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 →
Clinical algorithm showed racial bias in health care recommendations
In 2019, a study revealed that a clinical algorithm used by many hospitals to identify patients needing extra care was racially biased. Black patients had to be significantly sicker than white patients to be recommended for the same care, due to the algorithm being trained on historical health care spending data that reflected racial disparities. The bias was eventually detected and corrected, but the incident raised concerns about the potential for AI to worsen medical racism.
5 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 →
CMS warns insurers against using AI to deny Medicare Advantage care
The Centers for Medicare & Medicaid Services (CMS) clarified that health insurers cannot use algorithms or AI to deny care to Medicare Advantage members. This follows lawsuits alleging UnitedHealth and Humana used an AI tool, nH Predict, to wrongfully deny post-acute care to elderly patients. The tool reportedly produced rigid estimates ignoring individual patient needs, leading to premature denials. CMS warned that non-compliance could result in penalties and increased audits.
- Company involved
- UnitedHealth, Humana
- AI system involved
- nH Predict
10 source articles · read the reporting →
UnitedHealthcare sued for using AI to deny Medicare Advantage patients care
A class action complaint alleges that UnitedHealthcare and its subsidiary naviHealth deployed an artificial intelligence model to override treating physicians' determinations of medically necessary care for elderly Medicare Advantage patients. The complaint claims the AI model has a known 90% error rate and wrongfully denied patients care. The lawsuit, filed in the U.S. District Court for the District of Minnesota, seeks damages on behalf of the estates of two deceased patients and all others similarly situated.
- Company involved
- UnitedHealthcare, Inc.
10 source articles · read the reporting →
Arkansas algorithm slashed home care for disabled people, causing suffering
In Arkansas and other states, algorithms were used to allocate home care hours for disabled and elderly people, replacing nurse judgments. The system assigned hours based on a scoring tool that failed to account for specific disabilities, leading to drastic cuts. Many suffered severe harm, including bed sores, missed meals, and one death. After lawsuits, Arkansas's system was thrown out in 2018, and Idaho's was declared unconstitutional.
- Company involved
- Arkansas state government
1 source article · read the reporting →
Care Health Insurance rejected heart attack patient's mediclaim over ‘pre-existing diabetes, hypertension’ - The Economic Times
Rejected a heart attack patient's mediclaim reimbursement of Rs 1,93,234
- Company involved
- Care Health Insurance
1 source article · read the reporting →
SA Health aged care AI trial generated 12,000 false alarms, missed real fall
A trial of AI-powered CCTV in two South Australian aged care facilities produced over 12,000 false alerts in a year, causing staff alert fatigue. The system, intended to detect falls and abuse, was overly sensitive and misidentified normal movements as incidents. At least one genuine resident fall went unresponded to because staff were overwhelmed. South Australia's health minister described the rollout as 'botched'.
- Company involved
- SA Health
5 source articles · read the reporting →
Beijing school uses Hanwang emotion recognition system to monitor student behaviour
Niulanshan First Secondary School in Beijing has installed Hanwang Technology's Classroom Care System, which photographs students every second and analyses their facial expressions and behaviour. The system sends weekly reports to teachers and parents, and one student was described as low participation in English class despite being recorded as focused 94% of the time. The school has been highlighted in a report by Article 19, which says such emotion recognition tools rely on junk science and risk eroding privacy and human rights.
- Company involved
- Niulanshan First Secondary School
- AI system involved
- Classroom Care System
10 source articles · read the reporting →
ChatGPT Health fails to direct 52% of medical emergencies to emergency care in study
A study published in Nature Medicine found that OpenAI's ChatGPT Health tool under-triaged 52% of true medical emergencies, directing users to non-urgent care instead of emergency departments. The AI also misclassified 35% of non-urgent cases. Researchers at Mount Sinai conducted 960 tests across 60 clinical scenarios, noting the tool's susceptibility to anchoring bias when symptoms were minimized. The study highlights potential safety concerns as millions use AI for health guidance.
- Company involved
- OpenAI
- AI system involved
- ChatGPT Health
4 source articles · read the reporting →
Man sues ChatGPT over advice that endangered his life
Un hombre denuncia a ChatGPT por un consejo que puso en peligro su vida - El Nacional.cat
A former Florida pastor has sued OpenAI and CEO Sam Altman, alleging that ChatGPT repeatedly discouraged him from seeking medical care for symptoms of a massive pulmonary embolism. The lawsuit claims the chatbot downplayed his dizziness and unstable blood pressure, told him to stay home, and used religious language to keep him reliant on its advice. Scott Winters later ended up in intensive care and says he lost his job, career, and home.
- Company involved
- OpenAI
- AI system involved
- ChatGPT
1 source article · read the reporting →
Dutch Tax Authority discriminated against dual nationality applicants for child care benefits using automated risk system.
