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from the fight to #SaveIndiePharmacy
New York Times’ The Middlemen series

How artificial intelligence controls your health insurance coverage
Over the past decade, health insurance companies have increasingly embraced the use of artificial intelligence algorithms. Unlike doctors and hospitals, which use AI to help diagnose and treat patients, health insurers use these algorithms to decide whether to pay for health care treatments and services that are recommended by a given patient’s physicians.

New AI tool counters health insurance denials decided by automated algorithms
Insurance coverage denials have risen in recent years in the US, driven in part by automated algorithms powered by AI – and some recently launched artificial intelligence tools may fight back by generating automatic appeals.
Drugmakers including Purdue Pharma paid pharmacy benefit managers not to restrict painkiller prescriptions, a New York Times investigation found.