Why the Government’s Crackdown on Medicare Advantage AI Won’t Save Your Parent’s Rehab Stay

The feds told insurance companies to stop using algorithms to kick sick people out of nursing homes. The insurance companies are doing it anyway.

On day twelve of your mother’s rehab stay after a broken hip, a nurse hands you a Notice of Non-Coverage from her Medicare Advantage plan. The letter states her benefits end in 48 hours because she has met her 'predicted recovery goals,' even though she cannot stand without assistance. The algorithm has decided she is cured, and no federal memo is going to change the insurer's mind today.

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