Washington state hospitals say their Medicare patients are waiting two to four times longer in some cases for procedures that are now subject to prior authorization under a new Medicare program.  The report from Sen. Maria Cantwell (D-Wash.) is among the first to document alleged patient harm stemming from the Centers for Medicare and Medicaid Services’ new Wasteful and Inappropriate Service Reduction, or WISeR, Model.
Cantwell is one of several Democratic members of Congress who have been urging CMS to scrap the program, which launched Jan. 1.  Cantwell aired her concerns about WISeR to Health and Human Services Secretary Robert F.
Kennedy Jr. at a Senate Committee on Finance hearing Wednesday.
She said CMS is using artificial intelligence as a “denial device” and that patients are waiting weeks to get sign off for services that previously didn’t require approval.  Continue to STAT+ to read the full story...
A report by Senator Maria Cantwell (D‑Wash.)—summarized in STAT News—documents concerns from Washington state hospitals about delays for Medicare patients under a newly implemented Medicare program, the Wasteful and Inappropriate Service Reduction (WISeR) Model.
The WISeR Model began Jan 1.
The WISeR Model introduces a prior authorization process for certain services that previously did not require preapproval.
The report alleges CMS is employing artificial intelligence within that authorization workflow.
The concerns focus on Medicare beneficiaries receiving care at Washington state hospitals; broader geographic or demographic scope was not reported in the source.
Hospitals cited in the report said some Medicare patients are waiting two to four times longer for procedures now subject to prior authorization.
The report characterizes these as among the first documented instances of patient harm linked to WISeR.
Sen.
Cantwell raised these concerns at a Senate Finance Committee hearing with Health and Human Services Secretary Robert F.
Kennedy Jr.