The nation’s three largest Medicare Benefit insurers more and more refused to pay for rehabilitative look after seniors within the years after adopting subtle applied sciences to assist of their protection choices, a Senate investigation discovered.
UnitedHealth Group, Humana, and CVS Well being focused denials amongst older adults who have been requesting care in nursing properties, inpatient rehab hospitals, and long-term hospitals. As of 2022, these three insurers have been turning down roughly 1 / 4 of all requests for post-acute care amongst their Medicare Benefit enrollees, in line with the congressional report.
The report, performed by the U.S. Senate Everlasting Subcommittee on Investigations, extensively cites STAT’s sequence final yr that investigated the usage of algorithms and synthetic intelligence inside Medicare Benefit plans. The sequence centered on how UnitedHealth and its subsidiary NaviHealth have been utilizing unregulated algorithms to foretell when somebody may very well be minimize off from rehab care. STAT’s investigation revealed, for instance, how UnitedHealth pushed workers to abide by the algorithm’s predictions, even when sufferers may barely stroll and weren’t able to go house.
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