STAT+: Medicare’s AI prior authorization pilot was rushed and full of problems, new documents reveal
The rushed launch of a Medicare pilot to use AI for prior authorization led to delayed care in some instances, new documents reveal.
Medicare's AI prior authorization pilot, known as WISeR, has been criticized for being rushed and plagued with issues, according to newly released documents and data. The pilot program, which began in January, requires healthcare providers to obtain approvals before providing certain procedures and products, such as skin substitutes and epidural injections for pain management.
Operating in New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington, the program is set to run until 2031. One vendor involved in the project had warned the Centers for Medicare and Medicaid Services that it was unrealistic to expect the product to be fully functional by the time the federal agency had planned to launch it.
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