05 p.m. PST in the HLTH AI Theater B. The session will explore how public and private sector clients across the healthcare industry can use AI-enabled medical necessity review tools to accelerate utilization management while maintaining transparency and clinical rigor. Drawing on real-world experience, Telligen, a population health management company, will share how these tools can streamline workflows, align decisions with evidence-based guidelines, and support defensible decisions. Regarding the session, Mr. Cawood said, "At our session, HLTH attendees will hear the successful results of a real-world case study where AI supported improved efficiency of medical necessity reviews and reduced review time while keeping decisions grounded in nationally recognized, evidence-based guidelines. We'll also discuss how making those guidelines the transparent foundation for an AI-supported review can help support more clinically rigorous decisions." Ms. Johnson added, "At Telligen, we've seen firsthand how AI-enabled medical necessity review tools can transform the utilization management process. By combining the power of artificial intelligence with MCG's evidence-based clinical guidelines, we've been able to accelerate our review timelines without compromising quality or clinical integrity. This approach has enabled our team to focus more on complex cases while ensuring every decision remains defensible and aligned with best practices. We're excited to share our results and insights with the HLTH community." In addition to the case study session, MCG Vice President of Health AI Products, Naqi Khan, MD, MS, FAMIA, will participate in a three-person panel discussion entitled "Data You Can Trust: AI, Interoperability, and the Race for a Unified Patient Record" on Monday, November 16, from 1:00-1:45 p.m. PST in the HLTH AI Theater A. Dr. Khan will be joined by Andrew Cohen, Global Healthcare Industry Leader and Senior Partner at IBM, and Sara Zywicki, MPH, MBA, Chief Product Officer at b.well Connected Health. About Telligen Telligen is a 100-percent employee-owned population health organization dedicated to transforming lives and economies by improving health outcomes nationwide. For more than 50 years, Telligen has partnered with federal and state agencies, health plans, employers, and other stakeholders to deliver innovative, data-driven health management solutions that improve quality, lower costs, and promote equitable care. Combining deep clinical, analytical, and technical expertise, Telligen turns data into actionable insights and scalable solutions that help millions live their healthiest lives. As a CMS-designated Quality Innovation Network-Quality Improvement Organization (QIN-QIO), Telligen is committed to ingenuity, integrity, community, and ownership in advancing population health. About MCG Health MCG, part of the Hearst Health network, is the trusted source of truth for clinical guidance in the healthcare industry. MCG combines evidence-based guidelines and analytics with artificial intelligence to guide efficient and accurate, evidence-based clinical decisions. MCG solutions are licensed by a vast majority of health plans, thousands of hospitals, and many state and federal government agencies to drive quality health outcomes while controlling costs. For more information, visit: www.mcg.com. About Hearst Health The mission of Hearst Health is to guide healthcare organizations by delivering essential intelligence and software that improve the quality, safety, and efficiency of care. Hearst Health has been innovating with care for more than 40 years, with a commitment to making a lasting positive impact on health. The Hearst Health companies - FDB, Homecare Homebase, MCG, MHK, QGenda, and Zynx Health - elevate care by informing and empowering participants across the health journey. To learn more, visit www.hearst.com/hearst-health and follow @Hearst Health on LinkedIn. SOURCE MCG Health

MCG Health, part of the Hearst Health network, has partnered with Itiliti Health to help health plans meet new federal prior authorization and interoperability rules. The rules fall under the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F), with a January 2027 deadline. The joint solution pairs MCG Path, an HL7 FHIR-based application programming interface (API) that places clinical guidelines inside clinical workflows, with Itiliti Health's prior authorization automation platform. It aims to automate coverage requirements, documentation exchange, and prior authorization. The companies expect faster decisions, less provider burden, and lower administrative costs. Both take part in the HL7 Da Vinci Project, which helped develop the standards behind the rule. "Health plans need more than point solutions," said Michael Lunzer, president and co-founder of Itiliti Health.