Latest news with #HIPAA-protected
Business Insider
19-07-2025
- Health
- Business Insider
Luigi Mangione has an issue with another health insurance company — and it's not UnitedHealthcare
Lawyers for the accused United Healthcare CEO killer, Luigi Mangione, are up in arms over what they say were "secret" communications between his New York prosecutors and Aetna, his former health insurer. They say prosecutors sent Aetna an "unlawful," back-channel subpoena seeking his confidential insurance account number and the time period for his coverage — and that in response, Aetna mistakenly sent prosecutors Mangione's entire, 120-page insurance record. This "trove of protected medical information" includes "different diagnoses as well as specific medical complaints made by Mr. Mangione," his lawyers complained in a court filing Thursday night. New York prosecutors should never have had access to these private records, his lawyers contend. And they should never have looked at them once receiving them, they also argue. Aetna emailed the records to the Manhattan District Attorney's Office on June 12, in four files, with a cover letter advising "confidential." Each file was separately labeled "in large-type bold letters 'Request for Protected Health Information," the lawyers wrote. "It would be impossible for anyone to view a single page of these records and not immediately see that they were private, confidential medical records within the scope of HIPAA," the federal Health Insurance Portability and Accountability Act, the lawyers wrote. The sheer volume of Aetna's response should have alerted prosecutors that "the unlawful subpoena they served on Aetna resulted in far more material than they requested," the lawyers wrote. But instead of immediately sending the materials to the judge and the defense — where they should have been directly sent, as required by law — the DA's office says it downloaded them into an internal "discovery file," the lawyers wrote. The lawyers say prosecutors "sat on this information" for 12 days, until June 24, when they sent the judge and defense team an email forwarding the four files. Prosecutors have told Mangione's lawyers that in the interim, they had reviewed the records, but not "in their entirety," according to the defense filing. The defense filing, signed by defense lawyers Karen Friedman Agnifilo, Marc Agnifilo, and Jacob Kaplan, asks New York Supreme Court Justice Gregory Carro to order prosecutors to turn over all of their communications with Aetna. It also asks the judge to hold "a full evidentiary hearing," with sworn testimony, to determine possible remedies, including the recusal of lead prosecutor Joel Seidemann, the suppression of evidence, and the dismissal of Mangione's indictment. The subpoena, issued directly to Aetna and signed by Seidemann, bypassed the judge and defense team and should never have requested even the limited, HIPAA-protected information of Mangione's account number and period of coverage, his lawyers argue. "If they're seeking information that is privileged, like medical records, the DA can't just subpoena that stuff directly," veteran homicide public defender Sam Roberts told Business Insider on Friday. Prosecutors must first file a motion or application to the judge and defense team, alerting them to the subpoena, and then wait for the judge to review the subpoenaed materials privately, said Roberts, a senior staff attorney on the homicide defense task force of the Legal Aid Society. "It sounds like they jumped the gun here," Roberts said. "They got this information without first giving notice to the defense, and they got the information directly from Aetna when they should have sent it to the court first without opening it." Mangione's lawyers allege in their filing that the May 14 subpoena initially commanded Aetna to send someone to appear in court on May 23 with "the account number and period of time during which the following individual received coverage: Luigi Mangione." The subpoena was not made public or viewed by BI. May 23 was "a completely made-up date," on which no court proceeding was scheduled, Mangione's lawyers wrote. Along with the subpoena, Seidemann sent a cover letter with his phone number and email, advising that "in lieu of appearing personally with the requested documents," Aetna could mail or deliver the records to the court, the lawyers wrote. Prosecutors "were plainly lying to get the materials as soon as possible," they wrote, in order to bring their case to trial first, before he could be tried by federal prosecutors. In addition to the state-level case, which alleges murder as an act of terrorism, Mangione is facing related, death-penalty-eligible murder charges in federal court. Prosecutors in central Pennsylvania say they, too, will try him for forgery and firearm charges related to his arrest there on December 9, after a five-day national manhunt. Mangione's lawyers previously complained that in April, Manhattan prosecutors improperly listened to an 11-minute attorney-client phone call, something the DA's office has denied. Both state and federal jurisdictions are vying to be first to put Mangione on trial. Had Mangione's lawyers not been bypassed, they would have objected to the Aetna subpoena, including on the grounds that "the information sought is not relevant," they wrote. A spokesperson for the DA's office told BI on Friday that they will respond to the defense allegations in court papers. "Aetna received a subpoena for certain medical records, and we provided them appropriately," said Phil Blando, executive director for communications for Aetna's parent company, CVS Health. Asked if the district attorney subpoena requested details beyond Mangione's account number and coverage period, Blando told BI in an email, "You have our statement." Mangione, a 27-year-old software developer, remains in a federal jail in Brooklyn in the December 4 murder of Thompson. The 50-year-old father of two from Minnesota was shot in the back at close range outside a Midtown hotel where he was about to address the UnitedHealthcare shareholders meeting. Mangione is linked to the killing by his so-called "manifesto" and by DNA, ballistics, video, and fingerprint evidence, according to state and federal prosecutors. He is next due in state court on September 16, and in federal court on December 5; both courts are in Manhattan.
