(Photo: Jim Mone/AP)

Although artificial intelligence is in its early stages in the health-care industry, it already has triggered legal action. A class-action lawsuit filed on Tuesday alleges that UnitedHealthcare used an artificial intelligence algorithm to wrongfully deny coverage under Medicare Advantage health policies.

The insurer made health-care determinations using its nH Predict algorithm, overrode physician recommendations, and denied elderly patients’ claims for stays in extended-care facilities, according to the lawsuit in the U.S. District Court for the District of Minnesota. The plaintiffs also alleged the technology lets the company “aggressively deny coverage, because they know they will not be held accountable for wrongful denials.”

Complete your profile to continue reading and get FREE access to BenefitsPRO.com, part of your ALM digital membership.

Your access to unlimited BenefitsPRO.com content isn’t changing.
Once you are an ALM digital member, you’ll receive:

  • Critical BenefitsPRO.com information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events.
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com

Already have an account?


NOT FOR REPRINT

© 2023 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.

BenefitsPRO Broker Expo 2024Event

The premier educational and networking event for employee benefits brokers and agents.

Get More Information
 

BenefitsPRO

Join BenefitsPRO

Don’t miss crucial news and insights you need to navigate the shifting employee benefits industry. Join BenefitsPRO.com now!

  • Unlimited access to BenefitsPRO.com - your roadmap to thriving in a disrupted environment
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
  • Exclusive discounts on BenefitsPRO.com and ALM events.

Already have an account? Sign In Now
Join BenefitsPRO

Copyright © 2023 ALM Global, LLC. All Rights Reserved.