UnitedHealthcare Used an AI With a 90% Error Rate to Deny Medicare Patients' Nursing Home Claims

A 2023 ProPublica investigation revealed that UnitedHealthcare was using an AI tool called 'nH Predict' to automatically cut off post-acute care for Medicare Advantage patients — often denying coverage for nursing home stays that doctors said were medically necessary. A federal lawsuit alleged the algorithm had an error rate of up to 90%, yet coverage was still being denied. Elderly patients who needed continued rehab after strokes and surgeries were being discharged and sent home before doctors considered them ready. A whistleblower claimed the company knew the tool was inaccurate but kept using it because it saved money.

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🦅EST. 2024 · PUBLIC RECORDDEPT. OF AI WEIRDNESS
U.S. Department of
Artificial Intelligence Weirdness
Report #84← All Incidents
TrendingUnitedHealthcareHealthcare AIMedicareAlgorithmInsurance Denial

UnitedHealthcare Used an AI With a 90% Error Rate to Deny Medicare Patients' Nursing Home Claims

Filed by @elder_care_advocateTool: nH Predict (NaviHealth AI)[original source ↗]
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A 2023 ProPublica investigation revealed that UnitedHealthcare was using an AI tool called 'nH Predict' to automatically cut off post-acute care for Medicare Advantage patients — often denying coverage for nursing home stays that doctors said were medically necessary. A federal lawsuit alleged the algorithm had an error rate of up to 90%, yet coverage was still being denied. Elderly patients who needed continued rehab after strokes and surgeries were being discharged and sent home before doctors considered them ready. A whistleblower claimed the company knew the tool was inaccurate but kept using it because it saved money.

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10/10 — Deeply unhinged
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