Medicare's new AI-driven prior authorization program, WISeR, is causing significant disruptions for patients and healthcare providers. The program, aimed at reducing fraud and misuse, has led to confusion, errors, and delays, with some describing it as 'horrendous'. The rapid rollout, announced in June 2025 and launched in January 2026, has caught doctors and patients off-guard, with many struggling to adapt. The program's focus on pre-approval for procedures like epidurals and kyphoplasties has created a backlog of appointments and payments, with some patients facing delays of up to eight weeks. The use of AI in the approval process has raised concerns about errors and 'hallucinations', with doctors suspecting that AI is making up information and causing denials. This has led to a surge in appeals, further delaying the process and increasing costs. The program's expansion beyond the initial 13 services is also a concern, with doctors predicting that prior authorization will become a standard part of healthcare, shifting costs to patients and doctors rather than saving money. The future of healthcare administration is at stake, and the impact on patients and providers is a critical issue that needs to be addressed.