The Dutch Data Protection Authority (AP) found that the Benefits Department of the Tax and Customs Administration (Belastingdienst) unlawfully processed the dual nationality of 1.4 million applicants for child care benefits. The data was used as an indicator in an automated risk-scoring system that flagged applications as high-risk, which was unnecessary and discriminatory. The AP concluded that the processing violated the GDPR and was discriminatory. The AP completed its fact-finding and will consider imposing a sanction.
- Company involved
- Belastingdienst
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 →
UK study finds AI cannot detect COVID-19 from cough sounds
The UK Department of Health and Social Care awarded contracts to Fujitsu to develop a "Cough In A Box" app that would use AI to detect COVID-19 from cough sounds, based on earlier claims of high accuracy. However, a study led by the Alan Turing Institute found that machine learning models could not accurately predict COVID-19 from coughs due to confounding variables. The study concluded that the technology does not work for COVID-19 diagnosis.
- Company involved
- UK Department of Health and Social Care
- AI system involved
- Cough In A Box
10 source articles · read the reporting →
Casi muere por un consejo de ChatGPT y demanda a la IA - debate.com.mx
ChatGPT-4o diagnosed Scott Winters with dysautonomia and advised him to stay in a recliner, delaying professional medical care.
- Company involved
- OpenAI
- AI system involved
- ChatGPT-4o
1 source article · read the reporting →
Facebook still allows discriminatory ads despite settlement
A Wisconsin health care agency, Tenderness Health Care, posted a job ad on Facebook targeting users under 55 with 'African American multicultural affinity.' Federal law prohibits such age and race discrimination in job ads. The Markup found the ad still appeared despite Facebook's 2019 settlement agreeing to change its practices. Facebook removed the ad after being contacted, but critics say the company's algorithm continues to deliver ads in a discriminatory manner.
- Company involved
- Facebook
- AI system involved
- Facebook Ads
10 source articles · read the reporting →
Online AI breastfeeding advice causes dangerous delays in infant care - News-Medical
Provided breastfeeding advice (feeding amounts and frequency) to new mothers.
1 source article · read the reporting →
University of Chicago report finds US healthcare algorithms rife with bias
A University of Chicago report alleges that algorithms used by hospitals, insurers and other businesses across the US are biased along racial and economic lines. The algorithms help triage patients, predict diabetes and flag those needing extra care, but the report says flawed products were introduced with little oversight. It says inequitable treatment has continued for more than a decade.
7 source articles · read the reporting →
Waymo driverless taxi blocked by men demanding passenger's number
A woman using a Waymo driverless taxi in San Francisco was trapped when two men blocked the vehicle and demanded her phone number. The autonomous car stalled, and the men persisted despite her protests. Waymo's rider support contacted her during the incident and followed up afterwards. The passenger described the experience as terrifying and warned others to be careful when riding alone.
- Company involved
- Waymo
- AI system involved
- Waymo
8 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 →
DOGE's Flawed AI Tool Threatens Veterans Affairs Services
The Department of Government Efficiency developed an AI tool to identify unnecessary VA contracts, but it used outdated models and lacked context, leading to misclassification. At least 24 contracts were canceled, affecting cancer research and nurse care tools. The VA acknowledged the tool's role but stated all contracts undergo human review. Experts criticized the use of AI for such complex decisions.
- Company involved
- Department of Veterans Affairs
- AI system involved
- Muncher
2 source articles · read the reporting →
AI transcription tools produce errors in social work records
AI transcription tools used by social workers in English and Scottish councils have been found to produce inaccurate transcripts and summaries, including false indications of suicidal ideation and 'gibberish' notes. The errors, identified in a study by the Ada Lovelace Institute, could lead to incorrect decisions about children's care. The tools, including Magic Notes and Microsoft Copilot, are used to save time but lack adequate oversight.
- Company involved
- Multiple local authorities in England and Scotland
- AI system involved
- Magic Notes,Microsoft Copilot
8 source articles · read the reporting →
Brookdale Senior Living algorithm blamed for understaffing at assisted-living facilities
Managers at Brookdale Senior Living, the largest assisted-living chain in the US, allege that an algorithm called 'Service Alignment' set staffing levels so low that facilities were dangerously short-handed. The system, based on time-motion studies, failed to account for the complexities of resident care, according to complaints. Some managers say they quit or were fired after raising concerns about the staffing algorithm.
- Company involved
- Brookdale Senior Living
- AI system involved
- Service Alignment
1 source article · read the reporting →
YouTube recommends self-harm videos to children as young as 13
The Telegraph found that YouTube was recommending graphic self-harm videos to users as young as 13, prompting criticism from UK health secretary Matt Hancock and the NSPCC. A YouTube spokesperson stated the platform has strict policies against such content and removes flagged violations. The NSPCC called on the government to impose a statutory duty of care on social media platforms to protect children.
- Company involved
- YouTube
- AI system involved
- YouTube
3 source articles · read the reporting →
