Top Democrat demands more detail from Medicare insurers about their use of AI

STAT News – Thursday, October 9, 2025
By Casey Ross

Sen. Richard Blumenthal (D-Conn.) is pressing the nation’s largest Medicare Advantage insurers to provide more detail about their use of artificial intelligence tools amid reports that these companies are rapidly increasing their reliance on the technology to help make decisions about patients’ care and coverage.

A copy of a letter sent to UnitedHealth Group, obtained by STAT, asks the company to inventory the AI products it is using for the evaluation of patient care or the payment of medical services. It also asks the company to describe any policies it’s put in place since October 2024 to prevent AI tools from “unduly influencing” the work of human clinicians. Similar letters were sent to executives at Humana and CVS Health, which owns Aetna.

The letter is a follow-up to a majority report by the Senate Permanent Subcommittee on Investigations that found payment denials for care of seriously ill patients increased significantly after UnitedHealth and other large Medicare Advantage insurers began using AI and other predictive tools to help make coverage decisions. Blumenthal is the top Democrat on the subcommittee.

“Since the release of the Subcommittee’s report, the rapid development of AI has only increased the possibility of its abuse in the healthcare sector,” Blumenthal’s letter states, adding that reports by the American Hospital Association and the American Medical Association have raised concern about increasing use of AI in care denials.

Despite the mounting concerns, the letter states, “the American people continue to be reliant on little more than insurers’ promises that they are not taking potential life-and-death decisions away from doctors and giving them to machines.”

UnitedHealth Group is the largest Medicare Advantage insurer, Humana is No. 2 and CVS Health’s Aetna is No. 3.

Ethan Slavin, a CVS spokesman, said the company received the letter and plans to respond to the committee. UnitedHealth and Humana didn’t respond to requests for comment.

In his correspondence to the insurers, Blumenthal cites a 2023 investigation by STAT that uncovered the widespread use of an algorithmic tool owned by UnitedHealth to cut off payment for patients seeking rehabilitative care to recover from serious illnesses and injuries. The reporting found the denials sometimes conflicted with the advice of the patients’ own doctors and UnitedHealth employees overseeing the use of the algorithm.

UnitedHealth’s algorithm is used by insurers nationwide to help make coverage determinations for patients with Medicare Advantage coverage. UnitedHealth and Humana are facing class action lawsuits relating to the use of the tool in decisions that allegedly harmed patients by denying them needed services.

In recent months, UnitedHealth and other major insurers have told investors they are scaling up their use of AI across their companies to help speed up decisions and save money. Many of the largest insurers are facing shrinking profit margins amid increasing use of medical services.

Late last year, UnitedHealth Group’s then-CEO, Andrew Witty, said employees at the company are using the technology to write millions of lines of software code and to vastly speed up decisions about which patients get access to costly medicines, among other uses.

“It’s completely exponential,” said Witty, adding that the company is using AI in 500 different tasks. “Every use case is delivering at least double-digit percentage rates of efficiency.” Witty has since been replaced at the helm of the company by Stephen Hemsley.

Since taking office, President Trump’s administration has announced an effort to use AI to scrutinize certain types of care to patients with traditional Medicare, and has invited UnitedHealth and other insurers to participate.

The administration’s plans run counter to recommendations made by Blumenthal’s subcommittee and other Democrats who have called for greater oversight of AI tools in processes like prior authorization, which is when insurers require doctors to seek their approval for certain services they recommend for their patients.

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