Wave of mRNA Vaccines Coming - In Your Food

There has been a longstanding routine vaccination of our animals (cattle, pork) against diseases. In the past these were manufactured with classic non-mRNA methods.

Are you ready for the total transformation of our food supply? There are dozens of veterinary vaccines (and human vaccines, for that matter) in production utilizing the new mRNA technology that underpinned the COVID vaccines. This new technology is entering our food supply under the cover of darkness—granted by censorship imposed during the COVID era that power brokers seem intent on keeping in place.  

What’s often not appreciated is how fundamentally different these vaccines are from previous vaccines. They rely on synthetic biology, essentially blurring the line between biology and technology. This blurring is one of the characteristics World Economic Forum founder and chairman, Klaus Schwab, relates to his dystopian concept of the Fourth Industrial Revolution, which includes gene-edited humans or ‘designer beings’.

We debated GMOs for years, why aren’t we debating the latest bioengineering tech: mRNA? Action Alert!

There are major questions about the long-term consequences of using mRNA technology given its novelty, both for food animals and for humans. Yet there isn’t even a semblance of a public debate about how to move forward or the need for transparency of supply chains including foodstuffs derived from animals treated with mRNA vaccines. This needs to change, especially as mRNA vaccines may well become a mainstay in human and veterinary medicine.

The coming use of mRNA vaccines in livestock presents a massive issue pertaining to our right to know what is in our food. The use of mRNA vaccines in humans is of course another massive public health issue that we’ve written about a number of times over the last three years, such as here and here. It was with a similar sense of humility and caution in the face of this new vaccine technology that we issued a joint call with our colleagues at the Alliance for Natural Health International to protect autoimmune patients from compulsory COVID vaccination.Are you ready for the total transformation of our food supply? There are dozens of veterinary vaccines (and human vaccines, for that matter) in production utilizing the new mRNA technology that underpinned the COVID vaccines. This new technology is entering our food supply under the cover of darkness—granted by censorship imposed during the COVID era that power brokers seem intent on keeping in place.  

The field of mRNA vaccines is exploding. Vaccines based on this novel technology are being explored for cancer treatment, the flu, HIV, hepatitis C, malaria, tuberculosis, and dozens of other diseases. They are also viewed as a boon to the livestock industry by proponents hailing it as a “revolutionary technology.” Researchers are working on mRNA vaccines against porcine reproductive and respiratory syndrome, African swine fever, avian influenza, and other food-animal diseases. Note, however, that there are currently no mRNA vaccines licensed for use in livestock…yet. Additionally, a recent Chinese study broke new ground in demonstrating that mice could be vaccinated against COVID through ingesting milk loaded with mRNA.

To be clear: there are important differences between the mRNA technology used in COVID vaccines and RNA vaccines that have been used in veterinary medicine for some time. In fact, there appears to be little awareness among the public over how much of a departure these new COVID vaccines are from traditional vaccines, this being a direct result of draconian censorship justified by authorities and cop-opted media during the COVID crisis of 2020 to 2022. mRNA vaccines deliver synthetically-produced genetic instructions via a lipid nanoparticle into cells; these instructions then force the vaccinee’s cells to produce whatever protein has been encoded in the instructions. In the case of the COVID vaccines, this is modified and patented version of the spike protein in selected variants of the circulating SARS-CoV-2 virus. It isn’t widely recognized that the spike protein produced following vaccination is different to the spike on the wild virus.

Now that we are poised at this interface of applying the latest bioengineering technology to ourselves and the animals many rely on for food, in full appreciation that we can turn our bodies and those of farm animals into drug factories, we must be humble, not arrogant. Put simply, there are no long-term safety data for any mRNA vaccines whether used on humans or animals, and emerging safety data on COVID vaccines suggests considerably more problems than were anticipated by manufacturers and health authorities at the time of the launch of the mass vaccination program some two and a half years ago.

