Medicare AI prior-authorization pilot plagued by rollout glitches, causing care delays

Documents obtained through a Freedom of Information Act lawsuit reveal that the Medicare program using artificial intelligence for prior authorization was launched hastily and suffered numerous technical problems.

The pilot, called the Wasteful and Inappropriate Service Reduction model (WISeR), began in January and requires providers to obtain AI‑generated approvals for certain procedures and products, such as skin substitutes and epidural injections. It is being tested in New Jersey, Ohio, Oklahoma, Texas, Arizona and Washington and is slated to run until 2031.

The released papers show that the rushed rollout led to delays in care delivery. One vendor warned the Centers for Medicare and Medicaid Services that delivering a functional AI system within the timeline was unrealistic, yet the program proceeded.

The findings raise concerns about the readiness of AI tools in Medicare, the potential impact on patient access, and the need for tighter oversight of such technology pilots.