Senators probing largest Medicare Advantage plans over how algorithms factor in care denials

Senators warned the country’s largest Medicare Advantage insurers that they cannot rely on algorithms to deny care that patients need.

May 17, 2023 - 20:00
Senators probing largest Medicare Advantage plans over how algorithms factor in care denials

Senators warned the country’s largest Medicare Advantage insurers at a hearing on Wednesday that they must abide by Medicare’s coverage rules and cannot rely on algorithms to deny care that patients need.

Congress is ramping up its oversight, too. Lawmakers in both parties have asked UnitedHealth Group, Humana, and CVS Health’s Aetna for internal documents that “will show how decisions are made to grant or deny access to care, including how they are using [artificial intelligence],” said Sen. Richard Blumenthal, the top Democrat on a subcommittee with the power to investigate government affairs, during the hearing.

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