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Senate Republicans blocked an attempt by Democrats on Thursday to stop a Trump administration pilot program for Medicare that uses artificial intelligence to approve or deny physician-ordered care.
The vote on a resolution to invoke the Congressional Review Act (CRA) and end the program failed on party lines, 46 to 50. CRA votes need a simple majority to pass.
Last year, the Centers for Medicare and Medicaid Services (CMS) launched an experiment to use artificial intelligence to approve or deny select medical services for Medicare beneficiaries in six states. That practice, known as prior authorization, is rarely allowed in traditional Medicare.
The experiment is called the WISeR (Wasteful and Inappropriate Service Reduction) Model. It began on Jan. 1 and is set to last for six years.
It puts prior authorization requirements in place for specific types of services or items, including skin and tissue substitutes, electrical nerve stimulator implants and knee arthroscopy for osteoarthritis.
CMS has said the pilot is an important experiment to test ways to save taxpayer dollars and prevent services that aren’t needed.
Private insurers in Medicare Advantage (MA) often require prior authorization for specialist visits, certain prescriptions or to get services from out-of-network providers. But the practice is allowed in traditional Medicare only for some outpatient physician services and medical equipment.
“It is bad enough that this is the state of affairs in Medicare Advantage, but now the Trump administration is trying to import insurance company tactics into traditional Medicare,” said Sen. Ron Wyden (D-Ore.).
Thursday’s Senate vote was an attempt by Democrats to force Republicans to defend a policy that’s widely unpopular with voters.
“I don’t know any senior, Republican or Democrat, who asked President Trump to let AI decide if their doctor-recommended treatment was necessary,” Sen. Patty Murray (D-Wash.) said Thursday.
Lawmakers are scrutinizing the practice in Medicare Advantage plans. Legislation to streamline MA plan prior authorization unanimously cleared the House Ways and Means Committee Wednesday.
A report from Sen. Maria Cantwell (D-Wash.) argued prior authorization increased wait times for certain procedures. Patients dealing with WISeR were waiting two to four times longer to get the care recommended by their doctors, from a previous average of around two weeks to between four to eight weeks.
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