Wyden, Senate Democrats Take Action to Roll Back Trump AI Care Denial Experiment on Seniors

Wyden, Senate Democrats Take Action to Roll Back Trump AI Care Denial Experiment on Seniors

Introduction of Congressional Review Act Resolution to End Controversial WISeR Model in Traditional Medicare Marks First Step Towards Forcing a Vote On Experimental Prior Authorization Scheme

Summary of the Resolution (PDF)

Washington, D.C. - Senate Finance Committee Ranking Member Ron Wyden (D-OR) and Senators Patty Murray (D-WA), Maria Cantwell (D-WA), Richard Blumenthal (D-CT), and Kirsten Gillibrand (D-NY) led 20 Senate Democrats as they introduced a resolution to invoke the Congressional Review Act and end an experiment launched by the Trump administration that allows artificial intelligence to conduct prior authorization and profit from denying seniors' medical claims in Traditional Medicare.

"Americans are sick and tired of abusive prior authorization tactics putting needed health care out of reach," Wyden said. "The last thing seniors need is even more AI denying the care they need. Forcing a vote on this ill-conceived experiment will show the American people that Democrats are on the side of seniors and families who want timely access to health care while Republicans want to import the worst abuses by insurance companies that Americans loathe into Traditional Medicare."

Last year, the Centers for Medicare & Medicaid Services (CMS), led by Administrator Mehmet Oz, launched an experiment to use "enhanced technologies, such as Artificial Intelligence (AI) and Machine Learning (ML)" to approve or deny select medical services for Medicare beneficiaries in six states. This experiment is called the WISeR (Wasteful and Inappropriate Service Reduction) Model.

In September, Wyden, Gillibrand and Blumenthal led an effort to call on the Trump administration to halt this experiment. In December, Murray, Wyden and Gillibrand introduced legislation that would prohibit CMS from implementing WISeR. Last month, Cantwell released a snapshot report describing the impact of care delays and denials on seniors.

Last week, the Government Accountability Office (GAO) released a determination that the WISeR model is subject to the Congressional Review Act, following a request from Senate Democrats. This determination starts a 60 day period during which Democrats can force a vote on the resolution of disapproval to repeal the WISeR model.

The text of the resolution is here. A summary of the resolution is here. A House companion resolution was introduced by Representatives Greg Landsman (D-OH) and Suzan DelBene (D-WA).

Additional Senate co-sponsors of the resolution include Senators Ruben Gallego (D-AZ), Mark Kelly (D-AZ), Cory Booker (D-NJ), Ed Markey (D-MA), Tammy Duckworth (D-IL), Tammy Baldwin (D-WI), Andy Kim (D-NJ), Bernie Sanders (I-VT), Elizabeth Warren (D-MA), Mark Warner (D-VA), Tina Smith (D-MN), Ben?Ray?Luján (D-NM), Jeff Merkley (D-OR), and Dick Durbin (D-IL).

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