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Medicare's AI prior authorization program causes delays and errors for patients and doctors

By

KFF Health News

7h ago· 9 min readenNews

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

bskyMedicare's AI prior authorization program causes delays and errors for patients and doctorsdailynews.com

Key quotes

· 3 pulled
In 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.
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A pilot program testing the use of preapprovals in traditional Medicare is using artificial intelligence.

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