Sens. Richard Blumenthal (D-Conn.) and Josh Hawley (R-Mo.) are demanding that the nation’s largest Medicare Advantage insurers turn over internal records detailing their use of artificial intelligence to deny or delay rehabilitative care.
In letters sent to UnitedHealth Group, Humana, and CVS Health, the senators cited a June 2026 report by the HHS Office of the Inspector General that found a continuing pattern of inappropriate denials in the Medicare Advantage program. The lawmakers said the findings undercut the insurers’ claims to have reduced barriers to care and suggested practices “may have grown worse.”
The inquiry targets prior authorization algorithms — systems that insurers use to automatically approve or deny coverage for post-acute care such as skilled nursing and rehabilitation. Similar AI-driven denial systems have faced class-action lawsuits, including a pending case against UnitedHealth’s nH Predict algorithm.
“It was stunning,” the senators wrote, describing the OIG findings that more than 95% of appealed denials in post-acute care are overturned upon review, suggesting the algorithms systematically deny valid claims. The letters request documents on how each company develops, validates, and audits its AI decision tools.
