Using unvalidated algorithms (including AI) when life is on the line should not be legal.
This is clearly the direct case for medical devices, but there should also be a standard when algorithms are being applied that moderate access to healthcare too - because they have effects exactly like that of doctors making medical decisions.
Agreed, I think of a standardized clerical process (even if wholly administered by humans) as an algorithm.
I’m not a lawyer but I suspect there are regulations that apply to unjustified denial of insurance healthcare services - they don’t seem to be closely enforced and moreover there is also a frustrating magical enforcement loophole when software becomes involved where even previous precedents seem to need to be reestablished just because tech doing the denial is somehow different than people following a process.
In European bank I worked at, it was worked around by having an employee "reviewing" the "recommendation" given by AI, and making the final decision. The final decision was of course 100% in line with AI "recommendation".
The AI act is less than a month old; you were likely dealing with either older or local legislation, or some attempt at corporate responsibility (possibly risk management; if you tell your financial regulators “yeah, an unverifiable magic box makes the lending decisions, unreviewed”, you will likely get in trouble, at least in the post-noughties-financial-crisis era).
The EC is usually rather sceptical of attempts to work around the rules.
GDPR Article 22 has been in force for a long time:
> The data subject shall have the right not to be subject to a decision based solely on automated processing, including profiling, which produces legal effects concerning him or her or similarly significantly affects him or her.
If an employee is pressured to deliver faster, and the employer looks the other way when chatgpt comes out - then there is little for the regulator to do. If you penalize the employee, another will just do the same.
The company is much larger and incentivized to make it look like an employee issue. Unless there are active mechanisms to prevent this, it will be the default outcome.
Well if there are high denial rates for procedures that are within the accepted body of medical practice then the claims process is standing in the way of individual healthcare.
Who validates that a procedure is accepted practice, doctors or insurance accountants.
Insurance claim processing is already so bad that it needs drastic regulation, even if there no AI. I have a feeling these companies save money by exhausting patients. How many times can you call and be on hold for an hour only for them to tell you they’re still looking into it and need 30 business days?
I don’t get why we aren’t able to regulate them further. Fines for each day a claim is open past some limit. Fines for average wait times that are too long. Jail time for executives. Etc
I remember reading an article about some company trying to sell their service to school districts, it uses "AI" to grade assignments, add comments, etc... the safeguard was that teachers have to read the AI comments before basically clicking on an "Accept" button.
This is the future (present?), students using ChatGPT to write their papers, teachers using ChatGPT to grade.
I know it's not an amazing safeguard, but providing that alternative would be a deterrent for some teachers just blindly feeding it into an AI and not reviewing the outputs critically. I don't think many teachers would do that, but they are quite overworked as well.
Any source for the chatGPT claim? Typically (in the US) when doctors disagree with an insurance denial they have to do a "peer to peer" call, and plead their case with a doctor employed by the insurance company.
I think it is a wonderful product because it can be a great accessibility tool. I use it for speech recognition, cleaning up my writing(speech mis-recognition errors) and programming.
This is clearly the direct case for medical devices, but there should also be a standard when algorithms are being applied that moderate access to healthcare too - because they have effects exactly like that of doctors making medical decisions.