Healthcare Finance News November 15, 2023
The suit alleges the company uses the algorithm to “prematurely and in bad faith” halt payments for healthcare services.
A class action lawsuit filed this week alleges that healthcare giant UnitedHealth Group unlawfully used an artificial intelligence algorithm to deny rehabilitative care to sick Medicare Advantage patients.
The suit claims that UnitedHealth knew the AI algorithm had a high potential for error.
The algorithm in question is nH Predict, which was developed by UnitedHealth subsidiary NaviHealth, which the former acquired in 2020. One of the allegations is that UnitedHealth uses nH Predict to evaluate claims for post-acute care, including in-home care and extended stays in skilled nursing facilities, and that the company uses the algorithm to “prematurely and in bad...
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