Sens. Richard Blumenthal (D-Conn.) and Josh Hawley (R-Mo.) are calling on the nation’s largest Medicare Advantage insurers to provide internal records on their use of artificial intelligence to block rehabilitative care.
The bipartisan probe targets UnitedHealth Group, Humana and CVS Health, demanding documents related to how AI algorithms are used to deny or delay coverage for post-acute care services. The senators said insurers’ prior authorization practices “may have grown worse” despite years of scrutiny.
The investigation follows STAT News reporting that revealed how insurers rely on AI-powered tools from NaviHealth and similar vendors to scrutinize rehabilitation requests — reporting that was a finalist for the Pulitzer Prize. The senators want to know whether these algorithms are systematically under-recommending care, and whether patients are being harmed as a result.
Health insurers have repeatedly touted their use of AI to process claims faster and reduce prior authorization delays. But the bipartisan letter signals growing concern in Congress that these tools may prioritize cost savings over patient outcomes, particularly for elderly and disabled beneficiaries who rely on Medicare Advantage plans.
The request for documents covers internal studies, algorithm training data, audit results and communications with vendors. Blumenthal and Hawley have given the insurers until August to respond. The outcome could shape how AI is regulated in Medicare Advantage — a program covering more than 33 million Americans.
