this post was submitted on 06 Dec 2024
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[–] [email protected] 19 points 2 weeks ago (4 children)

I hadn't heard that algorithmic health care decisions had been ruled illegal. If the company were doing that, couldn't they be considered a criminal enterprise?

[–] MartianSands 19 points 2 weeks ago (1 children)

Presumably they stopped doing it in those states, or it's being appealed or something.

Also possible they're just ignoring a court order, I suppose, but that seems unlikely

[–] [email protected] 4 points 2 weeks ago (1 children)

They definitely made an exception for those states. The same thing happened with the announcement of that Blue Cross branch that was going to stop paying for anesthesia after an arbitrary time limit. They made an exception for Connecticut because they passed a law making it illegal.

[–] [email protected] 4 points 2 weeks ago

Given how businesses work they probably didn't stop doing it they probably just toned it down a little bit. Like instead of "deny 50% of coverage by default" they set it to like "deny 43%".

As long as it flies under the radar right?

[–] Voroxpete 18 points 2 weeks ago (2 children)

Only ruled illegal in a couple of states. And no, doing some illegal things doesn't make you (under the law) a criminal enterprise. That's a term used for operations whose fundamental business is crime, as opposed to just employing some illegal methods in the pursuit of legal activities.

(This is not, remotely, an argument against much, much stronger penalties for companies that do illegal shit. If the fine is less than the profit then its just a cost of doing business).

[–] [email protected] 7 points 2 weeks ago

I knew it was a fantasy when I wrote it. I mean, obviously they pay more for lawyers than anything else.

Just amazing how far they can stretch the law without it snapping back on them.

[–] [email protected] 2 points 2 weeks ago

... for operations whose fundamental business is crime

Oh, so, insurance companies are "criminal enterpriseS", plural. Gotcha.

[–] [email protected] 2 points 2 weeks ago* (last edited 2 weeks ago)

You can do deeply unethical things that are legal, such as delay deny defend. If only insurance stopped there it would be a great improvement. It's more likely they cross the line of what's legal as long as there's a chance of profit, even when penalties apply.

[–] [email protected] 1 points 2 weeks ago

~~If the company were doing that,~~ couldn't they be considered a criminal enterprise?