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

namingthingsiseasy , 7 months ago

Same shit, different day. Companies love denying people basic needs and then blaming it on “the computer” (to borrow a '90s parlance). They love it because you can’t blame a person, rather you can just say it’s some inherent fault of the universe rather than some trash executive’s decision to let people die in the name of profits. When their profits are in danger, the universe can be bent to anyone’s will to save them; when their profits are rosy, well, chaotic universe theory, what are you gonna do? :shrug:

The whole “AI” aspect of it is nothing new. “AI” is just regular software with different (and highly non-deterministic) algorithms running under the hood. Can’t wait till this stupid term is relegated to the dustbin of history.

interceder270 , 7 months ago

Downvoted for trashy headline.

quindraco , 7 months ago

What were the customers expecting when they paid for health insurance?

ilinamorato , 7 months ago

The full source code of that “AI:”

function process_claim (claim_id){

return “denied”;

}

kiranraine , 7 months ago

Nah its got like a 2% chance approval which is even giving too much credit imo 🤣

rivermonster , 7 months ago

Capitalism and healthcare are fundamentally incompatible, the failed USA proves it every day, all day, 365.

SirQuackTheDuck , 7 months ago

US healthcare on February 29th:

GIF of “Wedding Crashers” of two men popping champagne amidst a dancing crowd

andyburke , 7 months ago

People with no moral compass are selling "AI" to credulous hospital administrators trying to maximize their bonuses by cutting healthcare worker hours.

Fuck for-profit healthcare.

trash80 , 7 months ago

Is there any criteria for what is considered to be A.I.?

nous , 7 months ago

Yes. It is can I spin this as AI to investors?

I admit, not a very high bar to pass so basically everything is labeled as AI these days. It is what investors want to see.

trash80 , 7 months ago

new buzzword for the media to abuse

flumph , 7 months ago

Nope. It’s fully a marketing term and always has been. Worked at a firm that used a very, very basic bit of machine learning. But you better believe our marketing and investor pitch decks said “AI” a ton.

Lophostemon , 7 months ago

Elysium here we come.

Kalkaline , 7 months ago

United can suck my balls, they denied an ADHD med I’ve been on for years.

LazaroFilm , 7 months ago

My doc tried to change my ADHD meds to another one with less side effects. Denied and told him to try another one. T felt completely inebriated all day and fell asleep at the dinner table. At this point I give up. I’ll just deal with ADHD. It’s better than dealing with fixking health insurance.

EvacuateSoul , 7 months ago

I use Primatene OTC and caffeine to self-medicate.

Zrybew , 7 months 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.

tehbilly , 7 months ago

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

HaggierRapscallier , 7 months ago

Seems criminal tbh. In a decent society.

Listlessnomad , 7 months ago

Their excuse is that they aren’t “overruling the doctor”, they just aren’t going to pay for it. Never mind that in the US it’s functionally the same thing.

They will just say “you do what you think is best for the patient doc. We just disagree and aren’t going to cover it.” It forces doctors, hospitals, rehabs, and nursing homes into situations where they either have to provide care for free, or not at all. I’ll never understand how we allowed things to get this bad.