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The lawsuit alleges UnitedHealth used nH Predict to deny claims despite the algorithm’s determinations being overturned in more than 90% of appeals.
UnitedHealth executives pressured clinical staff to follow an algorithm to cut off patients’ rehab care, leading to coverage decisions that may violate Medicare regulations.
An investigation of UnitedHealth Group's NaviHealth reveals its algorithm is a focal point for determining Medicare Advantage coverage.
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