JOHN YANG: Tonight on "PBS News Weekend," we look at what's ahead, legally and politically for former President Trump as he makes historic appearance in a Manhattan courtroom.

Then, how one major health insurance company is using artificial intelligence to deny patient claims.

WOMAN: It's hard to find the time and wherewithal to be able to figure out how to appeal these claims.

And the reality is that very few people do.

JOHN YANG: President Biden's complicated relationship with the oil and gas industry and in environmentalists.

(BREAK) JOHN YANG: Good evening.

I'm John Yang.

President Biden declared a major disaster in Arkansas this morning and pledged federal resources to help recovery efforts there after severe storms and tornadoes struck across the South, Midwest and even the East Coast this past week.

Today, cleanup is already underway as families picked through the rubble created by confirmed or suspected tornadoes in at least 10 states.

The storms leveled homes and businesses, tore roofs off churches and toppled trees.

So far, 26 people have died.

In Russia, an explosion at a cafe in St. Petersburg has killed a prominent pro war military blogger.

More than a dozen others were injured.

Russian media reports that there have been no claims of responsibility.

Meanwhile, Secretary of State Antony Blinken spoke with Russia's foreign minister today, calling for the immediate release of a Wall Street Journal reporter who was detained in Russia last week, as well as another imprisoned American, Paul Whelan.

Saudi Arabia and other OPEC oil producers say they'll voluntarily cut oil production from May until the end of 2023.

The Saudi Energy Ministry called it a precautionary step aimed at stabilizing the oil market.

But it's a move that could raise prices at the pump, further straining U.S.-Saudi relations as the world continues to cope with inflation.

Former Arkansas Governor Asa Hutchinson says he's running for president.

Today, the longtime Republican offered himself as an alternative to Donald Trump and urged the former president to pull out of the race and focus on his legal troubles.

ASA HUTCHINSON, Former Governor of Arkansas: The office is more important than any individual person, and so for the sake of the office of the presidency, I do think that's too much of a sideshow and distraction.

JOHN YANG: Hutchison says he'll formally announce his run later this month that would make him the fourth candidate in the Republican race.

The Taliban closed Afghanistan's only radio station run by women.

They allege it broke the law by playing music during the holy month of Ramadan.

The head of the station denies it and called the closing of the station a conspiracy.

The Taliban have barred women from most forms of employment and from education beyond the 6th grade.

Many Afghan journalists lost their jobs after the Taliban took over in August 2021.

Still to come on "PBS News Weekend," how artificial intelligence is being used to deny health insurance claims and the Biden administration's complex relationship with fossil fuels.

(BREAK) JOHN YANG: America enters uncharted waters this week as Donald Trump is to appear in a New York court to face the first criminal charges ever brought against a former president.

Reports indicate the sealed indictment charges him with more than 30 counts stemming from hush money payments allegedly made to women during the 2016 presidential campaign.

At the same time, recent polling shows him leading the 2024 Republican presidential field.

Those are the topics of today's weekend briefing with Chuck Rosenberg, a former U.S. attorney and senior FBI official, and Sarah Longwell, a Republican strategist and the founder of the Republican Accountability Pact.

Chuck, I'd like to start with you.

This hearing that he's going to go to on Tuesday, it's a routine procedure called an arraignment.

Now, the former president was referring to it as being arrested.

What's going to happen on Tuesday?

CHUCK ROSENBERG, Former U.S. Attorney: Yes, in the routine case, John, it's a routine proceeding.

The defendant appears, enters a plea of not guilty.

The indictment is unsealed, and he's given a copy.

And then the judge does some logistics.

He or she sets the dates for motions and possibly even for trial.

Again, in a routine case, it's a very brief and rather uninteresting proceeding.

JOHN YANG: But obviously, this is not a routine case.

What is a trial going to look like?

Or what would you imagine a trial would look like with the defendant as a former President of the United States?

