He falls and breaks his arm. The doctor will set a break and send you to a rehabilitation facility. Although it's expensive, your insurance should cover it, so you file a claim, only to be denied. Was it the claims examiner who denied it? Or AI?
On February 6, the U.S. government sent a memo to some Medicare insurers clarifying that they cannot use artificial intelligence to deny claims. Machine learning algorithms can be used to support patient decisions, but algorithms cannot be the sole basis for denying care.
The memo was sent by the Centers for Medicare and Medicaid Services in response to a lawsuit against health insurance companies for allegedly using AI to wrongly deny patients the care they deserve. United Healthcare and Humana are each being sued by patients for fraudulently using their AI model nHPredict, which they claim has a 90% error rate. This is a clear and present danger of the technology, as many regulators and critics focus on the far-reaching threats of AI.
CMS is also concerned that algorithms tend to “exacerbate discrimination and bias” and is responsible for ensuring these models comply with the anti-discrimination requirements of the Affordable Care Act. said that the insurance company is responsible. And it's not just the federal government. Many states, including New York and California, have issued warnings to insurance companies that: secure The proprietary algorithm is not discriminatory.
