California is leading the way in ensuring that determinations of medically necessary health care services are made by licensed physicians and not artificial intelligence (AI) algorithms....more
1/31/2025
/ Artificial Intelligence ,
California ,
Class Action ,
Compliance ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Insurance Industry ,
New Legislation ,
Physicians ,
Regulatory Agenda
Now is the time for health care providers to consider participating in the recent Blue Cross Blue Shield (BCBS) antitrust class action settlement and the newly filed antitrust cases alleging widespread price fixing for...more
In a recent opinion, Smith et al. v. UnitedHealth Group Inc. et al., the US Court of Appeals for the Eighth Circuit affirmed the dismissal of an Employee Retirement Income Security Act (ERISA) class action suit brought by...more
With the surge of interest in artificial intelligence (AI), it should be no surprise that health insurers have come under scrutiny concerning their use of AI predictive tools to deny medical insurance claims.
The question...more
12/22/2023
/ Algorithms ,
Artificial Intelligence ,
Automated Decision Systems (ADS) ,
Beneficiaries ,
Breach of Duty ,
CIGNA ,
Class Action ,
Health Care Providers ,
Health Insurance ,
Insurance Claims ,
Patients ,
United Healthcare Insurance Co.