Senators Demand MA Insurer Records on AI Care Denials
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- Sens. Richard Blumenthal (D-Conn.) and Josh Hawley (R-Mo.) are calling on the nation's largest Medicare Advantage insurers to turn over internal records and detailed information on their use of artificial intelligence to block rehabilitative care.
- UnitedHealth Group, Humana, and CVS Health received letters from the senators specifically requesting details on how AI is used in their denial decisions.
- The Office of Inspector General for HHS recently unearthed a continuing pattern of denials within Medicare Advantage — findings the senators told the insurers directly undercut the companies' claims to have reduced barriers to crucial medical services.
- The lawmakers' request comes one month after that government investigation and marks a rare moment of bipartisan scrutiny on Medicare Advantage, a program that has drawn criticism for restricting patient access to care.
- The AI-driven denial practices at issue focus specifically on rehabilitative care — services that doctors order for patients recovering from illness, injury, or surgery.
Why it matters: Three of the largest MA insurers now face congressional demands for internal AI records — a rare bipartisan move that, paired with fresh OIG evidence of ongoing denials, directly contradicts the companies' public assurances that they have reduced barriers to care. For the millions enrolled in Medicare Advantage and the providers treating them, the letters escalate the prospect of formal oversight on algorithmic denials of rehabilitative services.
