Feds Have Warned Medicare Insurers That ‘AI’ Can’t Be Used To (Incompetently And Cruelly) Deny Patient Care (www.techdirt.com)
from einat2346@lemmy.today to technology@lemmy.world on 14 Feb 2024 16:28
https://lemmy.today/post/6529145

#technology

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SpaceNoodle@lemmy.world on 14 Feb 2024 17:26 next collapse

Sure, that’ll stop them.

Reverendender@sh.itjust.works on 14 Feb 2024 17:49 next collapse

I’m sure it was a stern warning.

SinningStromgald@lemmy.world on 14 Feb 2024 17:49 collapse

They will add someone who’s job it is to click okay to every decision the AI makes. Therefore the AI isn’t making a decision the human always clicking okay is.

GenderNeutralBro@lemmy.sdf.org on 14 Feb 2024 17:47 next collapse

Here’s a wild idea: make them publish the exact criteria and formulae used to determine coverage. Their decisions should be verifiable and reproducible.

This isn’t rocket science.

Reverendender@sh.itjust.works on 14 Feb 2024 17:48 next collapse

I nominate you for US Senate

4am@lemm.ee on 15 Feb 2024 00:22 collapse

They are already do. For example: bluecrossma.org/…/088 Preimplantation Genetic Tes…

Tolstoshev@lemmy.world on 14 Feb 2024 17:49 next collapse

AI will deny the care after being rubber stamped by a doctor who graduated last in his class and this is the only job he can get, being a traitor for the insurance companies.

tourist@lemmy.world on 14 Feb 2024 18:28 next collapse

well what were they using before

einat2346@lemmy.today on 14 Feb 2024 18:29 collapse

A doctor reviewing 600 medical cases a minute. www.youtube.com/watch?v=tCJcrIpgrr0

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Jubei_K_08@lemmy.world on 14 Feb 2024 18:38 next collapse

Oh, that’s some serious finger wagging, sure to make them think twice.

badcommandorfilename@lemmy.world on 14 Feb 2024 20:17 next collapse

Cruel AND unusual??

pineapplepizza@lemm.ee on 14 Feb 2024 20:22 next collapse

I am not from the US but it baffles me how someone can be cut off from health care in a supposed first world country.

pearsaltchocolatebar@discuss.online on 14 Feb 2024 21:14 collapse

Because greed.

just_change_it@lemmy.world on 14 Feb 2024 20:29 next collapse

Yeah, sure, ok. We pinky promise not to use AI to generate leads that are then printed out on paper and put in front of a doctor’s assistant’s autopen for signatures denying insurance or coverage.

There is absolutely ZERO way to practically enforce this. An AI team can act like a black box, ingesting data and outputting hard copies that cannot be traced back to them. There is no way this will not happen.

“We’ll audit the company!” -> they’ll send the data to an offshore shell company that doesn’t follow the law, then the recommendations will be sent back.

Prove that legislation can stop this, just try.

CaptainPedantic@lemmy.world on 15 Feb 2024 17:05 collapse

Who needs “AI” when the simple algorithm they already use works perfectly well?

while 1==1:
    deny_coverage = True
bartolomeo@suppo.fi on 15 Feb 2024 17:49 collapse

I hate that you are absolutely right.

Medical directors do not see any patient records or put their medical judgment to use, said former company employees familiar with the system. Instead, a computer does the work. A Cigna algorithm flags mismatches between diagnoses and what the company considers acceptable tests and procedures for those ailments. Company doctors then sign off on the denials in batches, according to interviews with former employees who spoke on condition of anonymity.

“We literally click and submit,” one former Cigna doctor said. “It takes all of 10 seconds to do 50 at a time.”