Any person or authority that claims COVID mRNA vaccines are safe to humans – like the CDC –  is misleading the public. We also have no idea about the long-term, potential effects of eating meat from animals treated with mRNA vaccines coding for different patented proteins once they are approved—especially given the data showing that the lipid nanoparticle coding for the patented spike protein enters the bloodstream and can travel to different areas of the body.

mRNA vaccine technology represents a radical departure from conventional pharmacology that’s ruled the roost in human and veterinary medicine for the last 80 or so years. This is why consumers deserve to know if our food has been treated with these products. We spent years as a society debating the ethics of genetically modified foods, with the public overwhelmingly supporting disclosure of foods with genetic modifications. This culminated in the unfortunate passage of a sham labeling bill that allows food companies to obscure the contents of their products—though legal challenges could improve this situation. But the point is, there was a national debate about this issue.

It is a sign of the times that reasonable questions about the risks and benefits of novel mRNA vaccine platforms are dismissed so readily as anti-vaxxer “misinformation.” If the public can overwhelmingly agree that we need transparency about the contents of our food, the same logic must apply here: we deserve to know if our food has been treated with mRNA technology—whether to immunize the animal against a disease, or in a more Orwellian twist, as a means to deliver a vaccination to those who ingest the food, a possibility raised by the Chinese study referenced above.

As with the GMO labeling issue, states are leading the charge on this. Missouri, Tennessee, and Arizona have bills that require disclosure on food products that have been treated with mRNA vaccines or gene therapy products—though none of these bills appear to be moving forward.

This comes down to the basic issue of transparency, traceability and truth in labeling that allows consumers to make informed decisions about the foods they buy. Given the unknowns with the long-term health effects of the new mRNA vaccination platforms, it is critical that consumers are afforded the opportunity to choose whether they want to ingest foods treated with these vaccines or not.

Are you ready for the total transformation of our food supply? There are dozens of veterinary vaccines (and human vaccines, for that matter) in production utilizing the new mRNA technology that underpinned the COVID vaccines. This new technology is entering our food supply under the cover of darkness—granted by censorship imposed during the COVID era that power brokers seem intent on keeping in place.  

As with the GMO labeling issue, states are leading the charge on this. Missouri, Tennessee, and Arizona have bills that require disclosure on food products that have been treated with mRNA vaccines or gene therapy products—though none of these bills appear to be moving forward.

Action Alert! Write to Congress in support of transparency in labeling on meat products in the event they are treated with mRNA vaccines. Please send your message immediately.

Wave of mRNA Vaccines Coming - Alliance for Natural Health USA - Protecting Natural Health

 mRNA became a fashionable eponym in 2020 when it was necessary to develop a vaccine for COVID 19 to mitigate the world wide pandemic.

It is a novel way to manufacture a vaccine by only using the "protein spike" of the viral particle.

Prior to the pandemic vaccines were manufactured using different platforms

Vaccine Platforms:

Different types of vaccines were developed using various platforms, including:

mRNA Vaccines (e.g., Pfizer-BioNTech, Moderna): These vaccines use a small piece of the virus's genetic material (mRNA) that encodes the spike protein. This mRNA is encapsulated in lipid nanoparticles. When injected, cells in the body use the mRNA to produce the spike protein, triggering an immune response.

Viral Vector Vaccines (e.g., Oxford-AstraZeneca, Johnson & Johnson): These vaccines use a harmless virus (not the coronavirus causing COVID-19) as a vector. The viral vector is modified to carry the genetic code for the spike protein. Once injected, the vector virus delivers this genetic information to cells, leading to spike protein production and immune response.

Protein Subunit Vaccines (e.g., Novavax): These vaccines contain purified pieces of the virus, such as the spike protein. They don't contain the live virus and can't cause the disease. The immune system recognizes these proteins as foreign and mounts an immune response.

1. **Expanded Vaccine Development:** Researchers were exploring the use of mRNA technology to create vaccines for other infectious diseases beyond COVID-19. This could include diseases like influenza, Zika virus, and more.

2. **Cancer Immunotherapy:** mRNA technology held promise in the field of cancer treatment. Personalized cancer vaccines based on a patient's tumor-specific antigens were being researched, with the potential to stimulate the immune system to target and destroy cancer cells.

3. **Rare Diseases and Genetic Disorders:** mRNA technology might be used to treat rare genetic disorders by delivering functional mRNA to correct genetic mutations.