CHUCK ROSENBERG: Well, I hope in a sense, it looks like any other trial for any other person, that a fair jury is selected and paneled, that the judge presides in a dignified and thoughtful way, and that both sides present whatever arguments and evidence they choose to present.

It's really important that whatever judge presides over this treats it like any other case, even if we think about it as very different than any other case.

JOHN YANG: Sarah, we mentioned in the introduction about some polling.

There was a Yahoo news YouGov poll that went in the field after the news of the indictment came out.

It showed Trump widening his lead head to head against DeSantis, and then well ahead when he was put up against a larger field of other candidates.

And again, this was after the news of the indictment came out.

What do you make of that?

SARAH LONGWELL, Republican Strategist: Yes, this is what you'd call a rally round trump effect.

You've seen basically every elected Republican official come out in defense of Trump.

You've seen all the conservative news sites make bociferous defenses of Trump.

Even his 2024 likely opposing candidates have been out defending him.

And so you're going to see a temporary bump for Trump.

The question is it a short term effect, which it certainly is.

But how short is short term?

It the length of a GOP primary, or is it a week?

And I think a lot of that is going to depend, really, on two factors.

One is the quality of Donald Trump's opposition.

You know, somebody like Ron DeSantis figure out how to use this, actually, as a political opening to go after Trump, because unless that happens and it's also a question of how many other indictments are there?

You know, if there's more indictments, and you continue to just see all of the focus and all of the oxygen being absorbed by Trump, it creates this dynamic where all of the other 2024 contenders actually end up being supporting cast members in Donald Trump's drama.

There's no other room for them to make an affirmative case for why they should be the 2024 nominee.

That would really be how Donald Trump would win this nomination again.

JOHN YANG: Sarah, I know you had a focus group on Friday with people who voted for Donald Trump both in 2016 and in 2020.

What did you hear?

SARAH LONGWELL: Yes, I mean, look, people were very upset, very angry on Trump's behalf.

And they were saying things like they were more excited to give him money.

If there was going to be a T-shirt with his mug shot on it, they were likely to buy it.

But most importantly, what they said was that every single one of them wanted to support him for the 2024 nomination.

And I haven't had a group of two time Trump voters where everybody has wanted to support Donald Trump in months and months.

There's really been this big opening lately, especially since the 2022 midterms, where a lot of these voters are very interested in somebody like Ron DeSantis.

And you'd usually get a big chunk of the group interested in moving on from Trump, believing he had too much baggage, looking for somebody electable.

This group was 100 percent all in on Trump.

JOHN YANG: Chuck, Sarah mentioned the other investigations, federal investigations, his handling of classified documents, his role on January 6, the state investigation in Georgia about trying to overturn the election.

Now that he's facing charges in New York, how does this all play together?

Does one affect another?

CHUCK ROSENBERG: Yes and no.

I mean, sometimes when there are parallel investigations, prosecutors in different jurisdictions will coordinate their work to the extent they're permitted to by law.

Even if that doesn't happen and he's indicted in other places, well, then he simply has to respond and appear in all of them.

So, you would hope there was some level of coordination.

John there may not be, but that doesn't help Mr. Trump in the end, if he's indicted in three places, well, then he has to appear in three places, and if he so chooses, defend himself in three places.

JOHN YANG: Sarah, among these different charges or different investigations, I should say, has only been charged in one.

Do voters differentiate between these allegations?

Do they see one is more serious than another?

SARAH LONGWELL: It's not as much the voters as it is the right wing media.

So this is the one that folks on the right are much more eager to defend because they think this is the weakest case.

And so they're happy, especially, you know, politicians who are going on Fox News, they're happy to defend him on this case because they don't think it's as strong.

They're going to be less happy to defend him potentially on an indictment around January 6 or on putting pressure on Georgia election officials to find votes.

Those are going to be tougher for them to defend.

And I don't think you'll see the big emotional our democracy is ending type rhetoric from as many people.

