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 care for older and disabled Americans as profits soared, a STAT investigation has found.
UnitedHealth Group has repeatedly said its algorithm, which predicts how long patients will need to stay in rehab, is merely a guidepost for their recoveries. But inside the company, managers delivered a much different message: that the algorithm was to be followed precisely so payments could be cut off by the date it predicted.
Denied by AI: How Medicare Advantage plans to use algorithms to cut off care for Seniors in need. Internal documents show that a UnitedHealth subsidiary called NaviHealth set a target for 2023 to keep the rehab stays of patients in Medicare Advantage plans within 1% of the days projected by the algorithm. Former employees said missing the target for patients under their watch meant exposing themselves to discipline, including possible termination, regardless of whether the additional days were justified under Medicare coverage rules.
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Ethical and moral guardrails are lagging behind in the use of artificial intelligence in health care. The United States is lagging behind other countries (EU) in regulating this segment of information technology. Specifically human oversight.
The European Union (EU) has taken significant steps to regulate artificial intelligence (AI) with a focus on ethical considerations. Here are some key points regarding the EU regulations on AI ethics:
1. **AI Act** The EU's proposed AI Act aims to create a legal framework for AI technologies, ensuring they are safe and respect fundamental rights. Key aspects include:
- **Risk-based classification:** AI systems are categorized by risk levels: unacceptable, high, limited, and minimal. Unacceptable risk systems (like social scoring by governments) are banned.
- **High-risk AI systems:** These are subject to strict requirements, including risk assessments, transparency, and accountability measures.
Ethical Guidelines**
The EU has published guidelines emphasizing the following principles:
Human agency and oversight:** AI should augment human abilities and not undermine them.
- **Technical robustness and safety:** Systems should be reliable and secure.
- **Privacy and data governance:** AI should protect personal data and privacy.
- **Transparency:** AI operations should be understandable and traceable.
- **Fairness:** Avoid discrimination and ensure inclusivity.
- **Environmental and societal well-being:** Promote sustainability and societal benefits.
The proposed regulations recommend setting up national supervisory bodies to monitor AI compliance and encourage best practices.
The EU's approach to AI ethics emphasizes a balanced framework that promotes innovation while safeguarding fundamental rights and societal values. These regulations are still evolving, and ongoing discussions will shape their final form.
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