Medicare WISeR AI Prior Authorization Pilot: High Denial Rates 2026

Documents show 'staggering' denial rate for Medicare AI program in WA

Medicare's new AI-enabled program denied more claims than it approved during a rocky rollout, leaving patients who were in pain to wait out a long appeals process.

Medicare WISeR AI prior authorization pilot: high denial rates 2026

Documents obtained through a FOIA lawsuit show one vendor denied more requests than it approved and a request went unanswered for 83 days

One Medicare AI Prior Authorization Request Went Unanswered for 83 Days as Vendors Often Missed the 72-Hour Standard

Records released by EFF show vendors in Medicare's AI-assisted WISeR prior authorization pilot often missed a 72-hour goal, with one request unanswered for 83 days.

CMS WISeR Pilot Plagued by Delays

This WISeR AI prior authorization documents release reveals an 83-day-old unanswered request and vendor breakdowns.