CMS’ BALANCE Model Aims To Resolve Medicare Coverage Of Weight-Loss Drugs

CMS has launched the BALANCE Model, a five-year test to lower costs & expand Medicare access to GLP-1 weight-loss drugs while ...
The Boston Globe

UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care

The nation’s largest health insurance company pressured its medical staff to cut off payments for seriously ill patients in lockstep with a computer algorithm’s calculations, denying rehabilitation ...
STAT

Humana used algorithm in ‘fraudulent scheme’ to deny care to Medicare Advantage patients, lawsuit alleges

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 ...
Seeking Alpha

UnitedHealth sued over algorithm-based care denials for Medicare members

A class action lawsuit has been filed in Minnesota against UnitedHealth Group (NYSE:UNH) over allegations that the health insurer and its subsidiary, NaviHealth, used a faulty algorithm to deny ...