Lawsuit Investigation: Did an Algorithm Deny Your Medicare Advantage Claim? 

Last Updated on December 21, 2023

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At A Glance

This Alert Affects:
Medicare Advantage plan policyholders whose insurer ended coverage prematurely for care that was needed following a hospital stay. This may have included care from home health agencies, skilled nursing facilities, inpatient rehab centers or long-term care hospitals.
What’s Going On?
Concerns are growing that some health insurance companies may be using predictions from a faulty, profit-driven AI tool – over doctor recommendations – to decide how long patients need rehabilitative care, often resulting in coverage being cut off too soon. Attorneys are now looking into a number of insurance providers and need to hear from policyholders, as well as family members acting on their behalf, who’ve had this happen to them. The attorneys may be able to get class action lawsuits on file.
Which Insurance Providers Are Under Investigation?
UnitedHealthcare, Humana and BlueCross BlueShield
What You Can Do
If you or a family member had to go out of pocket or end rehabilitative care early because a UnitedHealthcare (sometimes branded as AARP), Humana or BlueCross BlueShield Medicare Advantage plan would no longer cover it, fill out the form on this page to learn more.
How a Lawsuit Could Help
A successful class action could give patients some money back for premiums and out-of-pocket costs. A lawsuit could also force the health insurer to change the way it uses AI in determining coverage.

The information submitted on this page will be forwarded to Milberg Coleman Bryson Phillips Grossman, PLLC who has sponsored this investigation.

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