Internal records show rushed rollout for Medicare AI authorization pilot

The short version

• Documents obtained via a Freedom of Information Act lawsuit by the Electronic Frontier Foundation indicate the Medicare WISeR pilot was launched hastily with various errors.[STAT]
• The WISeR initiative requires providers to gain approval prior to delivering specific products and treatments, including skin substitutes and epidural injections.[STAT]
• A program vendor cautioned the Centers for Medicare and Medicaid Services that expecting a functional product by the target launch date was unrealistic.[STAT]
• The pilot launched in January across six states and is currently scheduled to operate through 2031.[STAT]

Key facts

• The Wasteful and Inappropriate Service Reduction model (WISeR) requires healthcare providers in six states to request pre-approvals for certain procedures and products.[STAT]
• WISeR began in January and is set to continue through 2031 across New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington.[STAT]
• Over a thousand pages of documents and data were secured by the Electronic Frontier Foundation through a FOIA lawsuit.[STAT]
• A project vendor warned the Centers for Medicare and Medicaid Services that expecting a fully functional product by the planned start date was unrealistic.[STAT]

Sources

Outlet counts describe coverage, not independent confirmation. Reports may share a wire service or original source.

• STAT+: Medicare’s AI prior authorization pilot was rushed and full of problems, new documents revealSTAT metered