4. **Therapeutic Proteins:** mRNA could be utilized to produce therapeutic proteins within the body, offering potential treatments for various conditions such as metabolic disorders.

5. **Infectious Disease Research:** Beyond vaccines, mRNA technology might enable the development of treatments for infectious diseases by producing proteins that interfere with the pathogen's life cycle.

6. **Drug Delivery:** mRNA delivery systems could potentially be used to deliver other types of therapeutic molecules, not just protein-coding information, opening up avenues for novel drug delivery methods.

7. **Research and Development:** Ongoing research aimed to improve the stability, delivery efficiency, and safety of mRNA-based therapies.

 

US Military Confirms Myocarditis Spike After COVID Vaccine Introduction | ZeroHedge

A military student pilot has cardiac arrest while at the controls of his aircraft. The instructor took over, landing the plane.  He was given CPR and a cardiac defibrillation.  He was dead for 11 minutes.

The military recently admitted that myocarditis has spiked after the COVID vaccine was mandated. This is not new information to anyone who follows us, as we’ve shown proof of this for a year and a half now. These events shouldn’t be brushed over or swept under the rug, but the DOD’s official stance is that the vaccine is “safe and effective,” therefore don’t ask questions and just get it

Cases of myocarditis soared among U.S. service members in 2021 after the COVID-19 vaccines were rolled out, a top Pentagon official has confirmed.

There were 275 cases of myocarditis in 2021—a 151 percent spike from the annual average from 2016 to 2020, according to Gilbert Cisneros Jr., undersecretary of defense for personnel and readiness, who confirmed data revealed by a whistleblower earlier this year.

The COVID-19 vaccines can cause myocarditis, a form of heart inflammation that can lead to mortality, including sudden death. COVID-19 also can cause myocarditis.

The rate of cases per 100,000 person-years, a way to measure risk across a certain period of time. In 2021, the rate was 69.8 among those with prior infection, compared to 21.7 among members who had been vaccinated.

“This suggests that it was more likely to be [COVID-19] infection and not COVID-19 vaccination that was the cause,” Mr. Cisneros said.

The diagnosis data comes from the Defense Medical Epidemiology Database.

Military officials have struggled to provide accurate data on 2021 diagnoses.

Whistleblowers revealed in 2021 that myocarditis, as reflected in the Defense Medical Epidemiology Database (DMED), had soared to 2,868 percent higher than the average from 2016 to 2020. They downloaded the data in August 2021.

The number of 2021 myocarditis diagnoses, though, had plummeted from 1,239 to 263 when the data was downloaded later, prompting concerns of manipulation.

Chaos and Confusion and Disinformation

Military officials said they reviewed the data and found it was “faulty.” They said the data for the years 2016 to 2020 were “corrupted” during a “database maintenance process,” which resulted in the display of only 10 percent of the actual medical encounters for that time period.

Officials told Mr. Johnson in 2022 that the problem had been fixed. The fix significantly changed the records. Instead of a 2,181 percent increase in hypertension in 2021, for instance, the increase was just 1.9 percent. Female infertility, instead of increasing 472 percent, increased 13.2 percent.

The updated percentages, though, were called into question when another whistleblower looked at the database in 2023 and found they were different.

Testicular cancer, initially pegged as increasing 369 percent, was placed at 3 percent by the military. But the actual increase was 16.3 percent, the whistleblower found. Pulmonary embolism was among the other conditions that occurred more often in 2021 than the military had conveyed.

The whistleblower alerted Mr. Johnson, the top Republican on the Senate Subcommittee on Investigations, who asked military officials for answers.

Mr. Cisneros acknowledged that the data given to the senator was incomplete. He said the change stemmed from December 2021 figures not being available when the corrected data was offered. There was a data “lag by about three months,” meaning the data wasn’t available in February 2022, when officials provided Mr. Johnson with the corrected data, Mr. Cisneros said.

Pentagon officials replicated the analyses from the whistleblower and found the data “are similar” to the data the whistleblower sent to Mr. Johnson, Mr. Cisneros said.

Military officials hadn’t previously mentioned any data lag previously while communicating with Mr. Johnson or the public, and they didn’t incorporate the available data when they sent him another missive in mid-2022.

