Medicare Advantage Indust Use of AI -Robots Making Life, Death Decisions. Biden Urged to Crack Down

- 'Biden Urged to Crack Down on 'Terrifying' Use of AI by Medicare Advantage Insurers,' Common Dreams, March 27, 2023. Ed.

- "Robots should not be making life-or-death decisions," said healthcare campaigner Ady Barkan.

Sen. Elizabeth Warren joined healthcare campaigner Ady Barkan and others on Monday in sounding alarm over a recent investigation showing that Medicare Advantage insurers are using unregulated artificial intelligence systems to determine when to end payments for patients' treatments, a practice that has prematurely terminated coverage for vulnerable seniors. STATreported earlier this month that while "health insurance companies have rejected medical claims for as long as they've been around," AI is "driving their denials to new heights in Medicare Advantage," a privately run program funded by the federal government.

"Behind the scenes, insurers are using unregulated predictive algorithms, under the guise of scientific rigor, to pinpoint the precise moment when they can plausibly cut off payment for an older patient's treatment," the outlet found.

"The denials that follow are setting off heated disputes between doctors and insurers, often delaying treatment of seriously ill patients who are neither aware of the algorithms, nor able to question their calculations." "Older people who spent their lives paying into Medicare, and are now facing amputation, fast-spreading cancers, and other devastating diagnoses, are left to either pay for their care themselves or get by without it," STAT continued. "If they disagree, they can file an appeal, and spend months trying to recover their costs, even if they don't recover from their illnesses."

Barkan, co-executive director of Be a Hero and an ALS patient who is acutely aware of the injustices at the heart of the US for-profit healthcare system, tweeted Monday that STAT's reporting is "outrageous and terrifying" and circulated a petition imploring the Biden administration to crack down on the Medicare Advantage industry's use of AI. "This barbaric practice must end," the petition states. "We're calling on President Biden and the [Centers for Medicare and Medicaid Services] to stop this practice immediately." Warren (D-Mass.), who blasted the huge profits of top Medicare Advantage insurers last week, echoed Barkan in a tweet of her own. "Medicare Advantage insurers make patients look as sick as possible to overcharge taxpayers billions," Warren wrote, referring to a common industry practice known as upcoding.

"At the same time, they deny seniors and people with disabilities care—with the help of AI algorithms," the senator said.

"We must crack down on these abuses. No more #DeathByAI." An analysis published last year in the Journal of Medical Internet Research found that "despite the plethora of claims for the benefits of AI in enhancing clinical outcomes, there is a paucity of robust evidence." But that hasn't stopped hugely profitable private healthcare companies from increasingly using AI tools to "help make life-altering decisions with little independent oversight," STAT determined after reviewing secret corporate documents & hundreds of pages of federal records & court filings. "Over the last decade, a new industry has formed around these plans to predict how many hours of therapy patients will need, which types of doctors they might see, & exactly when they will be able to leave a hospital or nursing home," STAT reported... - More, https://www.commondreams.org/news/biden-ai-medicare-advantage
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* Here's How An AI Tool May Flag Parents with Disabilities: AP News, March 15, 2023.

PITTSBURGH (AP) — For the 2 weeks that the Hackneys’ baby girl lay in a Pittsburgh hospital bed weak from dehydration, her parents rarely left her side, sometimes sleeping on the fold-out sofa in the room. They stayed with their daughter around the clock when she was moved to a rehab center to regain her strength. Finally, the 8-month-old stopped batting away her bottles and started putting on weight again. “She was doing well and we started to ask when can she go home,” Lauren Hackney said.

“And then from that moment on, at the time, they completely stonewalled us and never said anything.” The couple was stunned when child welfare officials showed up, told them they were negligent & took their daughter away. “They had custody papers & they took her right there and then,” Lauren Hackney recalled. “And we started crying.”...https://www.democraticunderground.com/1016347301