Private health insurers use AI to approve or deny care. Soon Medicare will, too.
Source: NBC News
Sept. 24, 2025, 5:00 AM EDT
Taking a page from the private insurance industrys playbook, the Trump administration will launch a program next year to find out how much money an artificial intelligence algorithm could save the federal government by denying care to Medicare patients.
The pilot program, designed to weed out wasteful, low-value services, amounts to a federal expansion of an unpopular process called prior authorization, which requires patients or someone on their medical team to seek insurance approval before proceeding with certain procedures, tests, and prescriptions. It will affect Medicare patients, and the doctors and hospitals who care for them, in Arizona, Ohio, Oklahoma, New Jersey, Texas, and Washington, starting Jan. 1 and running through 2031.
The move has raised eyebrows among politicians and policy experts. The traditional version of Medicare, which covers adults 65 and older and some people with disabilities, has mostly eschewed prior authorization. Still, it is widely used by private insurers, especially in the Medicare Advantage market.
And the timing was surprising: The pilot was announced in late June, just days after the Trump administration unveiled a voluntary effort by private health insurers to revamp and reduce their own use of prior authorization, which causes care to be significantly delayed, said Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services. It erodes public trust in the health care system, Oz told the media. Its something that we cant tolerate in this administration.
Read more: https://www.nbcnews.com/health/health-care/private-health-insurers-use-ai-approve-deny-care-soon-medicare-will-rcna233214

hlthe2b
(111,495 posts)to do so. I always wonder why AARP is still around, given that they have done NOTHING to support their older constituency against the attacks on Social Security and Medicare for decades now against RW assaults. Sadly, a lot of older people are not computer literate nor understanding of the risks AI can render.
It behooves ALL of us to fight back on this. Call Congress.
Bengus81
(9,450 posts)Musk and their attacks on Medicaid,Medicare and SS. My sub runs out in 2026 and that will be that. Pretty soon they'll start running articles on steps people can take to like on less SS and NO Medicare.
gab13by13
(29,877 posts)Call it what you like, eugenics, like Hitler's master race, depopulation, genocide, the people behind Project 2025 want to murder millions of people here and around the world.
That Big Ugly Death Bill is going to kill or shorten the lives of unwashed Americans. When the next Covid or other disaster hits, the rich can afford a medical cocktail for treatment, we unwashed Americans will be told to take horse paste or drink bleach, or shove ultraviolet lamps up our asses.
not fooled
(6,478 posts)Krasnov has been quoted saying this. I have no doubt that's their goal. Attrition + targeted neglect are the means.
Marthe48
(21,934 posts)And that started out as a guideline for doctors
twodogsbarking
(15,980 posts)AI can tell us.
IronLionZion
(49,971 posts)OldBaldy1701E
(9,135 posts)Making sure that your insurance company-owning friends have precedence for making their AI's even tougher on 'approving' anything, eh?
I can hear them plotting now.
"Since the Feds can do it..."
IronLionZion
(49,971 posts)Saving money by denying care. And then give big tax cuts to billionaires.
Make intelligence real again
Scalded Nun
(1,514 posts)Last edited Wed Sep 24, 2025, 12:01 PM - Edit history (2)
As stated above, you can program AI to give you exactly the result you want it to give you.
You can also be assured that it will be perverted by those who control its programming.
Attilatheblond
(7,336 posts)CEOs pick decision makers who make shareholders happy then shareholders make CEOs happy. It's a circle jerk that costs lives.
slightlv
(6,619 posts)Elderly and need cancer care? Drug costs too high for your autoimmune disease? Cost Benefit Ratio AI's say it's cheaper just to let you die. Brave New World, people.
LatteLady
(85 posts)The government could use AI to improve patient outcomes. But no. Its all about the $$$ while billionaires get tax cuts.
Im especially concerned because many chronic conditions seen in older adults cannot be cured and have to be managed long term. Will they define tests and treatments that do not cure to be wasteful?
Also worried that the high variability in response to treatments seen in groups of older adults means that the average response to a treatment may be used for AI decision making despite being accompanied by subgroups of patients that respond very well. Will all older adults, including those individuals who might really benefit, be denied a certain treatment because the average response is not stellar?
Also worried that theyre very aware Medicare would save a lot of money if older people would just die versus needing health care.
area51
(12,451 posts)Delphinus
(12,446 posts)my quota for bad news was done for the day ...