Humana sued for using AI to deny seniors rehabilitation care
Health insurer Humana is accused in a class-action lawsuit of using an AI algorithm to systematically deny rehabilitation care to Medicare Advantage patients, despite recommendations from their doctors. The lawsuit, filed on December 12, 2023, alleges that the AI tool restricted medically necessary care. This is the second major health insurer to face legal action over its use of AI to deny care.
- Company involved
- Humana
9 source articles · read the reporting →
Judge rules lawsuit over UnitedHealth’s AI care denials can move forward - STAT
The system denied necessary medical care to Medicare Advantage beneficiaries.
- Company involved
- UnitedHealth Group
1 source article · read the reporting →
California EDD's automated fraud detection wrongly suspended 600,000 legitimate unemployment claims
In January 2021, the California Employment Development Department used Thompson Reuters automated batch review software to flag 1.1 million unemployment claims as potentially fraudulent. EDD stopped payments on those claims without prior notice. Later, over 600,000 were confirmed as legitimate after claimants used ID.me to verify their identity. The incident highlights the trade-off between fraud prevention and timely benefit access.
- Company involved
- California Employment Development Department (EDD)
- AI system involved
- Thompson Reuters Automated Batch Review
7 source articles · read the reporting →
Apple Watch algorithm changes raise research data concerns
Harvard biostatistician JP Onnela found that heart rate variability data exported from an Apple Watch at two different times showed inconsistencies for the same time period, suggesting Apple's algorithms change without warning. The discovery led Onnela's team to abandon plans to use Apple Watches in research studies. Apple said changes to its algorithms only apply to data going forward and did not explain the discrepancy.
- Company involved
- Apple
- AI system involved
- Apple Watch
6 source articles · read the reporting →
EvenUp AI errors in personal injury demand letters lead to scrutiny
EvenUp, a legal tech startup valued at $1 billion, uses AI to draft personal injury demand letters. Former employees revealed that the AI system frequently makes errors, including missing injuries and fabricating medical conditions. The company defends its hybrid approach with human oversight, but critics allege overpromised AI capabilities.
- Company involved
- EvenUp
6 source articles · read the reporting →
Black man alleges racial bias in kidney transplant algorithm
An African American man has filed a lawsuit in federal court alleging that the algorithm used to determine kidney transplant priority is racially biased. The plaintiff, a Los Angeles barber, claims the algorithm puts Black patients lower on the waitlist, denying them timely access to organs. He seeks damages and a higher position on the list.
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UNOS liver allocation policy reduces transplants in poorer states
The United Network for Organ Sharing (UNOS) implemented a new liver allocation policy in 2020 called the acuity circles system, which prioritizes the sickest patients regardless of location. An analysis by The Markup and The Washington Post found that the policy led to sharp declines in liver transplants in several Southern and Midwestern states and Puerto Rico, while increasing transplants in New York and California. Patients in affected states allege the system disadvantages poorer regions, and hospitals have sued to overturn the policy.
- Company involved
- United Network for Organ Sharing (UNOS)
- AI system involved
- Acuity circles liver allocation policy
10 source articles · read the reporting →
NHS plans AI to listen to appointments and generate notes
The UK's National Health Service announced plans to use AI to automatically generate notes from patient appointments. Health Secretary Victoria Atkins said the scheme would reduce admin time. Privacy campaigners raised concerns about data security and accuracy, citing an incident where AI misheard the chief medical officer's name. The Department of Health and Social Care stated that patient confidentiality remains a top priority.
- Company involved
- National Health Service (NHS)
3 source articles · read the reporting →
Swedish welfare agency's AI system flags marginalized groups for fraud investigations
Försäkringskassan, Sweden's Social Insurance Agency, uses an AI risk-scoring system to flag welfare applicants for fraud investigations. The system disproportionately targets women, individuals with foreign backgrounds, low-income earners, and those without university degrees, according to an investigation by Lighthouse Reports and Svenska Dagbladet. Amnesty International has called for the system to be discontinued, citing violations of the right to equality and non-discrimination.
