Software:nH Predict
From HandWiki
Short description: Computer program developed by naviHealth
nH Predict is a computer program developed by naviHealth that implements an algorithm that has allegedly been used by health insurance companies including United Healthcare and Humana[1][2] to automatically deny coverage to patients.[3][4][5] It is reported to work by cross-correlating patient health records with those of other patients.[6]
It is estimated that such software automates away 50–75% of human labor that would be involved in such tasks.[7]
A class action lawsuit (Estate of Gene B. Lokken et al. v. UnitedHealth Group, Inc. et al.) was filed in November 2023 against UnitedHealth Group regarding use of this software.[8][9][10] UnitedHeath Group have stated that the lawsuit is unjustified.[9]
References
- ↑ Mole, Beth (8 February 2024). "AI cannot be used to deny health care coverage, feds clarify to insurers". Ars Technica. https://arstechnica.com/science/2024/02/ai-cannot-be-used-to-deny-health-care-coverage-feds-clarify-to-insurers/.
- ↑ "AIAAIC - NaviHealth nH Predict post-acute care predictions" (in en-US). https://www.aiaaic.org/aiaaic-repository/ai-algorithmic-and-automation-incidents/navihealth-nh-predict-post-acute-care-predictions.
- ↑ Michelle M. Mello, Sherri Rose (7 March 2024). "Denial—Artificial Intelligence Tools and Health Insurance Coverage Decisions". JAMA Health Forum (JAMA Forum) 5 (3): e240622. doi:10.1001/jamahealthforum.2024.0622. PMID 38451493. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2816204. Retrieved 6 December 2024.
- ↑ Al-Sibai, Noor (December 5, 2024). "Murdered Insurance CEO Had Deployed an AI to Automatically Deny Benefits for Sick People". https://www.yahoo.com/news/murdered-insurance-ceo-had-deployed-175638581.html.
- ↑ Stanton, Andrew (December 5, 2024). "A year before CEO shooting, lawsuit alleged UHC used AI to deny coverage". https://www.newsweek.com/united-healthcare-ceo-shooting-ai-lawsuit-1996266.
- ↑ Jaffe, Susan (2023-10-05). "Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients" (in en-US). https://kffhealthnews.org/news/article/biden-administration-software-algorithms-medicare-advantage/.
- ↑ "UnitedHealth uses faulty AI to deny elderly patients medically necessary coverage, lawsuit claims - CBS News". November 20, 2023. https://www.cbsnews.com/news/unitedhealth-lawsuit-ai-deny-claims-medicare-advantage-health-insurance-denials/.
- ↑ Talia, Domenico (July 2024). "Algorithms That Can Deny Care, and a Call for AI Explainability". Computer 57 (7): 109–112. doi:10.1109/MC.2024.3387012. ISSN 0018-9162. Bibcode: 2024Compr..57g.109T.
- ↑ 9.0 9.1 "Lawsuit Filed Against UnitedHealth Group, Subsidiary for Use of AI to Deny Care". https://www.wha.org/vv-11-16-2023/1.
- ↑ "Estate of Gene B. Lokken et al. v. UnitedHealth Group, Inc. et al.". Georgetown University Law Center. https://litigationtracker.law.georgetown.edu/litigation/estate-of-gene-b-lokken-the-et-al-v-unitedhealth-group-inc-et-al/.
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