Federal Documents Expose Failures of Medicare's AI Prior Authorization Pilot

Federal records released earlier this month confirm that a Trump administration pilot program using artificial intelligence to authorize or deny care for Medicare patients has produced long delays, puzzling denials, and patients left suffering in pain.

The program, called WISeR, launched in January. It applies AI-driven prior authorization to certain types of care for Medicare patients — a federal healthcare program for seniors that previously never required doctors to obtain any such pre-approval.

The consequences surfaced quickly. Media outlets reported technical difficulties, long delays in decisions and care, baffling denials, exasperated doctors, and patients waiting in pain for approvals, according to reporting by MarketWatch, KJZZ, Medscape, and The Seattle Times.

Documents confirm the reports

The Electronic Frontier Foundation (EFF) obtained a tranche of federal documents about the program through litigation and published them in September. The records, which include feedback from healthcare providers, largely confirm the earlier media accounts.

One provider quoted in the documents called the program "a disgrace to the human race." The same provider reported seeing patients crying in pain as they waited for care.

The release gives the public the most direct view yet into how the pilot operates internally, and it grounds anecdotal reporting in the government's own records.

Lawmakers push back

Congressional lawmakers have been trying to get answers and shut the program down. Representative Suzan DelBene sent a letter seeking information in June 2026, and in May Democrats forced a House vote on ending the pilot, according to Stat News.

The Government Accountability Office (GAO) weighed in the same month. In May, the GAO determined that Trump administration officials did not follow proper procedure when setting up the program, a finding that calls the program's legality into question.

Despite the GAO determination, the legislative attempts, and the mounting evidence of patient harm, the program continues to operate. It is moving ahead unabated, with plans to expand in the years to come.

Why it matters

Medicare covers tens of millions of seniors, and prior authorization has long been a flashpoint in American healthcare over delayed treatment and administrative burden. WISeR extends that mechanism to a population that never faced it before — and hands the decision to an AI system with a documented record of technical failures and opaque denials in its first months.

The episode is also emerging as a test case for how federal agencies deploy AI in high-stakes administrative decisions. A GAO finding that the program was set up improperly, combined with provider accounts of patients in pain, sets up a direct confrontation between the administration's expansion plans and Congress's oversight authority.

With Democrats already forcing votes and the EFF's documents now public, the pressure on WISeR will likely intensify as the administration pushes toward expansion.