Medicare Advantage beneficiaries sue Humana over algorithm use


Medicare Advantage beneficiaries have filed a class-action lawsuit accusing Humana of illegally using an algorithm called nH Predict to stop payment for rehabilitation care for patients who have had serious illnesses and injuries. The lawsuit claims that this is part of a scheme to deny claims to sick people and reap financial benefits. This lawsuit was filed in response to a STAT investigation that found multiple Medicare Advantage insurers using this algorithm to cut off patients’ rehab care. This is the second lawsuit related to this issue, with an earlier one being filed against the algorithm’s maker and owner.

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