EFF sued the government back in March for information about the Wasteful and Inappropriate Service Reduction (WISeR) model, a new Medicare program that uses AI to evaluate prior authorization requests for certain medical services… The documents (available here) show that WISeR has resulted in widespread delays and denials of care, operational chaos, and reports of patient harm.
As someone not entirely against AI: No fucking shit. AI is terrible at reasoning and judgement.
Prior Authorization is a problem, not just AI. It’s supposed to be a solution for when doctors do things like order MRIs for every patient at imaging centers they own or get kickbacks from.
But we have a method to deal with that already and it’s called arrest and trial. Why is the solution make sick people wait for paperwork? The majority of these services are appropriate.
The article mentioned they were considering adding the need for prior auth for air ambulance transport.
…the fuck?
Fuck prior authorization and fuck letting insurance companies deny claims at all! We paid for our god damned insurance, being allowed to use it should be a right, not a vaunted privilege that can be fraudulently ripped away while we die with no recourse after a lifetime of paying exorbitant rates!
Even when people “win” their appeals, the delay in care can be enough to kill them. Shit, the stress alone is insane.
