Medscape November 20, 2023
UnitedHealthcare (UHC) is the latest payer accused of using artificial intelligence (AI) to deny patient claims by trading “real doctors’ recommendations” for a flawed algorithm to save money.
In a class action suit filed this week in Minnesota district court, the attorneys for the families of two deceased UHC Medicare Advantage plan policyholders say that the company uses the technology to systematically deny skilled nursing facility (SNF) claims and shirk its responsibility to adhere to Medicare’s coverage determination standards.
The case raises ethical and legal questions about whether AI can replace or supplement human tasks and interactions, particularly in a field as complex as healthcare. California-based public advocacy firm Clarkson Law filed a similar complaint against Cigna earlier this year...
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