These AI models are being used at select clinics in Texas, New Jersey, Oklahoma, Ohio, Washington and Arizona. After launching in January 2026, a lawsuit was filed<\/a> against the Centers for Medicare and Medicaid Services (CMS), revealing a slew of issues within the first few months.\u00a0<\/p>\n The program\u2019s administrator, Dr. Mehmet Oz<\/a>, said WISeR would use AI to review Medicare requests for medical treatments<\/a> and services. This marks a major change, as original Medicare beneficiaries<\/a> rarely needed approval from their insurance to receive certain services.<\/p>\n \u201cTasking an algorithm with making determinations about treatment can create unwarranted \u2014 and even discriminatory \u2014 delays or denials of necessary medical care,\u201d EFF\u2019s director of AI and access-to-knowledge legal projects, Kit Walsh, said in a press release<\/a>.\u00a0<\/p>\n \u201cGiven these serious risks, the public requires transparency that it hasn\u2019t gotten. We\u2019re suing to get badly needed answers about how Medicare\u2019s AI experiment works,\u201d Walsh added.<\/p>\n While the government\u2019s goal is to reduce unnecessary medical services and any wasteful spending<\/a>, healthcare experts, providers and lawmakers are worried over the program\u2019s algorithm as there\u2019s little information on how it\u2019s being used \u2014 including the training data it relies on.\u00a0<\/p>\n Additionally, there are too many unknowns \u2014 leaving folks in the six states vulnerable and in limbo for necessary medical care.\u00a0<\/p>\n The EFF originally filed the lawsuit to force the government to disclose records showing how \u2014 or if \u2014 the systems were tested for accuracy, bias and AI-generated errors. Additionally, it\u2019s unclear whether or not the government audited or monitored the performance.<\/p>\n The suit also found a couple of other important issues \u2014 a major contrast in approval numbers and a financial incentive to deny care to those people.<\/p>\n On page five<\/a> of the 10-page lawsuit, the WISeR Model\u2019s AI systems were \u201cdenying care at disproportionately high rates.\u201d For example, the AI models in Texas approved care for just 62% of folks, while humans approved 84%.\u00a0<\/p>\n![\"A](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/10\/nurse-support-sad-senior-man-146542079.jpg\")
AI models across six states are denying Medicare patients care Clement Coetzee\/peopleimages.com \u2013 stock.adobe.com<\/p>\n![\"A](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/10\/146542093.jpg\")
Medicare patients in Texas were denied treatment by AI at a higher rate than humans G_stockerthailand \u2013 stock.adobe.com<\/p>\n