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Friday, September 25, 2026

Vendors rolling out AI have an "incentive to deny as many claims as possible."

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Hospitals are using AI to submit insurance claims, insurance companies are using AI to dispute or deny them, and costs are up for everyone under this broken system. No more AI denials. No more unnecessary administrative costs. We need Medicare for All.

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-- Congresswoman Pramila Jayapal (@jayapal.house.gov) 1:30 PM · Sep 25, 2026

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More from the article ...

... In January, the Trump administration rolled out a pilot program that uses artificial intelligence to authorize or deny certain types of care for patients with Medicare -- a federal healthcare program for seniors that previously hasn't required doctors to get any such pre-approval, called prior authorization.

Not long after, media outlets began relaying the disastrous outcomes: technical difficulties, long delays in decisions and care, puzzling denials, frustrated doctors, and patients suffering in pain. Those reports were largely confirmed earlier this month when the Electronic Frontier Foundation released a tranche of federal documents about the program, called WISeR, that the group obtained amid litigation.

The documents included feedback from healthcare providers, including one who called the program "a disgrace to the human race" and reported seeing patients crying in pain as they waited for care.

Amid the worrying reports, lawmakers have been trying to get answers and shut the program down. Meanwhile, the Government Accountability Office determined in May that Trump officials did not follow proper procedure in setting up the program, calling its legality into question. Still, it appears to be moving ahead unabated, with plans to expand in the years to come.

Last week, Rep. Suzan DelBene (D-Wash.) called a committee vote to try to get the Trump administration to release more documents about WISeR, but Republicans voted the effort down. ...


#1 | Posted by LampLighter at 2026-09-25 01:27 PM | Reply

Vendors rolling out AI have an "incentive to deny as many claims as possible."

Well, in Canada, which has universal healthcare, they just off them; they off more than there are gun murders in the US.

People just don't seem to understand how resources work. So they overpromise, and then have to underdeliver.

People will always be denied when there is a finite resource.

#2 | Posted by oneironaut at 2026-09-25 03:08 PM | Reply

People just don't seem to understand how resources work. So they overpromise, and then have to underdeliver.

People will always be denied when there is a finite resource.

Thanks capitalism!

#3 | Posted by ClownShack at 2026-09-25 03:29 PM | Reply

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