Montefiore Medical Center in the Bronx has eliminated 12 nursing positions in its utilization review department, shifting insurance-authorization work to AI-powered software as of July 12, according to the New York State Nurses Association (NYSNA).
The affected nurses worked across Montefiore’s Moses, Einstein and Weiler campuses, reviewing physician-ordered treatments to determine whether they qualify for insurance coverage — a role that combines clinical judgment with administrative review. NYSNA says the hospital is shifting much of that work to automated software from Datavant, a health-data company.
A contract already under strain
Termination notices went out May 28, according to the union, just months after a 41-day nurses’ strike that began in January 2026 produced a new three-year contract with Montefiore. NYSNA filed a class-action grievance on June 1, arguing that management was contractually required to meet with the union before AI reduced the size of the bargaining unit, and failed to do so.
“Artificial Intelligence should never replace real human caring from a Nurse,” NYSNA President Nancy Hagans said in a statement announcing the grievance. Marilyn Shuler, a 39-year Montefiore nurse among those laid off, said the union wants the hospital to “keep a Licensed Nurse on final review” and “use AI to support us instead of replacing us.”
NYSNA also raised data-privacy concerns, pointing to Datavant’s business ties with Palantir Technologies — the data-analytics firm used by US immigration authorities — and to a past Datavant data-breach settlement, arguing the shift could expose sensitive patient records.
Hospital pushes back
Montefiore senior vice president Joe Solmonese called the union’s characterization “inaccurate and misleading,” describing the new tool as a “nonclinical program” used to process paperwork rather than make clinical decisions, and denied any connection to Palantir.
The dispute adds a concrete, contested case to a broader pattern of US hospitals adopting AI software for administrative functions like utilization review and insurance authorization, as health systems look to cut costs on work that has traditionally required licensed clinical staff.