WISeR: Medicare Now Uses AI for Prior Authorization in Six States. Here’s What Practices Need to Know.
For the first time, traditional Medicare is running AI-assisted prior authorization — in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington, through 2031. Early records show thousands of denials, an 83-day wait, and one vendor put on a corrective action plan, while Congress weighs repeal. This guide covers which services are affected, how the two submission paths work, what the first-year data shows, and a playbook for practices in and out of the six states.
MedVersify Editorial
October 9, 2026










