Health systems, insurers and AI companies are facing a wave of litigation in 2026 over how artificial intelligence is used to make or influence decisions about patient care, coverage and billing.
Here are three cases testing where accountability lands when an algorithm is involved:
- Mayo Clinic whistleblower lawsuit: Traci Tamiko Eto, Mayo Clinic’s former director of research operations, filed a federal lawsuit July 6 in the U.S. District Court for the District of Minnesota, alleging she was demoted and later fired after repeatedly raising concerns about the Rochester, Minn.-based health system’s AI oversight. The lawsuit brings claims under the False Claims Act’s retaliation provision, the Americans with Disabilities Act and the Family and Medical Leave Act. A Mayo Clinic spokesperson told Becker’s the health system is “committed to the responsible development and deployment of AI, with privacy, security, transparency and compliance embedded throughout our processes,” adding that its research and clinical innovation “are conducted in accordance with applicable laws and regulations.”
- UnitedHealth ordered to produce documents in Medicare Advantage AI denial case: A federal magistrate judge in Minnesota ordered UnitedHealth Group to produce a wide range of documents in a lawsuit accusing the insurer of using an AI algorithm to wrongfully deny Medicare Advantage members post-acute care. The March 9 order sided largely with the plaintiffs, granting or partially granting discovery requests across six of seven categories. The case, filed in 2023 by the families of two deceased MA members, centers on UnitedHealthcare’s use of nH Predict, a tool built by Optum subsidiary naviHealth (rebranded to Home & Community Care in 2024). Plaintiffs allege the tool overrode physicians’ decisions and led to premature denials of medically necessary skilled nursing facility care. “Claims that naviHealth is used to make adverse benefit or coverage decisions are false,” an Optum spokesperson told Becker’s. “Medical necessity determinations are made by qualified physicians following CMS guidance, not AI.” The company says nH Predict is a care-support tool, not a decision-making one, and is not generative AI.
- Florida man sues OpenAI over ChatGPT’s medical guidance: A lawsuit filed July 21 in the Superior Court of California in San Francisco accuses OpenAI and CEO Sam Altman of negligence, unlicensed practice of medicine and defective product design, alleging ChatGPT’s health guidance delayed care for a Florida man’s pulmonary embolism. Scott Winters, 55, claims that after he described dizziness and blood pressure instability in June 2025, ChatGPT-4o advised him to stay home and limit his movement, and that when he later reported groin pain, the chatbot dismissed it as minor. Winters was hospitalized the next morning with a pulmonary embolism that physicians attributed to weeks of immobility, according to the complaint. OpenAI spokesperson Drew Pusateri told The New York Times that ChatGPT’s terms of service state it is not meant for medical diagnosis or treatment, and said newer models are better at recognizing when someone should seek professional care. The suit seeks damages and an injunction pausing ChatGPT Health pending independent safety audits.
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