But right now, the voters are really taking their cues from the media and from the elected officials, all of whom are acting like this is a tremendous miscarriage of justice.

JOHN YANG: Chuck, it's one thing because I'm sure, one thing to get an indictment, another thing to get a conviction.

What are the challenges?

Or does trying a former president present special challenges for the prosecution?

CHUCK ROSENBERG: Well, all cases present challenges for the prosecution.

To your point, in order to get an indictment, you have to meet a probable cause standard, really one of the lowest standards in the law.

In order to obtain a conviction at trial by a unanimous jury, you need proof beyond a reasonable doubt, the highest standard in the law.

And so there's a huge gulf between probable cause and proof beyond a reasonable doubt.

And, oh, by the way, your evidence that you are introducing in court is challenged by the other side.

It's cross examined, and if they choose, they can put on their own witnesses.

So there is a big difference.

Good prosecutors, by the way, don't just indict a case because they can obtain probable cause.

They know they're going to have to try the case.

And our rules, at least as federal prosecutors, was not to indict a case unless you had a reasonable probability of conviction.

But there's a big difference between those two standards, and prosecutors understand they have to meet the more difficult standard in court.

JOHN YANG: Republican strategist Sarah Longwell, former federal prosecutor Chuck Rosenberg, it's going to be an interesting week.

Thank you both very much.

When health insurance companies deny claims, an appeal is not very likely.

Federal data shows that companies issued more than 49 million denials in 2021, but customers appealed only about two tenths of 1 percent of them.

While some denials come with specific justifications, most explanations are vague.

Ali Rogin explores how at least one major health insurance company is using artificial intelligence to assess and often deny claims in bulk.

ALI ROGIN: Investigative journalists at the nonprofit ProPublica found that the health insurance company Cigna uses an automated system that allows it to instantly reject claims on medical grounds without even opening the customer's file.

Some are accusing Cigna of using the system to help cut costs at the expense of the patients, a claim which Cigna denies.

Joining me now is Maya Miller, one of the reporters who worked on the story.

Maya, thank you so much for joining us.

Can you explain to me how this system works?

MAYA MILLER, ProPublica: Yes, absolutely.

When you go to a doctor or see your healthcare provider, they'll send in a claim to your health insurance plan and they'll list the diagnosis that think that you have and then a list of tests or procedures that they want to run.

We learned that there is a process that was developed at Cigna about a decade or so ago in which they created this code, this computer code, this algorithm that says, we're going to prove them if they match certain conditions.

But if they don't match another condition, let's say a diagnosis that they don't think that is worthy of that treatment, then it will be sent to the desk of a medical director, which is a company doctor, and that doctor is going to be able to quickly sign off on rejecting that claim and saying, we're not going to cover it in two months.

Last year, that happened in an average of under 2 seconds.

These medical directors were essentially saying for 50 patients at a time, they wouldn't even open a patient file, but they were signing their name off and saying, actually, this claim is not medically necessary, and so we're not going to cover it.

ALI ROGIN: I want to read to you from a statement that Cigna has provided.

First, they say that this automated process allows us to pay providers for claims quickly and automatically and allows medical directors time to look at more complex reviews.

It also says that even a denial should not result in any additional out of pocket costs for patients who are using in network providers.

What did you find related to those two statements that Cigna makes?

MAYA MILLER: Yes, so on the first statement, it's true that some of the claims that are processed through the system, which is called Pxdx, if they match the diagnoses and the treatments on the list, if the code sees that there's a match there, they will be automatically approved.

However, then there's a batch of them that get automatically denied.

And that's really what we're focusing on.

On the story, is the batch of claims which we found in two months last year, exceeded 300,000 claims.

So it's not an insignificant amount.

And to the second point about, you know, that this shouldn't result in any out of pocket costs for patients.

