“WISeR vendors failed to respond within 72 hours for a significant number of requests. One status report cites a prior authorization request that went unanswered for 83 days.”
CMS put an AI in front of Medicare care approvals and called it waste reduction. Two vendors denied over 20,000 requests in three months, and one patient waited 83 days for an answer on a 72-hour clock. The vendors get paid a cut of what they deny, which tells you exactly what the model was optimized for. It took a thousand pages of FOIA’d documents to learn any of this.