The Centers for Medicare and Medicaid Services has selected the six technology companies that will administer artificial intelligence-powered prior authorization programs for Medicare, STAT has learned.\u00a0<\/p>\n
The pilot, called the Wasteful and Inappropriate Services Reduction (WISeR) model, is a CMS effort to reduce waste and abuse within the taxpayer funded health insurance program that spent more than a trillion dollars in 2024. The new prior authorization program will launch in January and run until 2031 in New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington.\u00a0<\/p>\n
CMS\u2019 decision to test the use of AI technology for prior authorizations comes at a time when large private insurers \u2014 including UnitedHealthcare<\/a> and Humana<\/a> \u2014 are facing class action lawsuits<\/a> and congressional scrutiny<\/a> over their use of AI for making decisions about care for Medicare Advantage beneficiaries. There is also congressional pushback against the WISeR program; on Friday, a congressional representative from Washington, one of the states where the program will be implemented, is planning to introduce a bill<\/a> to prevent the Department of Health and Human Services from implementing WISeR.<\/p>\n STAT+ Exclusive Story<\/p>\n Already have an account? Log in<\/a><\/p>\n \t\t\t \t\t\t\t\t \t\t\t\tThis article is exclusive to STAT+ subscribers Already have an account? Log in<\/a><\/p>\n \t\t\t\t\t\tIndividual plans<\/p>\n \t\t\t\t\t\tGroup plans<\/p>\n![\"STAT+\"\/](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/06\/stat-plus-breaker-bg.png\")
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