1. United States
2. Calif.
3. Letter

I am writing to ask you to prohibit Medicare Advantage and traditional Medicare from using Artificial Intelligence to make prior authorization decisions. This includes practices by current Medicare Advantage insurers, and the planned Medicare pilot program of the so-called “WISeR” model, designed to reduce the provision of medications and services in the future. Don’t allow Artificial Intelligence to review treatments prescribed by human doctors, using their medical degrees, expertise, and clinical judgment. A recent Senate subcommittee report on the use of AI to make prior authorization decisions points to serious concerns. During the period that UnitedHealthcare, Humana, and CVS adopted AI tools, denials of authorization increased by 54% to 108%, depending on the insurer. For instance, between 2020 and 2022, when it first started using AI, UnitedHealthCare more than doubled its denials of post-acute care such as rehab facilities and nursing homes. Physicians, too, are speaking up. A 2024 AMA survey of 1,000 physicians (including 400 Primary Care Physicians and 600 specialists) found that 61% reported that the use of AI increases denials and harm to patients, and 49% ranked AI-based authorization decisions as one of the top three priorities for health legislation. Medicare Advantage’s use of AI resulted in sharp increases in delays, denials, and lawsuits, and the upcoming pilot program for traditional Medicare puts more patients at risk. Don’t let CMS sell out patient care to AI corporations. Thank you for helping to safeguard Medicare to provide the best of care for our nation’s seniors and people with disabilities.