“Without the whistleblower’s disclosure, I doubt DOD would have ever acknowledged that it provided incomplete information to my office in February 2022 and again in July 2022,” Mr. Johnson said.

He said the DOD had demonstrated “a complete disregard for transparency” and urged officials to make clear whether it has investigated whether any of the medical conditions for which diagnoses spiked are associated with the vaccines.

Pentagon Tracking 14 Cases of Heart Inflammation in Troops After COVID-19 Shots

 

US Military Confirms Myocarditis Spike After COVID Vaccine Introduction | ZeroHedge

Chronic Illness

Body and Soul

We have compiled a guide to dealing with a chronic illness.

Often a chronic illness will present with minor aches, pains or a myriad of signs and symptoms which are unexplained. At sometimes it will take months or years for the illness to become defined and accurately diagnosed.

Body and Soul authored by Gary M. Levin M.D. is a book with an overall approach to understanding a chronic illness such as hypertension, diabetes, autoimmune diseases, heart disease and genetic illness.

It is vital you find a primary care physician to manages your illness(es). If required he should manage referrals to specialists for an expert treatment plan.  Some conditions such as diabetes, hypertension can be managed by a PCP, however it is also useful to obtain a second opinion for new developments in managing your illness.

The book covers a variety of approaches to mental health, spiritual awareness and holistic or alternative medicine approaches.  Many PCPs are not trained in these areas and use allopathic medicines and only FDA approved treatments.   You should inquire of your physician about alternative approaches.

FDA approved treatments are limited to peer review studies, and can be misleading and incomplete because there are many off label treatments physicians use that are beneficial.

Not all treatments such as supplements are not easily studied by a clinical trial.

It is acceptable to use search engines such as Google, WebMD, MayoClinic to obtain information about your illness.  Discuss these sources with your PCP.  A competent physician should be open to discussions with you and can offer advice on the truthfulness of your research.

COVID19 and social media created much 'false information'. This created confusion, even among experts and there is still false information posted on Twitter X,  Substack and other social media sites.  At times TwitterX sensor posts that are filtered by algorithms (which are often incorrect as they use artificial intelligence that searches for keywords such as antivax, mRNA

Chronic Illness also affects your Mental Health creating depression and mood disorders. Consulting with a Behavioral specialist will add another component to use in managing chronic illness.

Chronic illness affects the entire family, spouse and children.  At times your family becomes a caregiver.

Build a Team

Poll: Public healthcare in America? - Robert Pearl, MD

 I was surprised by the results of this survey. I never imagined that 4 in 5 readers would vote for a public healthcare system.

If the United States went in that direction, it would be the final step ending the traditional fragmented, fee-for-service payment model of healthcare provision in this country.

Implementing this type of model would address the ongoing challenge of 30 million uninsured in the United States. And it would lead to lower costs for medical care.

However, as in other nations, this shift would most likely lead to delays in care for patients and continued dissatisfaction for providers. At the same time, it might be better than the delays and dissatisfaction of today. That would depend on exactly how the program were implemented.

I was equally surprised by how much readers would be willing to pay out of pocket to jump the line in this new public-healthcare system. Most people don’t spend anywhere near $5,000 to $10,000 per year of their own money on healthcare today.

One of the  factors which frustrate patients and providers more than anything is the chaos and lack of uniformity and regulations. While Medicare regulations are consistent, the majority of private payers, and private managed care programs are not uniform.

Poll: Public healthcare in America? - Robert Pearl, MD

This Healthcare Tech Company Has Become The First To Receive FDA De Novo Authorization For An OTC COVID-19 Test

There are still an average of over 2,000 patients with COVID-19 admitted to hospitals every day in the United States. For both the flu and COVID-19, early diagnosis and treatment are critical to preventing serious illness and even death.

The healthcare technology company Cue Health Inc.  has become the first company to get De Novo authorization from the U.S. Food and Drug Administration (FDA) for an over-the-counter COVID-19 test — as well as being the first FDA De Novo authorization for any over-the-counter molecular test for a respiratory disease. The Cue COVID-19 Molecular Test is designed for both at-home and point-of-care use. 

