Artificial Intelligence and Machine Learning in Healthcare: Investigation into UnitedHealthCare CEO’s Murder
By Marianne Kolbasuk McGee (HealthInfoSec) • December 5, 2024
Authorities are actively investigating the tragic murder of Brian Thompson, CEO of UnitedHealthCare, focusing on possible motives linked to the company’s controversial denial of medical coverage. Reports indicate that bullet shell casings found at the shooting site featured inscriptions of the words "delay" and "deny," igniting speculation about a connection between the crime and frustrations directed at the insurer’s practices.
The investigation has garnered attention due to UnitedHealthCare’s recent challenges surrounding its use of artificial intelligence (AI) and machine learning (ML) in claims processing. The New York Times and other outlets have reported on the implications of the words found on the shell casings, which may reflect public outrage over the company’s alleged coverage denial mechanisms. This discontent is echoed across social media platforms, where reactions from both current and former members underscore widespread anger, especially regarding the healthcare insurance sector’s practices.
In addition to scrutiny from the public, UnitedHealthCare is facing proposed federal class action lawsuits alleging that its implementation of AI and ML systems is leading to systemic claim denials. One such lawsuit, initiated in late 2023 and subsequently amended, claims that UnitedHealthCare has utilized AI as a stand-in for qualified medical professionals, resulting in wrongful denials of coverage for elderly patients under Medicare Advantage Plans. The plaintiffs assert that this reliance on AI, which they allege has a 90% error rate, undermines the determinations made by physicians regarding necessary medical care.
Critics of UnitedHealthCare’s practices argue that the use of these technologies not only enriches the company through policy premiums and federal funding but also jeopardizes patient care, forcing elderly individuals out of necessary medical support or burdening families financially for essential services. However, as of now, UnitedHealthCare has not responded to requests for commentary on these allegations or the ongoing litigation.
David N. Hoffman, a bioethics expert and attorney, articulated concerns regarding the ethical implications behind the event. He emphasized that the death of Thompson highlights a significant ethical dilemma related to AI systems and their evolution towards becoming decision-making substitutes rather than mere support tools. Hoffman pointed out that human oversight in AI applications is often compromised by time constraints and a lack of understanding of the AI’s foundational knowledge.
Hoffman illustrated his viewpoint with a current Apple commercial, where employees rely on AI software to generate critical summaries without prior review, exemplifying the risk of AI systems being misused as replacements for human judgment and insight. These concerns resonate strongly within the context of the legal challenges UnitedHealthCare faces, as they center around the themes of decision-making transparency and accountability.
Furthermore, federal regulators are beginning to examine the utilization of AI by health plans, particularly regarding its potential to unfairly deny coverage. Recently, the Department of Health and Human Services proposed new regulations aimed at establishing safeguards to prevent inequitable access to healthcare services under Medicare Advantage programs.
In addition to its ongoing challenges with AI technologies and the investigation into Thompson’s murder, UnitedHealthCare’s parent company, UnitedHealth Group, faces numerous other lawsuits, many linked to a significant cybersecurity breach involving its Change Healthcare IT services in early 2024. This incident has disrupted the broader healthcare ecosystem, compounding the organization’s challenges at a critical moment.
As the investigation into Brian Thompson’s murder unfolds, and amid growing scrutiny of AI in healthcare, these developments underscore the critical intersection of technology, accountability, and patient care ethics in today’s healthcare landscape.
