In 2011 Ai worked with the Maryland Health Care Commission on a project to develop best standards for prior authorization, which is a process to determine in advance the medical necessity of certain care and services covered by insurance carriers. These best standards were informed through facilitation of a workgroup, and culminated in a final report, which assessed legislation needs, a comprehensive literature review of the subject, and minimum technical specifications for web portals forms, key questions, and response times for prior authorization.