Wasteful and Inappropriate Service Reduction AI Pilot Program

planned

Prospective

A federal AI pilot program called Wasteful and Inappropriate Service Reduction is being implemented in six U.S. states to incorporate artificial intelligence into Medicare coverage decisions. The program introduces AI-based prior authorization for outpatient procedures considered low-value services, aiming to reduce fraud and waste. It requires traditional Medicare recipients to obtain prior approval from private contractors before accessing certain treatments, a significant change from the previous 60 years without prior authorization in traditional Medicare.

Newsweek

Project

Government