The Wasteful and Inappropriate Service Reduction (WISeR) Model will continue operating in six states, including Arizona, after Senate Democrats failed late last week to end the widely criticized pilot, which uses artificial intelligence to support prior authorization decisions for traditional Medicare claims.
The program uses AI to...Arizona News
Artificial intelligence software is rapidly changing all aspects of the healthcare industry but some are advocating for caution in the face of insurmountable change. This week, people are increasingly turning to AI and social media for health information and House Democrats are turning up the scrutiny of a Medicare demonstration model...Arizona News
Criticism continues to mount against the Trump administration's plan to use AI-based prior authorization for Medicare claims. The Wasteful and Inappropriate Service Reduction (WISeR) model, now active in Arizona and five other states, has already generated reports of delayed care for seniors since its January launch. On Tuesday, a House...CMS Rules
Almost one year ago, 50 major health insurers met with U.S. health department leadership and pledged to rein in their use of prior authorization, which patients and providers complain severely disrupts the continuity of care. Now, despite industry studies demonstrating that the practice has been curbed by a little over 10%, the practice...Arizona News
Nearly four months after CMS launched its Wasteful and Inappropriate Service Reduction, or WISeR, model, the Electronic Frontier Foundation filed a lawsuit March 25 seeking details on how the AI-enhanced prior authorization program works for Medicare fee-for-service beneficiaries. The model is now operating in Arizona and several other...Arizona News
House Democrats have introduced legislation that would block the Trump administration's plan to use AI to implement prior authorization in traditional Medicare. The Centers for Medicare and Medicaid Services (CMS) announced the Wasteful and Inappropriate Service Reduction (WISeR) model earlier this year for testing in six states,...Arizona News
A new study shows that Medicare Advantage physician networks pale in comparison to traditional Medicare, but the Centers for Medicare and Medicaid Services (CMS) is pushing ahead with plans to make traditional Medicare look more like Medicare Advantage.
Medicare beneficiaries enrolled in both programs report that physician...News
A new policy brief from the influential Washington-based Paragon Health Institute warns that Congress should either reform or shut down the CMS Innovation Center, arguing the program has failed to deliver meaningful savings or quality improvements despite costing taxpayers billions. The report concludes that, after more than a decade of...Arizona News
The Centers for Medicare and Medicaid Services (CMS) will launch a pilot program for the Wasteful and Inappropriate Service Reduction (WISeR) Model, which will implement prior authorization into the traditional Medicare program. CMS has selected six states for the pilot, including Arizona.
The Hertel Report covered the model after it...
