Top Democrat questions Medicare Advantage insurers on AI claims denials

Dive Brief:

A prominent Democrat lawmaker is questioning major Medicare Advantage insurers about their use of artificial intelligence to make care decisions.

In letters sent to CVS Health , UnitedHealthcare and Humana on Thursday, Sen. Richard Blumenthal, D-Conn., pressed the payers on whether they make coverage decisions based on AI tools or predictive technology, which products are in use and whether they have implemented any guardrails to prevent the tools from influencing providers’ work.

The letter comes a year after the Senate Permanent Subcommittee on Investigations, where Blumenthal is ranking member, released a report criticizing the insurers for using predictive technology to deny claims for post-acute care.

Dive Insight:

Insurers’ growing use of AI in coverage