Medicare official says parts of AI prior-authorization pilot are not working

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A senior Medicare official said Oct. 15 that "there are a lot of things about WISeR that are not working," referring to the agency's pilot of artificial intelligence-supported prior authorization in six states, Nextgov/FCW reported.

Kimberly Brandt, a deputy administrator of the Centers for Medicare & Medicaid Services, made the remark at a conference in Santa Fe, New Mexico, where her slides said the technology requires continuous oversight and that human clinical review is essential. Elsewhere, the Food and Drug Administration cleared an automated insulin pump for adults with insulin-treated type 2 diabetes, and three health systems said they have ended or are ending hospital-at-home programs.

In this episode

• CMS deputy administrator says "a lot of things" about WISeR, Medicare's AI prior-authorization pilot, are not working
• Cone Health, Health First and Covenant Health end hospital-at-home programs although Medicare's waiver runs through 2030
• FDA clears Sequel's twiist automated insulin delivery system for adults with insulin-treated type 2 diabetes
• Digital GLP-1 program in UK reports 15.5% average weight loss and 91.4% retention among 8,127 women at six months, Nature Medicine study finds
• Otter Health raises $8 million for software that checks care decisions against evidence in place of prior authorization