{
  "id": 7635289,
  "title": "Delays, tech failures abound in CMS' WISeR AI prior auth pilot, documents show",
  "url": "https://urgent.news/2026/09/15/delays-tech-failures-abound-in-cms-wiser-ai-prior-auth-pilot",
  "topic": "ai",
  "section": "AI",
  "published": "2026-09-15T19:26:04.000Z",
  "source": {
    "name": "Fierce Healthcare",
    "slug": "fierce-healthcare",
    "url": "https://www.fiercehealthcare.com/regulatory/delays-tech-failures-abound-cms-wiser-ai-prior-auth-pilot-documents-show"
  },
  "original_language": "en",
  "account": "A 1,000-page collection of documents from the Centers for Medicare & Medicaid Services (CMS) reveals significant challenges in the agency's recent AI-driven prior authorization pilot program, known as WISeR. The documents, obtained through a Freedom of Information lawsuit, detail delays, communication breakdowns, provider frustration, and technical issues. The records, spanning from January 2024 to April 2026, show that many prior authorization requests took longer than the program's target of three days and some remained unresolved by the end of March, with one request dating back 83 days. Issues arose from miscommunications between tech vendors and Medicare administrative contractors (MACs), system downtime, and complaints about delays or insufficient communication from the vendor Innovaccer, which was processing requests in Ohio. Providers have expressed concern over the delays affecting patients in pain, with some submitting angry feedback. Innovaccer had previously informed CMS that its systems required more time to implement and that it was still working to clear backlogs. CMS' payment methodology for WISeR vendors is said to incentivize more denials, and the program's inclusion of additional medical services is under scrutiny. Critics, including the American Hospital Association, American Medical Association, and Democrats, argue the AI systems are delaying care for Medicare beneficiaries. Despite attempts by lawmakers to roll back the WISeR model, it remains active in several states, with the U.S. Government Accountability Office (GAO) noting that the program should have been subject to Congress' review before implementation.",
  "summary": "A trove of CMS documents obtained and shared by a privacy nonprofit outline sweeping issues such as delayed approvals, miscommunication and provider frustration.",
  "key_points": [],
  "editors_take": null,
  "illustration": null,
  "coverage": {
    "outlets": 1,
    "also_reported_by": []
  },
  "ai_generated": true,
  "disclaimer": "Summaries, key points and the editor’s take are written by software from other outlets’ reporting and may contain errors — always check the linked original."
}