Landsman Calls for Immediate End to AI Medicare Denials
Cincinnati, OH – This week, Congressman Greg Landsman (D-OH) is calling for the immediate end of the use of artificial intelligence (AI) to deny Medicare claims and for a Government Accountability Office (GAO) investigation into the WISeR (Wasteful and Inappropriate Service Reduction) Model.
Recently, a digital rights watchdog group published a report after obtaining 1,000 pages of records from the Centers for Medicare and Medicaid Services (CMS) on the WISeR Model. The AI model is being tested in six states, including Ohio, to handle prior authorization for certain Medicare procedures.
In light of these findings, Congressman Landsman is calling for the immediate end of the use of AI to deny Medicare claims and for a GAO investigation into the WISeR Model over serious concerns, such as:
- Prior authorization exceeding the federal 72-hour response requirement.
- A prior authorization request going unanswered for 83 days.
- Providers reporting vendors are not returning phone calls.
- Thousands of Medicare claims denied.
- Confirms WISeR’s financial incentive to deny care.
The report also reveals CMS’s plans to expand the WISeR Model to all 50 states and add services to its prior authorization list, such as:
- Cancer care
- Life Flight
- Pacemakers
- Imaging
- Lab testing
This week, Landsman sent a letter to the CEO and cofounder of Innovaccer Inc. – the Ohio vendor administering the WISeR Model – requesting a detailed report on approval and denial rates, response times, technical issues, and financial benefits.
Congressman Landsman’s letter reads, in part:
“Recent documents released through a FOIA request show major issues with the WISeR model. These documents show long delays, high denial rates, and technical failures that are directly affecting seniors and medically vulnerable patients.
“These extreme delays have caused serious and preventable harm to patients across Ohio. No patient should be left suffering due to this administrative dysfunction.
“Innovaccer must address these concerns immediately to prevent any further patient harm.”
Congressman Landsman introduced legislation in late 2025 and, in May 2026, led a Congressional Review Act resolution to end the use of the WISeR Model.
Read the full letter here.
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