Democrats mount new attempt to end Medicare AI prior authorization pilot
Democrats mount new attempt to end Medicare AI prior authorization pilot
Publish Date: 2026-05-20 15:29:00
Source Domain: www.statnews.com
- Senate and House Democrats introduced resolutions to overturn a Medicare pilot program using AI for care approval.
- The program, called Wasteful and Inappropriate Service Reduction (WISeR), has led to allegations of delayed care in the six states it’s implemented: Arizona, New Jersey, Oklahoma, Ohio, Texas, and Washington.
- This action follows a GAO ruling that WISeR should have been submitted to Congress before implementation in January.
- Proponents argue WISeR denies necessary care and could be a backdoor approach to privatizing Medicare.
- The program targets specific supplies and procedures for AI review; providers submit for approval to contractors paid based on the number of denials, which some experts deem an incentivization to deny care.
- CMS will audit participants and terminate those with high inaccuracy rates in response to these concerns.
- The resolution requires 30 signatures to proceed to a Senate floor vote, with a goal of ending the WISeR pilot if passed. Bipartisan support is uncertain.