The at-home and point-of-care COVID-19 tests deliver lab-quality results to connected mobile smart devices in about 20 minutes. The test integrates into Cue Care, the company's state-of-the-art test-to-treatment service where patients can connect with a healthcare provider through the Cue Health App to discuss their results, form a treatment plan and have prescribed medications delivered straight to their door. 

COVID-19 Diagnostics Market Remains As The Disease Becomes Endemic

Cue’s De Novo authorization comes as public health officials and epidemiologists have been continuously reporting that COVID-19 has transitioned from pandemic to endemic. Similar to the flu, COVID-19 cases will likely continue to cycle between highs and lows, but in a relatively more predictable manner. Movement into endemic status only means that testing will be even more important and needed over a much longer period of time.

Early diagnosis of a respiratory illness can potentially lead to a milder infection and a decreased likelihood of hospitalization. Maintaining vigilance in preventing infection and opting for early detection and treatment at the first sign of symptoms (especially in households with children, senior citizens, family members with disabilities, or other at-risk individuals) can be crucial, especially for COVID-19.

Cue Health’s diagnostic platform is able to help both patients and care providers stay ahead of COVID-19 over the long term, as the disease enters its endemic stage. By providing fast and accurate results, the platform could help minimize the spread of the disease and the risk of hospitalizations.

Cue’s Molecular Diagnostic Platform — A Game Changer For Testing

Cue’s test is a NAAT (Nucleic Acid Amplification Test) that amplifies and detects the virus’s RNA. Because it can amplify the genetic material, Cue’s test is much more sensitive than an antigen test. In clinical studies, the Cue COVID-19 Molecular Test matched three FDA-authorized, lab-based PCR tests with 98% accuracy. The company’s innovative technology turned the complex test into a user-friendly kit that requires no advanced training. 

Cue’s molecular test is proven to deliver accurate results even in the early days after exposure whereas antigen results are not nearly as reliable. This is important as, according to the CDC, treatment must be started within days after you first develop symptoms to be effective. Cue's molecular test, which delivers results in 20 minutes, is also much faster than a PCR test, which can take anywhere from 12 hours to five days. 

The test can be used on adults or children with or without signs or symptoms of COVID-19 and it is self-contained, meaning it doesn’t involve mixing fluids or running an involved testing procedure. Users simply insert the cartridge into their Cue Reader, collect a nasal sample with a Cue Sample Wand, and insert the Wand into the cartridge. About 20 minutes later, results are sent to the Cue Health App on the user’s phone.

With its head start in the transition from EUA to permanent market authorization for its at-home COVID-19 molecular test and a slate of additional at-home tests compatible with the same Cue Reader device, analysts have expressed optimism about the healthcare tech company’s future earnings potential.

The device is still in development, pending FDA approval for marketing.

UnitedHealth cutting back on prior authorizations

Health payers are catching up on precision medicine.   Physicians are complaining about the increasing work burden and administrative expenses associated with providing services to patients.

Starting next month, UnitedHealthcare says it will move forward with plans to drop prior authorization requirements for a range of procedures, including dozens of radiology services and genetic tests, among others.

Why it matters: UnitedHealth is among the health insurance giants who have announced plans to cut back on prior authorization as federal regulators consider tougher curbs on the practice.

Catch up quick: Prior authorization is often criticized by patients and doctors, who complain they are an administrative burden or impede necessary care. Insurers, meanwhile, say prior authorization provides important guardrails against improper health care utilization, helping to keep costs down.

UnitedHealth, the largest commercial U.S. insurer, previously said its prior authorization removals will represent roughly 20% of its overall prior authorization volume.

Cigna and Aetna also announced plans to roll back some prior authorization requirements.

The Centers for Medicare and Medicaid Services proposed a rule to limit the amount of time insurers have to review requests on services for which they require prior approval, BenefitsPro previously reported.

Congress is also eyeing a plan to streamline and add transparency to the process by which Medicare Advantage plans can deny coverage for services via prior authorization.

Zoom in: UnitedHealth says the removals will take effect Sept. 1 and Nov. 1 across the vast majority of its plans.

The company also spelled out which procedures would see prior authorization requirements removed. For instance, hundreds of codes for genetic testing — accounting for tens of thousands of prior authorization requests a year from commercial and Medicaid members — are among those that will be removed, officials said.

