UnitedHealth to Disclose AI Algorithm Used to Deny Medicare Care, Court Orders Broad Discovery

UnitedHealth Group faces expanding legal pressure to explain how it used an artificial intelligence tool with an alleged 90% error rate to deny post-acute care to Medicare Advantage patients, with a federal court in Minnesota ordering the company to turn over internal documents detailing the algorithm's design and deployment. The class-action lawsuit, filed in November 2023 and now in active discovery, centers on nH Predict, an AI tool developed by NaviHealth, an Optum subsidiary of UnitedHealth. Court documents allege the algorithm overrides physician judgments about medically necessary care and was deployed with the understanding that most coverage denials would not be appealed—only about 0.2 percent of affected Medicare Advantage enrollees file appeals, according to a KFF analysis cited in the complaint.