STAT May 17, 2023
Bob Herman and Casey Ross

Senators warned the country’s largest Medicare Advantage insurers at a hearing on Wednesday that they must abide by Medicare’s coverage rules and cannot rely on algorithms to deny care that patients need.

Congress is ramping up its oversight, too. Lawmakers in both parties have asked UnitedHealth Group, Humana, and CVS Health’s Aetna for internal documents that “will show how decisions are made to grant or deny access to care, including how they are using [artificial intelligence],” said Sen. Richard Blumenthal, the top Democrat on a subcommittee with the power to investigate government affairs, during the hearing.

“I want to put these companies on notice,” said Blumenthal (D-Conn.). “If you deny life-saving coverage to seniors, we are watching. We will expose...

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Topics: Congress / White House, Govt Agencies, Insurance, Medicare, Medicare Advantage
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