Medicare AI Program Results in 'Lengthy Treatment Delays'—New Data Shows
Summary
A Medicare pilot program using artificial intelligence (AI) to speed up prior authorization for medical treatments has caused long delays and problems, according to government records. The program, called WISeR, was launched in six states but has faced technical issues and slow responses, leading to concerns about delayed care for patients.Key Facts
- The WISeR program started in January and uses AI to review prior authorization requests for certain medical procedures.
- It is operating in six states: Texas, Arizona, New Jersey, Ohio, Oklahoma, and Washington.
- The program covers 13 medical services thought to be at risk for fraud, waste, or inappropriate use.
- Requests are supposed to be answered within 72 hours, but many took weeks or even 83 days in some cases.
- There were technical failures, increased denials, and reports that patient care was delayed or harmed.
- Providers experienced difficulty getting timely approvals for necessary treatments.
- The Electronic Frontier Foundation (EFF) sued the Centers for Medicare & Medicaid Services (CMS) to release records about the use of AI in this program.
- CMS said it plans to improve the program based on feedback from doctors and patients.
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