House Democrats are raising concerns with the Biden administration that Medicare Advantage plans need better oversight, citing recent STAT investigations that found insurance companies are using artificial intelligence and algorithmic software to deny care even when people still need it.
On Friday, Rep. Judy Chu of California and Rep. Jerry Nadler of New York spearheaded a letter to the Centers for Medicare and Medicaid Services asking the agency to step up its oversight of Medicare Advantage insurers. Thirty other House Democrats also signed onto the letter.
STAT previously reported Medicare Advantage insurers are using proprietary algorithms and AI to initiate payment denials, but that technology does not fully account for someone’s particular care needs. As a result, many frail patients have been kicked out of nursing homes, faced the prospect of draining their savings, or slogged through a long appeals process to get care they and their clinical teams think they need.