STAT+: Humana used algorithm in ‘fraudulent scheme’ to deny care to Medicare Advantage patients, lawsuit alleges
STAT
DECEMBER 12, 2023
Medicare Advantage beneficiaries on Tuesday filed a class-action lawsuit alleging that the health insurance giant Humana illegally used an algorithm to prematurely cut off payment for rehabilitation care after patients suffered serious illnesses and injuries. The suit, filed in U.S. District Court in Western Kentucky, argues Humana’s reliance on the algorithm, known as nH Predict, was part of a fraudulent scheme to reap a windfall by systematically denying claims to desperately ill people
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