The Arizona-based company using artificial intelligence to review certain Medicare requests in Washington state under a controversial six-year pilot program has been found out of compliance by the federal government.
The Centers for Medicare and Medicaid Services announced Monday that Virtix Health was required to submit a Corrective Action Plan because it was not responding quickly… Read more »
The House Energy & Commerce health subcommittee advanced a broad package of bipartisan health care bills Thursday (June 25) aimed at increasing health care price transparency and strengthening prior authorization oversight.
The package includes measures requiring hospitals, insurers and other providers to disclose more pricing information, increasing reporting requirements… Read more »
Dive Brief:
Democrat lawmakers are calling on the CMS to release more data on a controversial pilot program that adds artificial intelligence-backed prior authorization for some services in traditional Medicare.
In a letter sent to CMS Administrator Dr. Mehmet Oz on Monday, representatives pushed the agency to release information on how long it takes technology vendors… Read more »
For months, Medicare patients in Washington have struggled with delays and denials for medical treatments due to a new program that uses artificial intelligence to review care.
Now, patients and their doctors are fed up and demanding changes. Lawmakers scrutinizing the program want to see it overhauled.
“Congress and the public deserve a full understanding of the impact this program is… Read more »
Today, Congresswoman Suzan DelBene (WA-01) hosted health care providers and Medicare patients at UW Medical Center to raise growing concerns about the Trump administration’s Wasteful and Inappropriate Service Reduction (WISeR) program, which pays private companies to use AI to delay and deny care to Washington seniors.
Since the program began in January, patients have been left in… Read more »
Legislation aimed at reducing delays when Medicare Advantage plans require preapproval for care could hit the House floor under fast-track rules for bills that have broad support.
The bill, sponsored by Rep. Mike Kelly, R-Pa., targets use of prior authorization in Medicare Advantage — in which insurers approve or deny services before they can be delivered.
The legislation would require… Read more »
Today, Congresswomen Suzan DelBene (WA-01), Suzanne Bonamici (OR-01), Emilia Sykes (OH-13), and Judy Chu (CA-28) led 83 of their colleagues in conducting oversight of the recently-launched Moms.gov. The letter demands that Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. provide answers about the department’s goals in developing, funding, reviewing, and operating… Read more »
Five months into a pilot program that uses AI to review certain Medicare procedure requests, Washington seniors face new hurdles and worsening health outcomes, according to health care providers and lawmakers.
The program, which incentivizes participating private companies to deny procedures, has become the target of a repeal effort by Democratic Congressional members, including those… Read more »
Democrats are pushing to shut down a new Medicare pilot program using artificial intelligence to approve or deny certain medical services under a new prior authorization model.
The pilot initiative, known as the Wasteful and Inappropriate Services Reduction (WISeR) model, uses AI-assisted prior authorization in traditional Medicare, but lawmakers say it could delay or deny care for… Read more »
Sen. Ron Wyden (Oregon), the top Democrat on the Senate Finance Committee, is launching an effort to overturn a Trump administration pilot project that’s testing the use of AI-driven prior authorization in traditional Medicare.
The pilot, called the Wasteful and Inappropriate Service Reduction, or WISeR, uses contracts with artificial intelligence companies to process requests —… Read more »
