AI Will Soon Have a Say in Approving or Denying Medicare Treatments

(By Lauren Sausser and Darius Tahir for KFF Health News)

Taking a page from the private insurance industry’s playbook, the Trump administration will launch a program next year to find out how much money an artificial intelligence algorithm could save the federal government by denying care to Medicare patients.

The pilot program, designed to weed out wasteful, “low-value” services, amounts to a federal expansion of an unpopular process called prior authorization, which requires patients or someone on their medical team to seek insurance approval before proceeding with certain procedures, tests, and prescriptions. It will affect Medicare patients, and the doctors and hospitals who care for them, in Arizona, Ohio, Oklahoma, New Jersey, Texas, and Washington, starting Jan. 1 and running through 2031. Continue reading here…

Kaiser Health News is a nonprofit national health polity news service that is part of the nonpartisan Henry J. Kaiser Family Foundation

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