Medicare AI program results in "lengthy treatment delays" -- New data shows
2026-09-14
Newsweek
The information displayed in the AIM should not be reported as representing the official views of the OECD or of its member countries.
The Centers for Medicare & Medicaid Services' WISeR pilot, using AI to evaluate prior authorization requests in six US states, led to widespread delays, technical failures, and high denial rates. These issues caused harm to patients, including pain, canceled procedures, and emotional distress, as documented in federal records released by EFF.[AI generated]
Why's our monitor labelling this an incident or hazard?
The AI system is explicitly involved as it assists in reviewing prior authorization requests. Its use has directly led to lengthy treatment delays and inappropriate denials, harming patients' health and access to care. The delays exceed the intended 72-hour response time, with some requests unanswered for over 80 days, demonstrating malfunction or inadequate deployment. The harm is realized and documented, fulfilling criteria for an AI Incident. The event is not merely a potential risk or a response update but a concrete case of AI-related harm in healthcare.[AI generated]