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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."
Dear Common Dreams reader, It’s been nearly 30 years since I co-founded Common Dreams with my late wife, Lina Newhouser. We had the radical notion that journalism should serve the public good, not corporate profits. It was clear to us from the outset what it would take to build such a project. No paid advertisements. No corporate sponsors. No millionaire publisher telling us what to think or do. Many people said we wouldn't last a year, but we proved those doubters wrong. Together with a tremendous team of journalists and dedicated staff, we built an independent media outlet free from the constraints of profits and corporate control. Our mission has always been simple: To inform. To inspire. To ignite change for the common good. Building Common Dreams was not easy. Our survival was never guaranteed. When you take on the most powerful forces—Wall Street greed, fossil fuel industry destruction, Big Tech lobbyists, and uber-rich oligarchs who have spent billions upon billions rigging the economy and democracy in their favor—the only bulwark you have is supporters who believe in your work. But here’s the urgent message from me today. It's never been this bad out there. And it's never been this hard to keep us going. At the very moment Common Dreams is most needed, the threats we face are intensifying. We need your support now more than ever. We don't accept corporate advertising and never will. We don't have a paywall because we don't think people should be blocked from critical news based on their ability to pay. Everything we do is funded by the donations of readers like you. When everyone does the little they can afford, we are strong. But if that support retreats or dries up, so do we. Will you donate now to make sure Common Dreams not only survives but thrives? —Craig Brown, Co-founder |
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."
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."