As artificial intelligence becomes more common in healthcare, several lawsuits are testing who may be responsible when AI is involved in decisions or guidance related to patient care, insurance coverage and clinical operations. Becker’s highlighted three cases that illustrate some of the legal and compliance questions emerging around healthcare AI:
- Mayo Clinic: A former employee filed a lawsuit alleging she faced retaliation after raising concerns about the health system’s oversight of AI. Mayo has stated that its AI development and use incorporate privacy, security, transparency and compliance measures.
- UnitedHealth Group: A federal court ordered UnitedHealth to provide documents in a lawsuit involving allegations that an AI-supported tool contributed to inappropriate Medicare Advantage coverage denials. UnitedHealth and Optum have disputed the allegations, stating that medical necessity decisions are made by physicians and that the tool is intended to support care rather than make coverage decisions.
- OpenAI: A Florida man filed a lawsuit alleging that ChatGPT provided medical guidance that contributed to a delay in treatment for a pulmonary embolism. OpenAI has stated that ChatGPT is not intended to diagnose or treat medical conditions and that newer models have improved capabilities for recognizing when users should seek professional care.
Resource: 4 lawsuits testing where AI accountability lands in healthcare