Medicare Pilots AI Prior Authorization, Causes Delays
Federal Medicare began a six-state pilot, the Wasteful and Inappropriate Service Reduction Model (WISeR), that uses AI-assisted reviews for prior authorization of certain procedures, according to KFF Health News and other reporting. WISeR launched in mid-January and applies to services including epidural steroid injections, knee procedures, and nerve stimulators in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington, per KFF. The pilot affects roughly 6.4 million traditional Medicare beneficiaries, Yahoo reporting noted. Early reporting and a study cited by Senator Maria Cantwell found approvals that previously took about two weeks are now taking four to eight weeks, producing rescheduling, longer travel for patients, and reported administrative confusion, according to Healthcare Dive, FierceHealthcare, and KFF. CMS contracts with private firms to run "enhanced technologies, including artificial intelligence," for reviews, Yahoo Finance reports.














