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Get AI out of my health care
You fall and break an arm. Doctors set the break and send you to rehab. It’s pricy, but insurance should take care of it, so you submit your claim – only to be denied. Was it a claims examiner who rejected it? Or AI?
On Feb. 6, the US government sent a memo to certain Medicare insurers clarifying that no, they cannot use artificial intelligence to deny claims. While machine-learning algorithms can be used to assist them in making determinations, an algorithm alone cannot be the basis for denying care.
This memo, sent by the Centers for Medicare & Medicaid Services, follows lawsuits against health insurers for allegedly using AI to erroneously deny deserved care to patients. United Healthcare and Humana have each been sued by patients claiming the companies used the AI model nH Predict nefariously — a model they claim has a 90% error rate. It’s a clear and present danger of the technology at a time when many regulators and critics are focusing on far-off threats of AI.
CMS also said it’s concerned about the propensity for algorithms to “exacerbate discrimination and bias” and said the onus is on insurers to make sure these models comply with the Affordable Care Act’s anti-discrimination requirements. And it’s not just the federal government: A number of states including New York and California have issued warnings to insurance companies to ensure their own algorithms aren’t discriminatory.
The WHO’s AI warning
Generative AI could be game-changing for the world of medicine. It could help researchers discover new drugs and better match ailing patients with correct diagnoses.
But the World Health Organization is concerned about everything that could go wrong. The global health authority is formally warning countries to monitor and evaluate large language models for medical and health-related risks.
“The very last thing that we want to see happen as part of this leap forward with technology is the propagation or amplification of inequities and biases in the social fabric of countries around the world,” said WHO official Alain Labrique. This advice was issued as part of a larger guidance on AI in healthcare, a topic on which the WHO began advising in 2021.
Artificial intelligence systems are susceptible to bias, because the inclusion or absence of data could seriously affect its outputs. For example, if a medical AI model is trained solely on health data from people in wealthy nations, it could miss or misunderstand populations in poorer nations and do harm if used improperly.
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153: A group of 153 Spanish doctors won a lawsuit against the regional government in Valencia over inadequate PPE supply during the early days of the pandemic. A judge awarded compensation ranging from 5,000 to 49,000 euros ($5,732-56,177) per plaintiff because health workers were only given one face mask a week and expected to reuse gowns.
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440: A small-town mayor in northern Niger was arrested after 200 kilograms (440 pounds) of pure cocaine were found in his vehicle. Drug seizures are on a recent upswing in West Africa, which narcos use as a transit point on the way to lucrative markets in Europe.
62: North Korea conducted on Wednesday its 62nd ballistic missile test in a decade, by firing a projectile — which Pyongyang says was hypersonic — that landed in the sea between the Korean Peninsula and Japan. During his 10 years as North Korea’s supreme leader, Kim Jong Un has blasted three times as many missiles as his dad, and six times as many as his grandfather.
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