35%
IsItCap Score
Truth Potential MeterVery Low Credibility
Very Low Credibility
Medicare Advantage Plans Face $100M Liability in AI Denial Rates
A Senate investigation found AI-assisted denial rates ran up to 16 times higher than human review rates at the nation's largest Medicare Advantage plans.
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AMA
How AI is leading to more prior authorization denials
AI tools have been accused of producing care denial rates 16 times higher than typical, according to a 2024 Senate committee report cited by the AMA.
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Investopedia
Denied by a Bot? Doctors Warn AI Is Blocking Your Medicare ...
A Senate subcommittee report found UnitedHealthcare, Humana, and CVS increasingly used AI for prior authorization, coinciding with denial rates rising 54% to 108%.
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CBS News
Medicare's AI push snarls patients and doctors in errors and delays
Medicare's experimental WISeR AI program for traditional Medicare is causing errors and delays, but no evidence is presented of 16x higher denial rates compared to human reviewers.
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USC Schaeffer
Medicare is Experimenting With Having AI Review Claims
Evidence suggests AI-aided prior authorization leads to higher denial rates, but the report does not confirm a specific 16x multiplier for Medicare's new AI system.
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KFF
Medicare Advantage Insurers Made Nearly 53 Million Prior Authorization Determinations in 2024
KFF data shows Medicare Advantage denial rates were 7.7% in 2024, with no mention of a 16x increase over human review rates for the specific AI system in question.
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