Medicare’s AI push snarls patients and doctors in errors and delays

Here is a summarized version of the article using an unordered list:

– Bill Curry, an Oklahoma cattle farmer, now faces additional trips to Oklahoma City for epidurals due to a new preapproval requirement as part of a Medicare pilot program.

– The pilot program, named WISeR, began in six states, including Oklahoma, to test prior authorization for 13 services deemed prone to fraud or misuse, like epidurals and kyphoplasties.

– Despite the use of artificial intelligence to streamline the process, early reports indicate issues such as confusion, long wait times, and errors.

– Key concerns about the program’s rapid implementation, such as insufficient preparation time for medical staff and IT problems, have led to significant frustrations for patients and practitioners.

– Medicare’s goal with WISeR is to reduce inappropriate care and fraud but the rollout in states has met with resistance, described by some as “horrendous”.

– Delays and payment backlogs have added to the program’s difficulties, with some saying the new requirements are creating issues and frustrations previously non-existent.

– Although human decisions ultimately approve the procedures, use of AI and potential errors, including misinterpretations, are seen adding to delays and creating obstacles.

– Participation in the pilot has led to increased costs due to more appeals, and there is debate whether these measures will simply shift costs onto patients rather than saving money.

– Some fear that if the pilot deems costs effective, the program may expand to cover more procedures; however, CMS maintains no changes are planned for the current services under the program’s scope.