A code for cardiology stress test prior authorization for Medicare Advantage members will also be eliminated, reducing roughly 316,000 prior authorization requests a year.

The company next year also will roll out a "gold card" program eliminating most prior authorization requirements for doctors who have high approval rates.

Flashback: Earlier this summer, UnitedHealth walked back a controversial plan to require prior authorizations for colonoscopies and other endoscopic procedures.

UnitedHealthcare, Cigna, Aetna revamping prior authorization ahead of CMS rule

UnitedHealth cutting back on prior authorizations

FREE E-BOOK -all you (never) wanted TO HAVE TO KNOW about the C19 mRNA injections - 156 pages of text and 20 pages of citations

 

Complete Text

Free e-book by some very smart people who actually give a crap about the quality of life and avoidance of needless death of people – as opposed to the Cult, that cares only about death – and causing billions of deaths along a “pathway” of suffering, poverty and disease.

mRNA Vaccine Toxicity – Doctors for COVID Ethics (doctors4covidethics.org)

It is split into these chapters and sections: (each section is clickable in the document - not from the below - from the main document contents page).

1 Introduction

1.1 Are mRNA vaccines dangerous in principle, or is the observed harm accidental?

1.2 COVID-19 vaccines were never about your health

1.3 The misuse of emergency use authorizations, and the breakdown of regulatory safeguards

1.4 Why this book was written

2 Some elements of virology and immunology

2.1 The life cycle of a virus

2.2 Immunity to viruses

2.3 How do the highly diverse T-cell and B-cell reservoirs originate?

2.4 Immunological memory

2.5 Cross-immunity

2.6 Who really controls viral infections: antibodies, or cytotoxic T-cells?

2.7 Immunity to respiratory viruses: systemic versus mucosal

2.8 Vaccination strategies

2.9 Appendix: some evidence of fraud in Pfizer’s clinical trials .

3 Immunological mechanisms of harm by mRNA vaccines

3.1 mRNA vaccines are distributed throughout the body and prominently affect the blood

