Medicare's AI Push Snarls Patients and Doctors in Errors and Delays

TL;DR

Medicare has launched a pilot program called WISeR in six states to test prior authorization for 13 medical services, including epidurals and skin substitutes, using AI to detect fraud and misuse.
Patients and healthcare providers in pilot states like Oklahoma are experiencing delays, errors, and confusion due to the new preapproval requirements, with some patients considering traveling out of state for treatment.
Despite claims that the program aims to be efficient and fast, stakeholders report a "horrendous" rollout with long wait times for approvals and payments, and concerns about AI-driven errors in decision-making.
The program's rapid implementation and the use of AI have raised questions about its effectiveness and potential to introduce more friction and costs for beneficiaries, even as the government aims to scale back prior authorization for private insurance.

Continue reading the original article