#medicare-advantage-plans

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Ars Technica
3 months ago
Artificial intelligence

AI cannot be used to deny health care coverage, feds clarify to insurers

Health insurers are not allowed to use algorithms or artificial intelligence to determine care or deny coverage for Medicare Advantage plans, according to the Centers for Medicare & Medicaid Services.
Both UnitedHealth and Humana are facing lawsuits for allegedly using an AI tool called nH Predict to deny care to elderly patients on Medicare Advantage plans. [ more ]
Theregister
6 months ago
Artificial intelligence

UnitedHealthcare sued over claims its AI denied healthcare

UnitedHealthcare is being sued for denying healthcare claims based on a faulty AI model.
The lawsuit claims that UnitedHealthcare has wrongfully refused to pay healthcare claims of senior patients using Medicare Advantage Plans.
The AI system deployed by UnitedHealthcare reportedly had a 90 percent error rate and overrode physician recommendations. [ more ]
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