3.2 The expression of spike protein in the body is widespread and long-lasting

3.3 The mRNA vaccine LNPs fly under the radar of the immune system

3.4 Induction of autoimmune disease

3.5 Vaccine-induced immunosuppression

3.6 The fundamental mechanism of damage by mRNA vaccines is completely general

4 Pathological evidence of immunological harm due to mRNA vaccines

4.1 Key techniques used in histopathology

4.2 Sources of evidence

4.3 Vasculitis induced by mRNA vaccination

4.4 Immune attack on organ-specific cells and tissues

5 Pharmacokinetics and lipid toxicity of mRNA vaccines

5.1 Structure and function of lipid nanoparticles

5.2 Pharmacokinetics of mRNA vaccines

5.3 Lipid nanoparticle toxicity

5.4 Appendix: Evidence of substandard manufacturing Quality of COVID-19 mRNA

6 Genotoxicity of mRNA vaccines

6.1 Genotoxicity of synthetic cationic lipids

6.2 Reverse transcription of vaccine mRNA sequences into DNA

6.3 Contaminating plasmid DNA in Pfizer’s and Moderna’s mRNA vaccines

6.4 Known and plausible risks posed by DNA copies of non-self

7 Epidemiology of COVID-19 mRNA Vaccine Adverse Events Margot DesBois, B.A. and Brian S. Hooker, Ph.D.

7.1 Introduction

7.2 General Adverse Events, Serious Adverse Events, Death, Hospitalization, Life-Threatening Events

7.3 Cardiac Events

7.4 Thrombotic Events

7.5 Neurological Events

7.6 Immunological Events

7.7 Reproductive Events

7.8 Conclusion

8 AIDS & HIV: The Blueprint for the Perversion of Medical Science David Rasnick, Ph.D.

8.1 AIDS does not behave like a novel contagious disease

8.2 AIDS and drug abuse

8.3 Peter Duesberg’s scientific critique of the HIV/AIDS

8.4 HIV is not sexually transmitted

8.5 Kary Mullis’ quest for evidence that HIV causes AIDS

8.6 The crucifixion of a dissident

8.7 AIDS in Africa

8.8 Thabo Mbeki’s ill-fated attempt to get at the truth about AIDS

8.9 Some evidence to challenge the AIDS orthodoxy

9 Summary and conclusions

9.1 The key mechanism of mRNA vaccine toxicity

9.2 The immunological mechanism of harm is completely general

9.3 Could a return to good manufacturing practices abolish the toxicity of the mRNA vaccines?

9.4 If mRNA vaccines are inherently dangerous, why are they urged and even forced on us?

9.5 What can we do?

Afterword by Catherine Austin Fitts

New lawsuit accuses health insurer Cigna of denying claims in bulk

An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered left shoulder and an allergy to pain medicine. In 16.6 days, it is estimated, she would be ready to leave her nursing home.

On the 17th day, her Medicare Advantage insurer, Security Health Plan, followed the algorithm and cut off payment for her care, concluding she was ready to return to the apartment where she lived alone. Meanwhile, medical notes in June 2019 showed Walter’s pain was maxing out the scales and that she could not dress, go to the bathroom, or even push a walker without help. 

It would take more than a year for a federal judge to conclude the insurer’s decision was “at best, speculative” and that Walter was owed thousands of dollars for more than three weeks of treatment. While she fought the denial, she had to spend her life savings and enroll in Medicaid just to progress to the point of putting on her shoes, her arm still in a sling.

Health insurance companies have rejected medical claims for as long as they’ve been around. But the investigation found artificial intelligence is now driving their denials to new heights in Medicare Advantage, the taxpayer-funded alternative to traditional Medicare that covers more than 31 million people.

Behind the scenes, insurers are using unregulated predictive algorithms, under the guise of scientific rigor, to pinpoint the precise moment when they can plausibly cut off payment for an older patient’s treatment. The denials that follow are setting off heated disputes between doctors and insurers, often delaying the treatment of seriously ill patients who are neither aware of the algorithms nor able to question their calculations.

Older people who spent their lives paying into Medicare, and are now facing amputation, fast-spreading cancers, and other devastating diagnoses, are left to either pay for their care themselves or get by without it. If they disagree, they can file an appeal, and spend months trying to recover their costs, even if they don’t recover from their illnesses.

“We take patients who are going to die of their diseases within a three-month period of time, and we force them into a denial and appeals process that lasts up to 2.5 years,” Chris Comfort, chief operating officer of Calvary Hospital, a palliative and hospice facility in the Bronx, N.Y., said of Medicare Advantage. “So what happens is the appeal outlasts the beneficiary.”

In other words, "Deny until dead".  Or don't diagnose or treat patients with less than six months to live.

The algorithms sit at the beginning of the process, promising to deliver personalized care and better outcomes. But patient advocates said in many cases they do the exact opposite — spitting out recommendations that fail to adjust for a patient’s individual circumstances and conflict with basic rules on what Medicare plans must cover.

“While the firms say [the algorithm] is suggestive, it ends up being a hard-and-fast rule that the plan or the care management firms really try to follow,” said David Lipschutz, associate director of the Center for Medicare Advocacy, a nonprofit group that has reviewed such denials for more than two years in its work with Medicare patients. “There’s no deviation from it, no accounting for changes in condition, no accounting for situations in which a person could use more care.”

Medicare has its own set of guidance (rules) for benefit determination as set forth in the Code of Federal Regulations. 

As the influence of these predictive tools has spread, a recent examination by federal inspectors of denials made in 2019 found that private insurers repeatedly strayed beyond Medicare’s detailed set of rules. Instead, they were using internally developed criteria to delay or deny care. Although some insurers follow Medicare's guidelines private insurers often set their own guideline.  Since MA plans are private plans they are free to do so unless Medicare restricts it.

In interviews, doctors, medical directors, and hospital administrators described increasingly frequent Medicare Advantage payment denials for care routinely covered in traditional Medicare. UnitedHealthcare and other insurers said they offer to discuss a patient’s care with providers before a denial is made. But many providers said their attempts to get explanations are met with blank stares and refusals to share more information. The black box of AI has become a blanket excuse for denials. 

New lawsuit accuses health insurer Cigna of denying claims in bulk