Lawsuit targets UnitedHealth's algorithm use in Medicare Advantage plans

UnitedHealth Group and its subsidiary, NaviHealth, are facing a class action lawsuit alleging that they are using an algorithm to wrongfully deny rehabilitation care to seriously ill patients in their Medicare Advantage plans. The lawsuit claims that the algorithm has a high error rate and that UnitedHealth knew about it. Internal documents revealed that the company set a goal for clinical employees to keep patients' rehab stays within 1% of the days projected by the algorithm. The lawsuit accuses UnitedHealth and NaviHealth of systematically denying claims and causing financial harm to Medicare beneficiaries. UnitedHealth denies the allegations and states that the algorithm is only used as a guide, not to make coverage determinations.