Case file / AI claim denial
UnitedHealthcare
nH Predict
A class action alleges UnitedHealthcare used an AI tool, nH Predict, as a hard cap on post-acute care for Medicare Advantage patients, with roughly 90% of appealed denials overturned, cutting vulnerable seniors off from care.
Status: Active litigation (Estate of Lokken v. UnitedHealth)
The alleged harm
- /Patients allegedly cut off from medically necessary care
- /Deaths alleged in some cases where care was terminated
- /Hit Medicare Advantage members least able to navigate appeals
On the record
| Estate of Gene B. Lokken et al. v. UnitedHealth Group | D. Minnesota | 14 Nov 2023 |
| Senate PSI report on Medicare Advantage AI denials | senate.gov | 17 Oct 2024 |
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