This week, Senator Maria Cantwell released a report outlining how the WISeR artificial intelligence model is eroding long-standing Medicare coverage practices by introducing AI-driven prior authorization requirements.
The findings are clear and concerning. Patients are waiting two to four times longer for procedures, with approvals that once took days now stretching into weeks. In some cases, decisions that were historically guided by physicians are now being delayed or overturned by third-party systems using artificial intelligence.
For providers, the impact is just as significant. Hospitals report growing administrative burdens, inconsistent denials, and a system that too often prioritizes process over patient needs. At its core, this model risks shifting care decisions away from clinicians and toward opaque algorithms, undermining timely access to medically necessary services.
WSHA strongly opposes the use of artificial intelligence in Medicare when it interferes with patient care. AI has an important role in advancing research and improving care delivery, but it should never be a barrier between patients and their doctors.
We applaud Sen. Cantwell for her leadership in raising these concerns at the federal level. During a recent Senate Finance Committee hearing, she highlighted WISeR’s real-world impacts, including delays and denials leaving patients waiting for care they used to receive without barriers. Her call for transparency and accountability reflects what hospitals across Washington are experiencing every day.
This week, WSHA members had the opportunity to meet with Sen. Cantwell in Washington, D.C. and thank her directly for her commitment to understanding this issue. Her engagement and advocacy are critical to ensuring Medicare continues to work for patients, not against them.
Sincerely,
Cassie Sauer
WSHA President & CEO
[email protected]