The estates of two Medicare Benefit plan enrollees are suing UnitedHealth Group over using an automatic system for managing protection for expert nursing facility care, rehabilitation facility care and different types of post-acute care.
The plaintiffs say the corporate’s nH Predict system is simply too inflexible.
The plaintiffs filed the grievance within the U.S. District Court docket for the District of Minnesota and are in search of nationwide class-action standing.
Along with UnitedHealth, the listing of defendants features a UnitedHealth medical insurance subsidiary, UnitedHealthcare, and the subsidiary that runs the nH Predict system, naviHealth.
The plaintiffs have accused the defendants of breach of contract, unjust enrichment and violation of state good-faith necessities.
Representatives for UnitedHealth weren’t instantly obtainable for remark.
The sufferers: One of many sufferers concerned within the go well with, Gene Lokken, was a 91-year-old man who broke his leg in Might 2022, went to the hospital and later entered hospice care.
After overlaying three weeks of hospice care, UnitedHealth mentioned Lokken ought to be discharged.
His household appealed and misplaced. Lokken had out-of-pocket care bills starting from $12,000 to $14,000 per thirty days till July 17, when he died.
