Medicare's AI Approval Program Faces Scrutiny Over Flawed Launch
By Editor • September 15, 2026 • 1 min read
The Medicare initiative employing artificial intelligence for prior authorization has come under fire for its rushed implementation and various operational flaws, according to newly released documents.
Launched in January 2023, the Wasteful and Inappropriate Service Reduction (WISeR) model mandates that healthcare providers obtain approvals for specific procedures, such as skin substitutes and pain management epidural injections. This pilot program spans several states, including New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington, and is slated to continue until 2031.
Insights from over a thousand pages of documents, acquired by the Electronic Frontier Foundation through a Freedom of Information Act lawsuit, reveal that a vendor involved in the WISeR program cautioned the Centers for Medicare and Medicaid Services (CMS) about the impracticality of meeting the launch deadline. This raises serious questions about the program's preparedness and the potential impact on patient care.
Source: www.statnews.com
