Anonymous ID: ca101d Nov. 24, 2023, 7:09 a.m. No.19969796   🗄️.is 🔗kun   >>0187 >>0247 >>0273

UnitedHealthcare accused of using AI that denies critical medical care coverage

 

(Allegedly) putting profit before patients? What a shock.

 

By Rob Thubron November 19, 2023, 9:55 AM 32 comments

 

A hot potato: In yet another story about the damaging effects of faulty artificial intelligence, the largest health insurance company in the US, 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 filed in the US District Court for the District of Minnesota comes from the estates of two now-deceased men who needed long-term care in post-acute facilities. The families of these men were forced to pay a combined $210,000 out of pocket for their therapy and care before their deaths.

 

The suit alleges that UnitedHealth repeatedly and wrongfully refused to pay the healthcare claims of the two seniors, who were using the Medicare Advantage Plans. It adds that such incidents have been going on since at least 2020, when UnitedHealthcare acquired post-acute care management firm Navihealth.

 

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. Furthermore, claims that nH Predict failed to take into account individual patient needs, such as comorbidities (having multiple conditions or diseases) and contracting an illness while staying at a facility.

 

Another damning section of the suit claims that while only a few patients appealed coverage denials that were based on nH Predict estimates, over 90% of them were reversed through internal appeals processes or federal Administrative Law Judge proceedings.

 

https://www.techspot.com/news/100895-un … dical.html

Anonymous ID: ca101d Nov. 24, 2023, 7:10 a.m. No.19969800   🗄️.is 🔗kun   >>9808 >>0187 >>0247 >>0273

Economists May Have Been Flying Blind All Along

Declining response rates to official surveys raise the possibility that government and central bank officials have been making decisions based on flawed data.

 

November 24, 2023 at 5:00 AM CST

 

By Claudia Sahm

 

https://www.bloomberg.com/opinion/articles/2023-11-24/economists-may-have-been-flying-blind-all-along