Humana used AI tool from UnitedHealth to deny Medicare Advantage claims, lawsuit alleges

Eileen Cook December 14, 2023December 14, 2023 AI, Care Coordination and Integrated Case Management, Denied Medicare Advantage Claims, Medicare Advantage, nH Predict, Older Adults

(By Jakob Emerson for Becker’s Hospital Review)

Humana used an artificial intelligence tool owned by UnitedHealth Group to wrongfully deny Medicare Advantage members’ medical claims, according to a class-action complaint filed Dec. 12.

The lawsuit was filed in the U.S. District Court for the Western District of Kentucky and is the latest legal action against major insurers such as UnitedHealthcare and Cigna for allegedly using automated data tools to wrongfully deny members’ claims. Continue reading here…

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