A ‘WISeR’ Move? House Panel Aims to Halt Funding for AI Prior Authorization Model
Stephen Bittinger discusses congressional efforts to halt funding for CMS’s AI-driven Wasteful and Inappropriate Service Reduction (WISeR) model, a prior authorization program currently operating in six states. He raises concerns about the program’s reliance on opaque AI decision-making, arguing that providers lack visibility into the technology’s methodology and that the model may create significant due process, compliance and patient access issues. Bittinger notes that while a House committee has moved to block future funding for WISeR, the program remains active for now and healthcare providers should continue documenting denials, appeals and operational impacts as scrutiny of the model intensifies.
