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1. Ars Technica (arstechnica@mastodon.social)'s status on Friday, 09-Feb-2024 08:36:45 JST Ars Technica

   AI cannot be used to deny health care coverage, feds clarify to insurers

   CMS worries AI could wrongfully deny care for those on Medicare Advantage plans.

   https://arstechnica.com/science/2024/02/ai-cannot-be-used-to-deny-health-care-coverage-feds-clarify-to-insurers/?utm_brand=arstechnica&utm_social-type=owned&utm_source=mastodon&utm_medium=social

   • Ben (benspiers@mastodon.social)'s status on Friday, 09-Feb-2024 08:40:44 JST Ben

     in reply to

     @arstechnica That’s what happens when you don’t see healthcare and corporate profits as a conflict of interests.

   • Urzl (gooba42@mastodon.social)'s status on Friday, 09-Feb-2024 09:55:50 JST Urzl

     in reply to

     @arstechnica I don't know what else an insurer would use it for? If they're going to risk an error, it's going to be one in their favor.

     They're sure as hell not going to let an AI *approve* payments.

   • The Green Knight (greenknight23@mastodon.social)'s status on Friday, 09-Feb-2024 10:13:32 JST The Green Knight

     in reply to

     @arstechnica "we used AI to determine the best choice in care, those cases that did not meet requirements were processed through our review board of 'medical professionals'. if further support is needed the board will identify next steps, if any, that can be taken"

     👆 this is what will happen, because it's how it happens right now.

   • iquanyin (iquaanyin@mastodon.social)'s status on Friday, 09-Feb-2024 13:24:45 JST iquanyin

     in reply to

     @arstechnica the should worry about the advantage plans themselves! those are a huge ripoff and will block them from getting care they would get without an advantage plan. google it of you want.

   • Alexa Sato (elextra@mastodon.social)'s status on Friday, 09-Feb-2024 18:13:41 JST Alexa Sato

     in reply to

     @arstechnica Total agree with how horrible these algorithms are and the atrocious denial rates but I hate the example they keep using for skilled nursing facility days. Like yes, patients can receive UP to 100 days of skilled nursing care in these facilities but only if it MEDICALLY NECESSARY. Most patients don't need more than 14 days honestly unless long term IV abx (take endocarditis), more complicated wound care, or progressing slower than expected with rehab.