this post was submitted on 19 Nov 2023
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UnitedHealthcare accused of using AI that denies critical medical care coverage | (Allegedly) putting profit before patients? What a shock.::undefined

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[–] Zrybew@lemmy.world 20 points 2 years ago* (last edited 2 years ago) (3 children)

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.

[–] tehbilly@le.ptr.is 27 points 2 years ago (2 children)

The fact that insurance companies don't have to defer to physicians for medical decisions is mind boggling.

[–] HaggierRapscallier@feddit.nl 3 points 2 years ago

Seems criminal tbh. In a decent society.

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