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

L4sBot@lemmy.worldmod to Technology@lemmy.world – 321 points –
UnitedHealthcare accused of using AI that denies critical medical care coverage
techspot.com

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

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

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.

The full source code of that "AI:"

function process_claim (claim_id){

return "denied";

}

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

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.

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.

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

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.

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.

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