Class action alleges improper use of AI to deny Medicare Advantage care
Company: UnitedHealth Group
Summary
In November 2023, a federal class action lawsuit was filed against UnitedHealth Group alleging that its subsidiary, UnitedHealthcare (through naviHealth), used the AI tool nH Predict to help make coverage decisions for Medicare Advantage patients receiving post-acute care. The plaintiffs allege that the system resulted in premature denials of medically necessary care and that the company continued using it despite concerns about its accuracy. UnitedHealth has denied the allegations, and the litigation is ongoing. News: https://www.statnews.com/2023/11/14/unitedhealth-class-action-lawsuit-algorithm-medicare-advantage/ Court case: Estate of Gene B. Lokken et al. v. UnitedHealth Group, Inc. et al., U.S. District Court, District of Minnesota, Case No. 23-cv-3514.