Bipartisan lawmakers demand AI use details from top Medicare Advantage insurers amid care denial concerns

Senators Richard Blumenthal and Josh Hawley have written to UnitedHealth, Humana, CVS and other large Medicare Advantage insurers asking for internal records that detail how artificial intelligence tools are used in prior authorization decisions that could block or delay rehabilitative services.

The request follows a recent government probe that uncovered a persistent pattern of denials within Medicare Advantage plans. Reporters have previously highlighted the insurers’ reliance on companies such as NaviHealth to scrutinize these requests, raising concerns that AI-driven algorithms may be worsening access to needed care.

Lawmakers say the information is needed to assess whether the AI systems are being applied fairly and to determine if regulatory action is required. The move adds fresh pressure on insurers to increase transparency around their use of technology in care management.