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Sep 14, 2026

New documents reveal problems with Medicare's AI prior authorization pilot

Newly released records show Medicare's controversial AI-based prior authorization pilot program experienced lengthy treatment delays, technical problems, backlogs, and early warnings about contractor readiness issues.

Sep 14, 20262 sources

Top claims

▪Arizona interventional pain specialist Matthew Crooks, MD, received a Wasteful and Inappropriate Service Reduction (WISeR) 'gold card' in July 2026, allowing his practice to bypass standard prior authorization.
▪The Centers for Medicare & Medicaid Services launched the Wasteful and Inappropriate Service Reduction (WISeR) AI-based prior authorization pilot program in January 2026 across six states.
▪Electronic Frontier Foundation's analysis of records showed some prior authorization requests under the Wasteful and Inappropriate Service Reduction (WISeR) program exceeded the 72-hour turnaround, with one request taking 83 days.

Subtopics

AI liability1 AI regulation & lawsuits1 AI standards, audits & compliance1 Drug Pricing and Access1 Healthcare Access and Insurance1 Prior authorization1

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