AI · Policy · 2026-09-09 07:35:00
EFF sued the government for records on Medicare's WISeR model, which uses AI to evaluate prior authorization requests. About 1,000 pages obtained from CMS show widespread delays, denials, operational chaos and patient harm. Vendors failed to respond within 72 hours for many requests, one going 83 days unanswered. The payment methodology creates a financial incentive to deny care, with two companies denying over 20,000 requests in three months. Providers reported patients in pain waiting for approvals. CMS launched WISeR six months after announcing it despite warnings, and vendor Innovaccer said it would auto-affirm all requests due to incomplete functionality.
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