Forbes
10-04-2025
- Business
- Forbes
Synergy In Innovation: Exploring The Collaborative Potential Of AI And Human Creativity
Kamya Elawadhi is Chief Client Officer at Doceree. The dawn of artificial intelligence (AI) has had a major impact on the healthcare industry. Apart from improving both diagnosis and delivery of healthcare, AI has also affected functions such as patient and healthcare professional (HCP) outreach—30% of outbound marketing messages will be synthetically generated by 2025. Taking advantage of this opportunity, modern-day marketers are using innovative solutions backed by advanced AI algorithms to improve their interactions with HCPs—and, ultimately, the overall effectiveness of their marketing strategies. To drive meaningful change, marketing experts are realizing the importance of backing AI with human intelligence. This is especially true for point of care (POC) marketing, which is undergoing a transformation thanks to the utilization of AI-based solutions married to human expertise. In the months ahead, the convergence of the two is expected to significantly impact how marketers deliver hyper-contextualized and relevant messaging to HCPs at critical junctures of the healthcare delivery cycle, thus enhancing patient outcomes and driving more personalized, impactful strategies. At its core, POC marketing in healthcare involves sharing targeted, relevant messaging with HCPs and sometimes patients at precise moments of the healthcare delivery cycle. Traditionally, POC marketing relied heavily on sharing marketing information through physical means such as brochures and posters. While somewhat effective, this one-size-fits-all approach falls short of addressing the nuanced needs of individual patients and healthcare providers. In today's digital-first world, where HCPs spend the majority of their clinical hours switching between electronic health records (EHRs), telemedicine and eRx platforms, the delivery of marketing messaging is best received when the HCP is found within the HIPAA-protected walled garden of trusted digital touchpoints. The goal for the marketer here is to provide relevant and actionable information in a timely manner that supports decision-making, fosters trust between stakeholders and helps the healthcare system provide value-based care to patients. This is where AI—combined with human ingenuity—comes into play, offering unprecedented potential for personalization and engagement. One of the biggest advantages of AI and machine learning (ML) models is their ability to process vast amounts of data—in this case, of patients and HCPs involved—in an ethical manner. They can extract insights from EHRs and other connected platforms, as well as devices, to uncover patient needs and preferences. Fed with the correct instructions, these tools can identify patterns that may otherwise be too time-consuming for humans. AI tools can also share hyper-personalized messaging at scale using natural language processing (NLP) models, all in real time. A study suggested a 50% increase in engagement when marketers adopt AI-powered personalization strategies. Using an advanced AI-backed solution, marketers can also push identity-agnostic, condition-based triggers to improve their messaging outcomes. For example, trigger-based AI solutions can reach an HCP at critical moments of patient care and healthcare delivery with information about a drug that a patient may need. Apart from this, AI can also offer access to predictive analytics by forecasting health trends and patient behaviors, allowing marketers to anticipate the needs of patients and HCPs and serve them better in a timely manner. This not only enhances patient outcomes but also maximizes the efficiency of marketing efforts. AI's ability to stick to its core programming and follow set rules can also ensure marketing materials adhere to regulatory standards and ethical guidelines. Automated systems can scan content for compliance with HIPAA and other regulations, reducing the risk of costly errors. While AI offers impressive capabilities, the human element remains indispensable in POC marketing. For example, in the case of marketing messaging, it must resonate on a deeper level with HCPs and patients. This is where a human marketer's ability to bring empathy and cultural sensitivity to the table cannot be underestimated. Similarly, while AI can generate data-driven insights, human ingenuity can help craft creative strategies that align with brand identity and patient expectations. Human intelligence will remain essential in overseeing AI-generated strategies and content to ensure accuracy, relevance and ethical alignment. By applying behavioral sciences and determining when to use smarter, more subtle marketing tactics that nudge rather than sludge, humans will continue to enhance AI-driven marketing efforts. Additionally, humans will be vital in identifying biases in AI algorithms and correcting any deficiencies. In an industry where not only money but millions of lives are at stake each day, the human touch will be indispensable. Suffice it to say, AI-human collaboration in POC marketing will enable marketers to craft strategies that offer better results for their pharma and healthcare partners. Instead of sludging, nudging HCPs with real-time, hyper-personalized and contextualized messages will remain the core objectives of marketing strategies. Marketers are also likely to adopt newer ways of reaching their goals. As such, augmented reality (AR) experiences are likely to become part of the POC ecosystem, along with solutions that enable humans and AI to collaborate in delivering marketing messages through AR. AI and human collaboration should also strengthen feedback loop systems. Both HCP and patient feedback will likely be captured and analyzed in real time, allowing marketers to quickly adjust their strategies. By combining the analytical power of AI with the creativity and intelligence of human marketers, POC marketing will become more personalized, efficient and impactful. This collaborative effort will enhance patient engagement and drive meaningful improvements in healthcare delivery. Data privacy and algorithmic biases will remain challenges, but with human ingenuity and intelligence at their side, AI-based solutions will be able to help work toward a more patient-centric approach to marketing. 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