UnitedHealth sued over use of algorithm in Medicare Advantage plans
UnitedHealth sued over use of algorithm in Medicare Advantage plans
A class action lawsuit was filed against UnitedHealth and a subsidiary alleging they use an algorithm to deny care to seriously ill patients
cross-posted from c/Medicine: https://lemmy.ca/post/9440628
Discussion on r/Medicine: https://www.reddit.com/r/medicine/comments/17vynjh
I liked this comment in particular:
For years I’ve had a smartphrase in epic for every test, medication or procedure I ordered that is denied by insurance. Basically stating that the medical director responsible for the denial will be medically and legally liable for any complications that may arise from the lack of such service. I thought it didn’t do shit, just something petty I thought of after a patient of mine lost his transplanted liver because the insurance would persistently deny his immune suppressant meds. It turns out the medical director for a recent insurance denial sent me a letter stating my statements were “inflammatory and inappropriate”. That put me in a good mood.
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I live this every day. I’ve had a United Medical Director tell me that being able to feed yourself was “not an essential skill” worthy of rehab because it could be performed by staff or a family member.
This man tried to tell me that my patient in their late 60s was unworthy of a rehab stint for strengthening their upper arms to be able to feed themselves because someone else could do it for them for the rest of their lives.
Stay the hell away from Medicare Advantage plans. No matter what they promise, it’s irrelevant because they won’t actually provide it when the time comes.