UnitedHealthcare accused of using AI that denies critical medical care coverage | (Allegedly) putting profit before patients? What a shock.::undefined
UnitedHealthcare, is being sued over claims it is using a flawed AI model. The system is said to have wrongfully denied health coverage to critical elderly patients and disagreed with doctors’ determinations.
The lawsuit followed an investigation by Stat News about the use of an AI algorithm called nH Predict developed by Navihealth. The algorithm is used to anticipate how long patients will stay in rehab following acute injuries, illness, or events. Post-acute care includes the likes of nursing homes and rehab centers. The algorithm reportedly does this by examining a database of medical cases from 6 million patients and estimating a patients’ medical requirements and length of stay.
The lawsuit alleges that the AI system has a 90% error rate and overruled the post-acute care opinions of physicians.
The fact that insurance companies don’t have to defer to physicians for medical decisions is mind boggling.
Their excuse is that they aren’t “overruling the doctor”, they just aren’t going to pay for it. Never mind that in the US it’s functionally the same thing.
They will just say “you do what you think is best for the patient doc. We just disagree and aren’t going to cover it.” It forces doctors, hospitals, rehabs, and nursing homes into situations where they either have to provide care for free, or not at all. I’ll never understand how we allowed things to get this bad.
United can suck my balls, they denied an ADHD med I’ve been on for years.
My doc tried to change my ADHD meds to another one with less side effects. Denied and told him to try another one. T felt completely inebriated all day and fell asleep at the dinner table. At this point I give up. I’ll just deal with ADHD. It’s better than dealing with fixking health insurance.
Elysium here we come.
Yes. It is can I spin this as AI to investors?
I admit, not a very high bar to pass so basically everything is labeled as AI these days. It is what investors want to see.
People with no moral compass are selling “AI” to credulous hospital administrators trying to maximize their bonuses by cutting healthcare worker hours.
Fuck for-profit healthcare.
