Medicare Advantage routinely denies reimbursements for necessary care, hospital execs say
31 million people are on Medicare Advantage plans, a private alternative to traditional Medicare. The plans are often cheaper and promise better benefits. However, the CEOs of rural hospital systems in six states told NBC News that Medicare Advantage routinely denies reimbursements for necessary care. NBC News’ Sam Brock reports.
Lawsuit Alleges Humana Used AI to Deny Medically Necessary Claims
The AI model projections led Humana to deny medically necessary claims, resulting in beneficiaries paying costs out of pocket or forgoing care.
https://healthpayerintelligence.com/news/lawsuit-alleges-humana-used-ai-to-deny-medically-necessary-claims#:~:text=December%2014%2C%202023%20%2D%20Humana%20is,claims%20for%20medically%20necessary%20care.
