Medicare's AI prior authorization program causes delays and errors for patients and doctors
By
KFF Health News
Summary
A KFF Health News investigation into Medicare's new AI-driven prior authorization pilot program, which is causing significant delays, errors, and burdens for both patients and doctors. The article follows Bill Curry, a 65-year-old cattle rancher in Oklahoma, who had to make multiple long drives for a routine spinal epidural due to unexpected preapproval requirements. The piece examines how the AI system, intended to streamline approvals, has instead created confusion, denied necessary care, and added administrative strain on medical practices, raising concerns about the technology's readiness and impact on patient access to care.
Source
Key quotes
· 3 pulledIn February, during one trip, he was told unexpectedly that he needed preapproval for the procedure. Then he went again a month or so later to get the injection, for a total of 10 hours on the road.
His clinic wanted him to...
A pilot program testing the use of preapprovals in traditional Medicare is using artificial intelligence.
You might also wanna read
Medicare's ACCESS program creates first federal payment mechanism for AI-driven patient care
Medicare's new ACCESS program, launching July 5, creates a payment mechanism for AI-driven medical care at federal scale. Pair Team, a healt
Physicians Face Liability Risks as AI Diagnostic Tools Enter Clinical Medicine
This article examines the trust gap between physicians and AI diagnostic tools in clinical medicine. While AI can analyze vast datasets and

Utah Pilot Program Allows AI Chatbot to Prescribe Psychiatric Medications
Utah has launched a one-year pilot program allowing Legion Health's AI chatbot to renew certain psychiatric medication prescriptions without
CMS Head Dr. Oz Proposes AI Avatars for Rural Healthcare, Faces Criticism
Dr. Mehmet Oz, head of the Centers for Medicare and Medicaid Services, is advocating for AI avatars as a solution to rural healthcare shorta
Why patients should be cautious about AI scribing systems in medical appointments
Emily M. Bender and Decca Muldowney argue against the use of AI-powered automatic scribing systems in healthcare settings. The article detai
buttondown.com·2mo agoAI Chatbots Fill Healthcare Gaps for Chinese Patients Seeking Medical Advice and Companionship
The article explores how patients in China, particularly elderly and chronically ill individuals, are turning to AI chatbots like DeepSeek f

Comments
Sign in to join the conversation.
No comments yet. Be the first.