Donald Trump claims he is Making America Great Again, which, in practice, often seems like a euphemism for making life harder, costs higher, and services slower. When it comes to public programs, the White House appears determined to make long-standing social welfare systems—like Social Security and Medicare—far less accessible and helpful.
The latest example came this week with the announcement of a new pilot program from the Centers for Medicare and Medicaid Services. According to the New York Times, the pilot, set to launch next year in six states, will use artificial intelligence software to judge whether certain medical services are “appropriate” or not. In a press release on CMS’s website that feels almost absurdly optimistic, the agency states that the program will “Target Wasteful, Inappropriate Services in Original Medicare.” It reads:
The Centers for Medicare & Medicaid Services (CMS) is announcing a new Innovation Center model aimed at helping ensure people with Original Medicare receive safe, effective, and necessary care.
Because, of course, unnecessary care would be a catastrophe, right? The press release goes on:
Through the Wasteful and Inappropriate Service Reduction (WISeR) Model, CMS will partner with companies specializing in enhanced technologies to test ways to provide an improved and expedited prior authorization process relative to Original Medicare’s existing processes, helping patients and providers avoid unnecessary or inappropriate care and safeguarding federal taxpayer dollars.
Prior authorization is the process where medical providers must check with insurance companies before delivering certain services. Usually, people on Original Medicare don’t have to deal with this, but for those on Medicare Advantage, prior authorization is a constant hassle. Now, recipients of Original Medicare will face it too under this pilot. AI algorithms will decide if the care they receive counts as a worthy use of “federal taxpayer dollars.” And, naturally, the government frames this as a generous improvement. The release adds:
The WISeR Model will test a new process on whether enhanced technologies, including artificial intelligence (AI), can expedite the prior authorization processes for select items and services that have been identified as particularly vulnerable to fraud, waste, and abuse, or inappropriate use.
The New York Times points out that similar algorithms have already faced litigation and notes that the AI companies involved “would have a strong financial incentive to deny claims.” The pilot has already earned the nickname “AI death panels.” Gizmodo reached out to the government for further details.
