STAT+: Medicare Advantage insurers face new bipartisan scrutiny over AI and care denials
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- Sens. Richard Blumenthal (D-Conn.) and Josh Hawley (R-Mo.) sent letters to the nation's largest Medicare Advantage insurers demanding internal records on their use of artificial intelligence to block rehabilitative care.
- The letters, addressed to executives at UnitedHealth Group, Humana, and CVS Health, cite findings from the HHS Office of the Inspector General that the lawmakers say undercut the insurers' claims of having reduced barriers to medical services.
- The request comes one month after a government investigation uncovered a continuing pattern of denials within the Medicare Advantage program, according to the source.
- The bipartisan nature of the inquiry represents an unusual cross-party alignment on oversight of a controversial federal health care program — Medicare Advantage enrolls tens of millions of beneficiaries but has long faced criticism over prior authorization practices.
Why it matters: Three of the largest Medicare Advantage insurers — UnitedHealth, Humana, and CVS — now face a bipartisan congressional demand for documents on AI-driven care denials, just weeks after a federal investigation found denials remain a persistent problem. If the records reveal systematic AI-driven denial patterns, lawmakers from both parties would have ammunition to push legislative or regulatory curbs on algorithmic prior authorization in a program serving a massive share of seniors.
