Medicare Launches AI-Based Prior Authorization Pilot

Medicare has launched a six-year pilot beginning January 2026 that requires AI-assisted prior authorization for 14 procedures and devices in traditional Medicare across six states (Arizona, New Jersey, Ohio, Oklahoma, Texas, Washington). CMS contracts tech firms to review and deny requests, aiming to reduce wasteful spending while the program runs through December 2031. The pilot will be closely monitored for inappropriate denials and impacts on patient access and provider burden.