Medicare AI Program Results in 'Lengthy Treatment Delays'—New Data Shows
The WISeR program is one of the federal government's most ambitious attempts to incorporate AI into Medicare administration.
A Medicare pilot program utilizing artificial intelligence to expedite prior authorization requests has resulted in prolonged treatment delays for patients and raised concerns over insufficient testing, according to newly disclosed government records. The Freedom of Information Act (FOIA) lawsuit filed by the Electronic Frontier Foundation (EFF) offers a detailed account of the federal government's Wasteful and Inappropriate Service Reduction (WISeR) model, which employs AI-assisted reviews for specific medical procedures.
The organization contends that the AI technology and the surrounding process were not adequately tested before implementation, leading to bottlenecks in the system. As a result, treatment requests that typically take 72 hours can sit unanswered for weeks, causing patients to face delayed care. Representative Kevin Thompson, CEO of 9i Capital Group and host of the 9innings podcast, emphasized that the lack of thorough testing has led to increased denials and extended prior authorization timelines.
The Electronic Frontier Foundation (EFF) expressed significant concerns about the thoroughness of AI system testing and the potential for unwarranted delays or denials of necessary medical care. The Center for Medicare & Medicaid Services (CMS) has acknowledged the need for improvements based on feedback from doctors and patients.
However, there remain critical questions regarding the evaluation of the technology before the program's launch and the transparency of AI-generated recommendations that influence human reviewers.
Written by urgent.news from Newsweek's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
