The Trump administration’s WISeR program is bringing AI-determined denials to traditional Medicare in six states
FOR IMMEDIATE RELEASE
Baton Rouge, LA — Nov. 17, 2025 — South Louisiana author Jeremy White’s latest memoir, “InHumana: An American Healthcare Story,” reveals the sort of horrors coming to traditional Medicare beneficiaries in six states next year from a new federal initiative employing artificial intelligence to deny prior authorization for several common medical treatments.
Thanks to the Wasteful and Inappropriate Service Reduction (WISeR) Model from the Centers for Medicare & Medicaid Services (CMS), millions of traditional Medicare beneficiaries in New Jersey, Ohio, Washington, Texas, Arizona, and Oklahoma will be subjected to the scourge of AI-driven denials. Starting Jan. 1, at least 17 categories of medical services will be affected by WISeR, including several common treatments like epidural steroid injections for pain management, electrical nerve stimulator implants, and incontinence control devices.
“‘InHumana’ poignantly illustrates just one of the countless horror stories that Medicare Advantage Plans and their AI-fueled denials force seniors and their families to endure,” White says. “Originally, I hoped ‘InHumana’ would encourage beneficiaries to stick with traditional Medicare to avoid such AI-driven denials, but WISeR may make that argument moot.”
“The AI companies selected to oversee the program would have a strong financial incentive to deny claims. Medicare plans to pay them a share of the savings generated from rejections.”
Critics have deemed WISeR “AI death panels” for seniors, particularly because CMS’s tech partners stand to directly profit from the denials. As “The New York Times” reported, “The AI companies selected to oversee the program would have a strong financial incentive to deny claims. Medicare plans to pay them a share of the savings generated from rejections.”
While CMS has characterized WISeR as a “voluntary” program, “the voluntary element applies to technology vendors,” which CMS defines as “‘participants,’ rather than to healthcare providers,” according to the consulting firm Applied Policy. “Although providers are not required to submit prior authorization requests,” the firm reported in August, “payment for the designated services cannot be secured without either prior authorization approval or successful passage through prepayment review.”
U.S. Sen. Patty Murray, of Washington, described it as a “backdoor move” to privatize Medicare in a way that draws minimal attention.
Since the pilot program requires zero congressional approval, WISeR represents the slow-boil method of achieving one of Project 2025’s main goals. U.S. Sen. Patty Murray, of Washington, described it as a “backdoor move” to privatize Medicare in a way that draws minimal attention. On Nov. 7, six members of Congress, including two physicians, introduced the Seniors Deserve SMARTER (Streamlined Medical Approvals for Timely, Efficient Recovery) Care Act to repeal the WISeR model.
“‘InHumana’ reveals how the war we waged on my mom’s behalf is one that frighteningly few Medicare Advantage Plan members like her bother fighting when companies like Humana deny coverage,” White explains. “Out of the millions of denials for prior authorization by Medicare Advantage Plans each year, fewer than 10% of such denials are appealed, yet 90% of appeals are successful. While the 10% figure illustrates how difficult it is for ailing Davids to fight off Goliath’s heel from their frail necks, the 90% overturn rate screams how wrong the denials are in the first place.”
“InHumana: An American Healthcare Story” is available as an audiobook, ebook, and 172-page paperback. All three versions are available through a host of booksellers, including hundreds of independent bookstores across the country, all listed and mapped on InHumanaBook.com. For more information and resources, visit our media center. Inquiries should be emailed to media [at] redstickcomedy [dot] com.
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