In a recent piece on radio station KGOU in Oklahoma, Jillian Taylor addressed the Wasteful and Inappropriate Service Reduction Model, or WISeR, a program being tested in six states, including Oklahoma, as of January this year. The program uses private companies with AI tools to process prior authorizations for, and reduce spending on, over a dozen treatments under traditional Medicare. Prior authorization has long been used by private insurance companies, including Medicare Advantage plans, to deny care, but this is the first widespread use in traditional Medicare. Oklahoma providers and patients are apprehensive about WISeR’s payment model and how the program could impact access to care for the nation’s growing aging population. CMA Co-Director David Lipschutz says there’s a huge disconnect between this program efforts to reform prior authorization. He recently testified before a Congress in support of legislation that would prevent testing WISeR and models like it under traditional Medicare.
- Read and listen to the full story at www.kgou.org/health/2026-01-15/as-ai-becomes-part-of-traditional-medicare-reviews-some-oklahomans-worry-theyll-lose-out-on-care