Unfortunately, the reality is oftentimes when we go to a doctor, a nurse, or to see a healthcare provider, we often have to sign off on a form.

And in that form we're saying that, you know, we'll take responsibility, financial responsibility, for this outcome, of this care.

And it does often get shunted onto the patient.

ALI ROGIN: What kind of procedures are we talking about that are getting routinely denied?

MAYA MILLER: Yes, so unfortunately, were trying to look for a comprehensive list of all of these claims that process through the system.

We know that not all of the claims that Cigna has end up going through the system.

But of those that do, we learn that vitamin D testing is labeled as part of the system.

We learned that autonomic nervous system testing to test, like whether your nerves are working well, oftentimes if you have diabetes or other autoimmune disease, you can have some nerve damage in your fingers or your toes and so, testing to kind of figure that out, among other conditions.

Unfortunately, we could not find a comprehensive list of all of the different procedures that are tagged for the system.

Those were two that were able to conclude from our reporting.

ALI ROGIN: Cigna and all insurers, frankly, in claims denial issues will say, well, there's always the appeal process.

What does that look like in reality?

MAYA MILLER: Yes.

One in seven claims are denied across the country, and health insurance claims.

So it affects a lot of people.

And yet one study found that 0.1 percent of all people who experience those denials actually took it to a step to do a formal appeal.

When you're going about your day to day, maybe you're facing an illness or you're facing a chronic disease, it's hard to find the time and wherewithal to be able to figure out how to appeal these claims.

And the reality is that very few people do.

And, you know, we actually found through our reporting that Cigna had a presentation in which they were putting forward the idea to put autonomic nervous system testing through the system.

And in the cost benefit analysis assessing whether to do this, they assumed only 5 percent of patients would end up appealing this, and that was part of the calculation of whether to put this test into this process or program or to leave it out.

ALI ROGIN: Now, Cigna is not the only insurer with some kind of automated system exactly like this.

Do you have a sense of how prevalent automated systems are right now in the health system writ large?

MAYA MILLER: It appears to be pretty prevalent.

And, you know, insurance companies are dealing with millions and millions of claims.

And so, in order to stay on top of those and to maintain efficiency, which is what they've said, they've, you know, turned to these algorithms and computer coding programs to be able to process claims as quickly and efficiently as possible is what they say.

So, it seems that this kind of technology is pretty prevalent across the industry, although we're still reporting that out for other insurance plans and trying to confirm that.

But, yes, it seems like it's pretty pervasive.

MAYA MILLER: Lastly, Maya, there was a robust debate happening about the hazards of using AI.

Where does this conversation fit into the broader debate about the utility and the hazards of using artificial intelligence?

MAYA MILLER: Yes, that's a great question and one that we're actually posing to regulators right now.

The former Insurance Commissioner of California, Dave Jones, was telling us that, you know, in the statutes, you need to have a thorough, fair, and objective assessment of these patient claims.

He was saying that if an insurer -- if a medical director or a company doctor for an insurance plan is really looking at a claim in less than two seconds and an average of less than two seconds, can you achieve that result?

So, yes, I'd pose that question really to the lawmakers, regulators and to see where they would stand on that.

ALI ROGIN: Maya Miller with ProPublica, thank you so much for your time.

MAYA MILLER: Thanks for having me.

JOHN YANG: For the second time in the last three weeks, the Biden administration has moved forward on plans to drill for oil in federally owned lands.

This week, it auctioned off a massive stretch of the Gulf of Mexico 73 million acres, roughly the size of Arizona.

Earlier, the administration approved the controversial Willow project in Alaska, an $8 billion oil drilling venture.

As a candidate, Biden promised to move the United States away from fossil fuels.

Ben Lefebvre covers the energy industry for politico.

Ben, as a candidate in 2020, he said, Mr. Biden said no more drilling on federal lands.

No more drilling, including offshore, no ability for the oil industry to continue to drill, period.

So what happened?

What's going on?

