Landsman, Watson Coleman Introduce Bill to Prohibit AI Model from Denying Medicare Procedures

Cincinnati, OH – Today, Congressman Greg Landsman (D-OH-01) and Congresswoman Bonnie Watson Coleman (D-NJ-12) introduced legislation to prohibit an Artificial Intelligence model from delaying or denying Medicare procedures. 

The U.S. Department of Health and Human services recently announced its plan to test an Artificial Intelligence (AI) model to handle prior authorization for certain procedures under traditional Medicare. The WISeR (Wasteful and Inappropriate Service Reduction) Model will be tested in six states: Ohio, New Jersey, Oklahoma, Texas, Arizona, and Washington.

Currently, most procedures under Medicare Part B do not require prior authorization.

Congressman Landsman and Congresswoman Watson Coleman introduced the Ban AI Denials in Medicare Act – legislation to prohibit the Department of Health and Human Services from testing the WISeR model and from using other models that would be used for prior authorization under Medicare Parts A and B, including through AI. 

Social Security Works, Just Care USA, Center for Health and Democracy, and Public Citizen have endorsed the bill.
Congressman Landsman:

“Targeting Medicare, a program that tens of millions of seniors have paid into and rely on, is reckless. They shouldn’t have to worry about AI deciding whether they get the care they need. That’s between a patient and their doctor. The Trump Administration continues to make it challenging for hardworking Americans to access healthcare.”

Rachel Madley, PHD, Center for Health and Democracy:

“AI bots should not be able to decide if we get potentially life-saving surgery or not. Nor should an AI bot be able to determine if, or which, doctor we can see. That is why this legislation is so vital. We need to be reigning in prior authorization and make health care about patients, not profit margins. We should not be turning it over to AI. We applaud the introduction of this important legislation and urge Congress to act on it without delay.”

Diane Archer, Founder and CEO, Just Care USA:

“Members of Congress on both sides of the aisle have decried the misuse of prior authorization by corporate health insurers in Medicare Advantage. These insurers use prior authorization as a tool to maximize profits. In the process, they inappropriately delay and deny care, forcing their enrollees to gamble with their lives. By preventing prior authorization in Traditional Medicare, Rep. Landsman’s bill helps guarantee that Traditional Medicare’s enrollees get the care their treating physicians deem necessary.”

Read the full bill text here.

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