An open letter to the U.S. Congress

Cancel the WISeR AI Prior Authorization Pilot Program

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I am writing to urge you to push for the immediate cancellation of the Wasteful and Inappropriate Service Reduction (WISeR) pilot program announced by the Center for Medicare and Medicaid Services in June. This program threatens to undermine the quality of healthcare for millions of Medicare recipients by inserting artificial intelligence between patients and their medically necessary care. Beginning in January 2026, the WISeR model will use AI to determine Medicare coverage eligibility for prescribed medical procedures in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. Original Medicare enrollees in these states will have no ability to opt out of this program. This means seniors who have paid into Medicare their entire working lives will suddenly face AI-driven gatekeeping for procedures their doctors have deemed medically necessary. The program's structure creates a dangerous conflict of interest. AI companies participating in WISeR will receive a share of the savings generated from rejected claims. This financial incentive to deny care mirrors the worst aspects of private insurance prior authorization, which the American Medical Association has documented causes significant delays and denials of necessary medical treatment. When profit depends on saying no to patient care, the system is fundamentally broken. Traditional Medicare has long been valued for its straightforward coverage without the bureaucratic barriers common in private insurance. The WISeR pilot threatens to erode this critical distinction. Patients facing serious health conditions cannot afford delays while an algorithm reviews their doctor's judgment. These delays can lead to worsening conditions, increased suffering, and potentially irreversible harm. I ask that you take immediate action to oppose and work toward canceling the WISeR pilot program before its January 2026 implementation. Medicare beneficiaries deserve healthcare decisions made by their physicians, not by AI systems financially motivated to deny coverage. Please protect the integrity of Medicare and the health of millions of Americans who depend on it.

▶ Created on March 7 by Griffin

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