STAT+: Medicare’s AI prior authorization pilot was rushed and full of problems, new documents reveal

Brittany Trang, Ph.D., covers AI in health and medicine: Does it actually work? Who benefits, or might be harmed? She writes the weekly AI Prognosis newsletter. Follow her on Threads, Mastodon, and Bluesky. You can reach Brittany on Signal at btrang.01.The rollout of a Medicare program that uses artificial intelligence to approve or deny care was hasty and error-ridden, according to more than a thousand pages of recently released documents and data. The pilot program, called the Wasteful and Inappropriate Service Reduction model, or WISeR, launched in January and requires health care providers to seek approvals before they can provide certain procedures and products, like skin substitutes and epidural injections for pain management. The experiment operates in New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington and will run until 2031. Among other issues, the documents obtained by the Electronic Frontier Foundation through a Freedom of Information Act lawsuit show that one WISeR vendor warned the Centers for Medicare and Medicaid Services that it was unrealistic to expect a working product by the time the federal agency wanted to launch the program. STAT+ Exclusive Story Already have an account? Log in This article is exclusive to STAT+ subscribers Unlock this article — and get additional analysis of the technologies disrupting health care — by subscribing to STAT+. Already have an account? Log in View All Plans To read the rest of this story subscribe to STAT+. Subscribe