- Company involved
- Försäkringskassan (Swedish Social Insurance Agency)
6 source articles · read the reporting →
Betfair algorithm failed to flag gambling addict before his suicide
Luke Ashton, a 40-year-old gambling addict from Leicester, died by suicide in April 2021 after building up huge debts betting online. An inquest found that Betfair's algorithm assessed him as low risk and did not intervene despite intensive betting activity. The coroner criticised Betfair for missed opportunities and said the company should have done more. Betfair denied wrongdoing but has since introduced additional safeguards.
- Company involved
- Betfair
10 source articles · read the reporting →
DWP algorithm mistakenly flags 200,000 Housing Benefit claimants for fraud review
The UK Department for Work and Pensions (DWP) uses an algorithm to flag Housing Benefit claimants for possible fraud or error. According to a Big Brother Watch investigation, the algorithm has mistakenly flagged 200,000 innocent people, subjecting them to intrusive reviews. Only one in three flagged cases actually had errors, compared to two in three during the pilot. The DWP has spent £4.4 million on these pointless checks.
- Company involved
- Department for Work and Pensions (DWP)
6 source articles · read the reporting →
Virginia courts' use of algorithms raises fairness concerns
The Washington Post considers the use of risk-assessment algorithms in Virginia's courts, which were introduced to make judicial decisions fairer. The analysis finds that the outcomes have been far more complicated than expected, raising concerns about the system's fairness. The algorithms affect potentially many criminal defendants across the state.
- Company involved
- Virginia court system
7 source articles · read the reporting →
Audit of RisCanvi finds biases and reliability issues in criminal justice system
Eticas conducted an adversarial audit of RisCanvi, an AI risk assessment tool used in Catalonia's criminal justice system. The audit uncovered biases in risk classifications against specific demographics and significant reliability issues. The findings call for fairer practices in criminal justice AI.
- Company involved
- Catalonia's criminal justice system
- AI system involved
- RisCanvi
4 source articles · read the reporting →
Tennessee's TennCare Connect algorithm illegally denied thousands Medicaid benefits
A U.S. District Court judge ruled that Tennessee's TennCare Connect system, built by Deloitte for over $400 million, illegally denied thousands of low-income residents and people with disabilities Medicaid and disability benefits due to programming and data errors. The system automatically terminated coverage without properly considering eligibility for all available programs. A class action lawsuit filed in 2020 resulted in the ruling.
- Company involved
- TennCare (Tennessee Medicaid)
- AI system involved
- TennCare Connect
10 source articles · read the reporting →
Deloitte software glitches wrongly remove Texans from Medicaid
Advocacy groups filed a complaint with the Federal Trade Commission alleging that Deloitte's eligibility software, TIERS, used by Texas Medicaid, wrongly disenrolled qualified recipients due to glitches. Nearly 1.8 million Texans lost coverage after the pandemic pause ended, with many errors attributed to procedural issues but some linked to system malfunctions. Deloitte denies the claims, while the state says it restored care for at least 90,000 people. The FTC has not yet responded to the complaint.
- Company involved
- Texas Health and Human Services Commission
- AI system involved
- TIERS
6 source articles · read the reporting →
Dutch probation service's OXREC algorithm flawed, leading to incorrect recidivism risk assessments
The Dutch Inspectorate of Justice and Security (Inspectie JenV) published a report finding that the probation service's (Reclassering) OXREC algorithm contains serious flaws, including swapped formulas and incorrect numbers, causing about a quarter of risk assessments to be wrong. The algorithm, used since 2018 for about 44,000 cases per year, also uses variables that can lead to discrimination, such as neighborhood score and income. The Inspectorate recommended immediate correction or temporary suspension. The probation service announced it would temporarily stop using OXREC.
