The Trump administration rolled out a pilot program that uses artificial intelligence to decide whether seniors on Medicare can get certain types of care. The program is called WISeR. It adds a step that Medicare did not have before: prior authorization, where doctors must get approval before certain care is covered.
Under the program, an AI system authorizes or denies those requests. Medicare is a federal healthcare program for seniors. Before this pilot, doctors treating Medicare patients did not have to seek this kind of pre-approval.
What Went Wrong With the AI Medicare Prior Authorization Pilot
Soon after the program started, media outlets began reporting serious problems. The issues included technical difficulties, long delays in decisions and in care, puzzling denials, and frustrated doctors. Patients were left suffering in pain while waiting.
Those reports were largely confirmed when the Electronic Frontier Foundation released a tranche of federal documents about WISeR. The group obtained the documents amid litigation. The documents included feedback from healthcare providers, including one who called the program disastrous.
Why the WISeR Documents Matter for Medicare Patients
The release of federal documents gave the public a direct look at how the program was working in practice. The feedback from providers matched what media outlets had already reported: denials that did not seem to make sense, delays that stretched on, and doctors struggling to get care approved for their patients.
- The program uses AI to authorize or deny certain types of care for Medicare patients.
- Medicare previously did not require doctors to get prior authorization for this care.
- Reported outcomes include technical difficulties, long delays, puzzling denials, and frustrated doctors.
- Patients were left suffering in pain, according to the reports.
- The Electronic Frontier Foundation obtained federal documents about WISeR amid litigation.
Our Take: Seniors Deserve Better Than an AI Experiment
To put it plainly, this is a dangerous way to run healthcare. Seniors on Medicare are some of the most vulnerable patients in the country. They should not be part of an experiment where a machine decides whether they get care.
In our view, the reported outcomes tell the whole story: delays, denials that make no sense, and patients in pain. When doctors say the program is failing, that should be a warning sign, not something to push through. The documents obtained by the Electronic Frontier Foundation confirm what patients and providers already knew.
What this means for readers: if you or a family member relies on Medicare, this program could affect your care. The pilot shows what happens when cost-cutting meets automation without enough safeguards. The administration should pause WISeR and let doctors, not algorithms, make care decisions for seniors.
