AI-driven prior authorization: New ‘WISeR’ CMS model is right around the corner

The CMS model Wasteful and Inappropriate Service Reduction (WISer) will leverage AI and other enhanced technologies (e.g., machine learning and algorithmic decision logic) to expedite the prior authorization process for these items and services with the goal of reducing inappropriate utilization, lowering spending in Original Medicare, expediting decision making, and easing provider administrative burden. Here’s what you can expect from CMS’ WISeR model for AI-driven prior authorization.