BEN LEFEBVRE, POLITICO: What happened was we always see candidates run for office promising one thing and most likely intending to do that thing once they get into office.

But then as soon as they step foot inside the Oval Office, reality steps in and changes those plans.

So, with this latest oil sale lease sale in the Gulf of Mexico, Biden pretty much had to follow the law.

These lease sales are run, you know, twice a year.

They got away with not having any last year, but I think their time ran out legally and they had to do it this time around.

JOHN YANG: I also read somewhere that they need the revenue from this for budget reasons.

BEN LEFEBVRE: Yes, drilling for oil in pretty much anywhere on public land, the government gets a cut of the proceeds.

I think local governments generally get half of the proceeds, and then the rest kind of goes to conservation efforts.

So, it's a big chunk of change.

I mean, this last lease sale on Wednesday resulted in 200, and I think it was $64 million.

That was the highest amount that the government's gotten for one of these Gulf lease sales since 2014, I think.

JOHN YANG: What has this done to his relationship with environmentalists?

BEN LEFEBVRE: It's not made it easy.

I mean, especially as you mentioned, after Willow, environmentalists were already angry at the administration.

This time around, the Biden administration didn't even put out, really, a press release with the results of this.

I kind of think it shows how sensitive they are to being seen as kind of facilitating oil development.

They had to do this to basically keep the legal promises to the oil industry.

And I think, as we've seen with this and Willow, when the administration tries to hew to the middle of the road, it ends up getting hit by a lot of political cars.

JOHN YANG: What's the Biden administration's relationship, like with the oil industry?

BEN LEFEBVRE: It's gotten better.

I mean, when they first came into office, they were pretty much at each other's throats.

Over the past two years, especially with Russia's invasion of Ukraine helping to kind of scramble trade flows and commodity markets, the industry and the administration have been talking more often.

I don't think they're maybe in love with each other by any means, but there seems to be at least a grudging respect and a kind of thawing of relationships.

JOHN YANG: Are there environmental concerns?

Are there worries about the North Slope of Alaska where the willow project is and the Gulf of Mexico?

BEN LEFEBVRE: Yes, there's environmental concerns for both Alaska.

I mean, Alaska -- I mean, The North Slope is, to a certain extent, in the middle of nowhere.

The fear is that if you have any big catastrophe out there's not a lot of emergency management, you know, emergency response, you know, facilities nearby.

It's not like the local fire station can rush out there.

In the Gulf of Mexico, as you mentioned, we obviously saw the Deepwater Horizon accident.

The Gulf of Mexico is closer to places that can get emergency response teams out there, but it's still, you know, it's fairly far away.

And if you have a big accident that's a major ecosystem that's in danger.

JOHN YANG: What has the administration done or doing to fulfill the promise of weaning the United States off fossil fuels or try to wean it off?

BEN LEFEBVRE: It's interesting after this latest announcement about the Gulf of Mexico lease sale, they also announced some major conservation efforts where they were going to allow nonprofits to basically lease federal land to kind of keep it in a natural state.

Before this, remember last year we had the Inflation Reduction Act and the bipartisan infrastructure law where those ceded a lot of money to clean energy, renewable energy innovations and infrastructure.

So the administration will say, well, look, we have to do some of this fossil fuel stuff basically to stay within the law and to make sure that fuel prices don't rise too high for the average family.

But it's we're doing things that in the next five to ten years, you are going to see a major rebalancing of U. S. Energy supply.

JOHN YANG: Ben Lefebvre from POLITICO.

Thank you very much.

BEN LEFEBVRE: Thank you.

JOHN YANG: Online tomorrow morning, our livestream of the announcement of the first astronauts chosen to crew an Artemis lunar mission.

All that and more is on our website, pbs.orgNewsHour.

That is "PBS News Weekend" for this Sunday.

I'm John Yang.

For all of my colleagues, thanks for joining us.

Have a good week.