FDA Announces Action Plan to Pump the Brakes on Commercial Health Insurance Industry Harm-for-Profit Denial of Care Business Model
U.S. government scrambles to regulate Artificial Intelligence across healthcare industries in the name of Patient Safety and Do No Harm
(The AI Healthcare We Need by Goinvo.)
The FDA is making an effort to slow the rate of Harm-for-Profit by implementing regulatory guardrails intended to prevent AI from making medical decisions.
This proposed oversight model, announced on January 22, 2024, only addresses Medicare Advantage White Collar Crime, but it is another incremental step in educating Americans about the scope and scale of methodical Denial of Care.
Three lawsuits filed late in 2023 allege that Humana, Cigna and UnitedHealthcare—the three largest players in the fraudulent Medicare Advantage market—used Artificial Intelligence (AI) algorithms to deny key rehabilitation medical care for its paying senior citizen members. The senior citizens died after Denial of Care was executed and the loved ones of the victims sued.
This is not only a Patients’ Rights issue, but a Consumer Rights issue.
Read the proposed FDA framework here>
(The AI Healthcare Future We Need by Goinvo.)
In an article published by ProPublica in April of 2023 (full disclosure, this Editor was a source for the story) evidence was reported that a system called PxDx now denies claims at a rate of 100 rejections per 1.2 seconds. The law has not yet caught up to the coders, engineers, and software designers who are complicit in architecting the software specifically designed to deny our fellow citizens and seniors medical care.
Read on about Denial of Care and why the Commercial Health Insurance industry is driving civically engaged citizens to build another model of healthcare delivery that de-incentivizes Harm-for-Profit across the United States healthcare ecosystem.
(The AI Healthcare Future We Need by Goinvo.)
Watch the Cigna investigation segment on the PBS NewsHour here>
Watch industry whistleblower Wendell Potter here>
(Former Cigna employee Wendell Potter testifying before the U.S Congress on the Denial of Care business model used by the Commercial Health Insurance industry.)
The Bill of the Month series is a crowdsourced investigation by KFF Health News and NPR. The series sheds light on the scope and scale of White Collar Healthcare Crime and fraud by the United States Commercial Health Insurance industry and helps patients to expose bad actors and hold power to account.
Read ongoing stories about Denial of Care here>
Coming soon to THE FINE PRINT, a conversation with Bart de Witte, CEO and co-founder of HIPPO AI Foundation in Berlin to discuss transparency, ethics and Tech for Good in healthcare.
(The AI Healthcare Future We Need by Goinvo.)
*The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.