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Medicare Advantage prior auth denials jumped 56% year-over-year. CMS published the data March 31 — the first time payers were required to disclose it. The policy meant to reverse the trend (7-day standard PA response window, 72-hour expedited, mandatory reason codes) takes effect January 1, 2027.
UnitedHealth Group announced a $3 billion AI investment to automate claim processing, fraud detection, and billing code selection. Engineering teams are being built to "reinvent how billions of medical claims are processed." The announcement landed 12 days after a federal judge ordered the company to explain its existing AI system's alleged 90% error rate in denying rehabilitation claims.
A Minnesota federal judge ordered UnitedHealth to hand over all nH Predict design records, medical director compensation files, and government investigation documents by April 29. Plaintiffs allege the algorithm — which overrides physician determinations for elderly rehabilitation patients — carries a 90% error rate. Post-acute denial rate rose from 8.7% to 22.7% between 2019 and 2022. Skilled nursing denials: 9x increase over the same period.
A March 2026 Gallup survey found 33% of Americans reduced spending on food, utilities, or prescription drugs to cover healthcare costs. Healthcare topped the list of American financial concerns in the same poll. The US spends $14,775 per person per year on healthcare — $4,975 more than Switzerland, which ranks second.
The same week UnitedHealth announced a $3 billion AI expansion, a federal judge was ordering the company to explain why its existing AI system denies rehabilitation care at an alleged 90% error rate. Plaintiffs represent elderly patients whose physician-ordered care was overridden by nH Predict. Documents due April 29.