'AI Death Panels': Trump Pilot Program Seeks to Bring 'Very Worst' For-Profit Insurance Practices to Medicare
The administration, warned two union leaders, "is inserting private AI companies, which have a giant financial stake in the denial of care, into the doctor-patient relationship."
Creating what critics are equating to "AI death panels" elderly Americans in need of care, the Trump administration is launching a pilot program in six states that will use artificial intelligence to determine whether Medicare recipients should qualify for certain procedures.
As reported by The New York Times on Thursday, the pilot program will hire private firms to deploy AI to make what are known as "prior authorization" decisions regarding whether Medicare should pay for certain procedures, including spinal surgeries and steroid injections. The program is set to run first in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.
According to the paper, the program will rely on algorithms similar to those "used by insurers have been the subject of several high-profile lawsuits, which have asserted that the technology allowed the companies to swiftly deny large batches of claims and cut patients off from care in rehabilitation facilities."
The way the program is being structured will also give AI firms big incentives to maximize the denial of claims for Medicare recipients, as the Times reported that "Medicare plans to pay them a share of the savings generated from rejections."
Abe Sutton, the director of the Center for Medicare and Medicaid Innovation, emphasized in an interview with the Times that this program would not be used to review emergency services or hospital stays.
Even so, some experts and advocates have warned that this program risks bringing the same problems experienced by people who use private insurance to Medicare.
"It's basically the same set of financial incentives that has created issues in Medicare Advantage and drawn so much scrutiny," Ohio-based surgeon Dr. Vinay Rathi, who is also an expert in Medicare payment policies, explained to the Times. "It directly puts them at odds with the clinicians."
Jathan Sadowski, a senior lecturer and research fellow in the Emerging Technologies Research Lab at Monash University, also warned about private insurance practices creeping into traditional Medicare.
"The government is hiring companies using AI to make those determinations about healthcare," he wrote on X. "This is exactly the same tactic that private insurers like UnitedHealth use to delay and deny treatment."
The reported pilot program also drew harsh reviews from the American Federation of Teachers (AFT), as president Randi Weingarten and the union's Retirees Program and Policy Council co-chair Tom Murphy issued a joint statement accusing the Trump administration of "attempting to transform Medicare into the very worst of private insurance."
"Instead of making life easier and better for older Americans, this administration is introducing extra hurdles that are burdensome to patients and often get in the way of their desperately needed treatments," they said. "And the administration is inserting private AI companies, which have a giant financial stake in the denial of care, into the doctor-patient relationship."
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Creating what critics are equating to "AI death panels" elderly Americans in need of care, the Trump administration is launching a pilot program in six states that will use artificial intelligence to determine whether Medicare recipients should qualify for certain procedures.
As reported by The New York Times on Thursday, the pilot program will hire private firms to deploy AI to make what are known as "prior authorization" decisions regarding whether Medicare should pay for certain procedures, including spinal surgeries and steroid injections. The program is set to run first in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.
According to the paper, the program will rely on algorithms similar to those "used by insurers have been the subject of several high-profile lawsuits, which have asserted that the technology allowed the companies to swiftly deny large batches of claims and cut patients off from care in rehabilitation facilities."
The way the program is being structured will also give AI firms big incentives to maximize the denial of claims for Medicare recipients, as the Times reported that "Medicare plans to pay them a share of the savings generated from rejections."
Abe Sutton, the director of the Center for Medicare and Medicaid Innovation, emphasized in an interview with the Times that this program would not be used to review emergency services or hospital stays.
Even so, some experts and advocates have warned that this program risks bringing the same problems experienced by people who use private insurance to Medicare.
"It's basically the same set of financial incentives that has created issues in Medicare Advantage and drawn so much scrutiny," Ohio-based surgeon Dr. Vinay Rathi, who is also an expert in Medicare payment policies, explained to the Times. "It directly puts them at odds with the clinicians."
Jathan Sadowski, a senior lecturer and research fellow in the Emerging Technologies Research Lab at Monash University, also warned about private insurance practices creeping into traditional Medicare.
"The government is hiring companies using AI to make those determinations about healthcare," he wrote on X. "This is exactly the same tactic that private insurers like UnitedHealth use to delay and deny treatment."
The reported pilot program also drew harsh reviews from the American Federation of Teachers (AFT), as president Randi Weingarten and the union's Retirees Program and Policy Council co-chair Tom Murphy issued a joint statement accusing the Trump administration of "attempting to transform Medicare into the very worst of private insurance."
"Instead of making life easier and better for older Americans, this administration is introducing extra hurdles that are burdensome to patients and often get in the way of their desperately needed treatments," they said. "And the administration is inserting private AI companies, which have a giant financial stake in the denial of care, into the doctor-patient relationship."
- 'This Should Be a National Scandal': For-Profit Medicare Advantage Plans Using AI for Denials ›
- Outrage Over Trump Use of AI to Revoke Visas of Students Deemed 'Hamas Supporters' ›
- Trump Reportedly Picks Medicare Advantage Lobbyist for Top Health Budget Role ›
Creating what critics are equating to "AI death panels" elderly Americans in need of care, the Trump administration is launching a pilot program in six states that will use artificial intelligence to determine whether Medicare recipients should qualify for certain procedures.
As reported by The New York Times on Thursday, the pilot program will hire private firms to deploy AI to make what are known as "prior authorization" decisions regarding whether Medicare should pay for certain procedures, including spinal surgeries and steroid injections. The program is set to run first in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.
According to the paper, the program will rely on algorithms similar to those "used by insurers have been the subject of several high-profile lawsuits, which have asserted that the technology allowed the companies to swiftly deny large batches of claims and cut patients off from care in rehabilitation facilities."
The way the program is being structured will also give AI firms big incentives to maximize the denial of claims for Medicare recipients, as the Times reported that "Medicare plans to pay them a share of the savings generated from rejections."
Abe Sutton, the director of the Center for Medicare and Medicaid Innovation, emphasized in an interview with the Times that this program would not be used to review emergency services or hospital stays.
Even so, some experts and advocates have warned that this program risks bringing the same problems experienced by people who use private insurance to Medicare.
"It's basically the same set of financial incentives that has created issues in Medicare Advantage and drawn so much scrutiny," Ohio-based surgeon Dr. Vinay Rathi, who is also an expert in Medicare payment policies, explained to the Times. "It directly puts them at odds with the clinicians."
Jathan Sadowski, a senior lecturer and research fellow in the Emerging Technologies Research Lab at Monash University, also warned about private insurance practices creeping into traditional Medicare.
"The government is hiring companies using AI to make those determinations about healthcare," he wrote on X. "This is exactly the same tactic that private insurers like UnitedHealth use to delay and deny treatment."
The reported pilot program also drew harsh reviews from the American Federation of Teachers (AFT), as president Randi Weingarten and the union's Retirees Program and Policy Council co-chair Tom Murphy issued a joint statement accusing the Trump administration of "attempting to transform Medicare into the very worst of private insurance."
"Instead of making life easier and better for older Americans, this administration is introducing extra hurdles that are burdensome to patients and often get in the way of their desperately needed treatments," they said. "And the administration is inserting private AI companies, which have a giant financial stake in the denial of care, into the doctor-patient relationship."
- 'This Should Be a National Scandal': For-Profit Medicare Advantage Plans Using AI for Denials ›
- Outrage Over Trump Use of AI to Revoke Visas of Students Deemed 'Hamas Supporters' ›
- Trump Reportedly Picks Medicare Advantage Lobbyist for Top Health Budget Role ›