According to a shocking new investigation, for-profit insurance companies are using artificial intelligence algorithms to shut off life or death care for seniors and people with disabilities on Medicare. This is happening through privatized plans known as Medicare Advantage (which really should be called “Medicare DISadvantage.”) In Medicare Advantage, for-profit insurance companies use hefty taxpayer subsidies to offer enrollees cheaper Medicare premiums, but then often fail to provide patients with adequate care when they need it and limit patients to small provider networks. Recent investigations have found that the largest insurers in Medicare Advantage have committed widespread fraud and denied patients critical care they were supposed to provide by law.
Now, an astonishing new investigative report from Stat News has found that these for-profit insurers operating in Medicare Advantage are using artificial intelligence algorithms to make life or death decisions about when to stop covering care—without ever consulting with patients’ doctors.
“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 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. 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.”
This barbaric practice must end. We’re calling on President Biden and the Center for Medicare/Medicaid services to stop this practice immediately, enforce these rules by holding insurers accountable, and take steps to protect any patients who have been harmed or wrongfully denied care.