- Company involved
- Reclassering Nederland
- AI system involved
- OXREC
4 source articles · read the reporting →
UK prison risk algorithm may embed racial bias, experts warn
The Ministry of Justice developed a digital tool to categorize prisoners, which experts and advocacy groups warn could automate and embed racism. The tool uses intelligence data that may reflect existing bias, potentially leading to disproportionate categorization of BAME prisoners. The MoJ claims no evidence of discrimination, but critics question the small trial sample and lack of transparency.
- Company involved
- Ministry of Justice
- AI system involved
- Digital prisoner categorisation tool
5 source articles · read the reporting →
Citizens Advice finds ethnicity penalty in car insurance pricing
Citizens Advice conducted exploratory research into car insurance pricing and found that people of colour may be paying £250 more per year than White people. The research suggests that areas with large communities of colour may be identified as more risky by algorithms, even when objective risk factors are controlled. Citizens Advice has called on the Financial Conduct Authority to investigate the issue.
9 source articles · read the reporting →
TransUnion AI tenant screening denied 75-year-old man apartment due to mistaken littering conviction
Chris Robinson, then 75, applied for a senior living apartment in California. The property manager used an AI screening program from TransUnion, which assigned him a low score based on a mistaken conviction for littering that belonged to a different person with the same name in Texas. Robinson lost the apartment and his application fee. A federal class-action lawsuit against TransUnion moved toward a $11.5 million settlement in 2023.
10 source articles · read the reporting →
Security Health Plan used AI to cut off nursing home care for 85-year-old woman
Frances Walter, an 85-year-old woman with a shattered shoulder, had her nursing home care payment cut off by Security Health Plan after an algorithm predicted she would recover in 16.6 days. The algorithm, nH Predict from NaviHealth, did not account for her severe pain and allergy to pain medicine. She was forced to spend her life savings and enroll in Medicaid while fighting the denial. A federal judge later ruled the denial was speculative and she was owed thousands of dollars.
- Company involved
- Security Health Plan
- AI system involved
- nH Predict
1 source article · read the reporting →
Researchers find bias in chest X-ray AI classifiers against women, Hispanic and Medicaid patients
A study by the University of Toronto, Vector Institute, and MIT found that AI classifiers trained on public chest X-ray datasets exhibited racial, gender, and socioeconomic bias. Female patients, Hispanic patients, and those with Medicaid insurance were disproportionately affected, with the classifiers often providing incorrect diagnoses for Medicaid patients. The researchers attributed the bias to imbalanced training data and called for rigorous fairness analyses before clinical deployment.
2 source articles · read the reporting →
Insurer drops California homeowner after aerial photo analysis
Cindy Picos was dropped by her home insurer after the company used aerial photos to assess her roof. The insurer refused to let her see the photos, and she believes her roof is in fine shape. The incident highlights the growing use of drones and aerial imagery by insurers to inspect properties without in-person visits.
2 source articles · read the reporting →
Facebook's automated ad system rejects adaptive fashion ads
Small adaptive fashion companies have had their advertisements repeatedly rejected by Facebook's automated advertising system, which misidentifies their products as medical devices. The system's inability to understand context leads to discrimination against people with disabilities. Facebook has acknowledged the issue and restored some ads, but the problem persists, highlighting biases in machine learning.
- Company involved
- Facebook
- AI system involved
- Facebook automated advertising review system
2 source articles · read the reporting →
Racial bias in lung test software led to underdiagnosis of Black men, study suggests
A study published in JAMA Network Open found that race-based adjustments in diagnostic software for lung function likely led to underdiagnosis of breathing problems in Black men. Researchers analyzed data from over 2,700 Black men and 5,700 white men at the University of Pennsylvania Health System and concluded that up to 40% more Black men might have been diagnosed if the algorithm were changed. The American Thoracic Society has recommended replacing race-focused adjustments, but changes may take time.
- Company involved
- University of Pennsylvania Health System
2 source articles · read the reporting →
