Coverage

Class Action Lawsuit Accuses UnitedHealthcare of Wrongfully Denying Coverage Using AI Algorithm for Elderly Patients’ Post-Acute Care Claims

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MINNEAPOLIS (AP) — A recent class action lawsuit against UnitedHealthcare alleges that the health insurance provider wrongfully denied claims for post-acute care using an artificial intelligence (AI) algorithm. The plaintiffs claim that UnitedHealthcare’s use of the “nH Predict” AI algorithm led to the rejection of elderly patients’ claims for stays in skilled nursing-care facilities and in-home care. When these denials were appealed to federal administrative law judges, roughly 90% of them were overturned. This lawsuit follows a similar case earlier this year against health insurance company Cigna, where plaintiffs accused the company of automatically denying … Read more

Axis Insurance Co. Appeals Ruling in Tampa Bay Buccaneers Coverage Dispute: What’s at Stake?

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Indianapolis, Indiana – In a recent legal appeal, Axis Insurance Co. is seeking to overturn a decision made by a federal judge in Indiana, regarding an indemnity coverage dispute involving the Tampa Bay Buccaneers. The case involves a broker who sided with the football team, and now it will be up to the appellate court to review the lower court’s ruling. Details of the original case were not provided, but it is clear that Axis Insurance Co. is dissatisfied with the outcome. The insurance company is hoping that the appellate court will see things differently … Read more

New Laws in Oklahoma: Secret Shopper Program for Medical Marijuana, Biomarker Testing Coverage, and More!

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Oklahoma City, Oklahoma – As the new year begins, several new laws have come into effect in Oklahoma that could have a significant impact on various aspects of daily life. One of these laws aims to combat illegal activity within the medical marijuana industry. House Bill 3971, passed during the 2022 regular session, mandates the implementation of a secret shopper program by the Oklahoma Medical Marijuana Authority (OMMA). These undercover individuals will be tasked with purchasing predetermined amounts of products from dispensaries for random testing. To promote accountability, at least 50 licensed dispensaries will be … Read more