Is Medicare WISeR model working?
The Medicare WISeR (Wasteful and Inappropriate Service Reduction) Model is a six-year Medicare initiative, starting January 1, 2026, that uses
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AI Powered Prior Authorization
4 recommendations to bring oversight to AI-driven prior auth: MACPAC
(By: Elizabeth Casolo for Becker’s Hospital Review) The Medicaid and CHIP Payment and Access Commission approved recommendations to boost transparency with
Read MoreRegulation of AI in Prior Authorization and Claims Review: A Look at Federal and State Consumer Protections
(Authors: Kaye Pestaina, Rayna Wallace, Michelle Long, and Justin Lo for The Kaiser Family Foundation Published: May 6, 2026) Rapid
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Louisiana bill would require human review of AI-driven coverage denials
(By: Jakob Emerson for Becker’s Hospital Review) Louisiana lawmakers are advancing a bill that would restrict how payers use AI
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Alabama bill would restrict insurers’ use of AI in prior authorization decisions
(By: Jakob Emerson for Becker’s Hospital Review) The Alabama Senate has passed legislation that would impose new requirements on insurers that
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Optum rolls out AI-powered prior authorization tools for payers, providers
(By: Jakob Emerson for Becker’s Hospital Review) Optum has launched a pair of AI-driven prior authorization products, one designed to
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