UnitedHealthcare accused of using AI that denies critical medical care coverage
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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...

UnitedHealthcare accused of using AI that denies critical medical care coverage | (Allegedly) putting profit before patients? What a shock.::undefined

  • ilinamorato@lemmy.worldEnglish
    20·
    1 year ago

    The full source code of that “AI:”

    function process_claim (claim_id){

    return "denied";

    }

  • Zrybew@lemmy.worldEnglish
    15·
    1 year ago

    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.