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STAT+: Federal test of AI prior authorization is delaying care for seniors, report says

Washington state hospitals say their Medicare patients are waiting two to four times longer in some cases for procedures that are now subject to prior authorization under a new Medicare program. 

The report from U.S. Sen. Maria Cantwell (D-Wash.) is among the first to document alleged patient harm stemming from the Centers for Medicare and Medicaid Services’ new Wasteful and Inappropriate Service Reduction, or WISeR, Model. Cantwell is one of several Democratic members of Congress who have been urging CMS to scrap the program, which launched Jan. 1. 

Cantwell aired her concerns about WISeR to Health and Human Services Secretary Robert F. Kennedy Jr. at a Senate Finance Committee hearing on Wednesday. She said CMS is using AI as a “denial device” and that patients are waiting weeks to get approval for services that previously didn’t require approval. 

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Washington state hospitals say their Medicare patients are waiting two to four times longer in some cases for procedures that are now subject to prior authorization under a new Medicare program. 

The report from U.S. Sen. Maria Cantwell (D-Wash.) is among the first to document alleged patient harm stemming from the Centers for Medicare and Medicaid Services’ new Wasteful and Inappropriate Service Reduction, or WISeR, Model. Cantwell is one of several Democratic members of Congress who have been urging CMS to scrap the program, which launched Jan. 1. 

Cantwell aired her concerns about WISeR to Health and Human Services Secretary Robert F. Kennedy Jr. at a Senate Finance Committee hearing on Wednesday. She said CMS is using AI as a “denial device” and that patients are waiting weeks to get approval for services that previously didn’t require approval. 

Continue to STAT+ to read the full story…

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