GOP blocks effort to end Medicare test of AI prior authorization

STAT News – Friday, July 17, 2026
By John Wilkerson

WASHINGTON — A Senate vote to halt a Medicare pilot that uses artificial intelligence to approve or deny care failed along party lines on Thursday.

Republicans voted to block consideration of a Democratic-led measure, which would have stopped the Trump administration from employing prior authorization in original Medicare, where the practice is rarely allowed. The vote was 46 to 50.

The White House had pushed back against the Democratic bill.

Medicare officials gave a handout to lawmakers’ offices on Tuesday outlining what they say are the benefits of the test, known as WISeR.
On the other hand, the American Medical Association opposes the pilot program, as do many seniors groups, including the AARP.

Plus, GOP senators have leveled plenty of scrutiny at the practice of prior authorization recently, particularly in Medicare Advantage plans. On Wednesday, Republicans and Democrats on a House committee passed a bill to rein in prior authorization in Medicare Advantage and require private MA plans to report their approval and denial rates to government regulators.

Senate Finance Committee Chair Mike Crapo (R-Idaho) defended the Medicare pilot program. He said it tests whether value-based payment arrangements curb wasteful spending on a limited set of nonemergency services with a documented history of overuse.

“Claims that meet existing Medicare coverage requirements are quickly approved,” Crapo said. “When issues arise, board-certified clinicians — not technological machines, board-certified clinicians — intervene to make the final decision.”

Democrats are likely to use Thursday’s vote to attack Republicans over health care.

“Many seniors choose traditional Medicare over other options because traditional Medicare rarely requires prior authorizations,” said Sen. Patty Murray (D-Wash.), a sponsor of the bill to stop the WISeR program.

“Thanks to Trump, AI is getting between seniors and their health care.”

Medicare in January launched the pilot, called the Wasteful and Inappropriate Service Reduction (WISeR) Model, which uses artificial intelligence to approve or deny care in original Medicare.

Private insurers in Medicare Advantage and Part D often require prior authorization to see specialists, to fill certain prescriptions, or to get services from out-of-network providers or for nonemergency hospital care.

But the practice has rarely been used in original Medicare. By law, prior authorization is only allowed in original Medicare for some outpatient services, certain medical equipment intended for home use, and nonemergency ambulance service.

The WISeR pilot waives that ban for 15 specific outpatient services and items, including skin and tissue substitutes, electrical nerve stimulator implants, and knee arthroscopy for knee osteoarthritis. The six-year program is being run in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.

A report by Sen. Maria Cantwell (D-Wash.) found that hospitals in Washington said their Medicare patients were waiting two to four times longer in some cases for procedures that are now subject to prior authorization under the program.

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