/Submit incident
Documented

Medicare AI Prior Authorization Pilot Causes Harm Through Delays and Denials

September 14, 2026
oecd:2026-09-14-8dd8View source ↗

What happened

The Centers for Medicare & Medicaid Services' WISeR pilot, using AI to evaluate prior authorization requests in six US states, led to widespread delays, technical failures, and high denial rates. These issues caused harm to patients, including pain, canceled procedures, and emotional distress, as documented in federal records released by EFF.

Reported impact

Affected parties
Not publicly disclosed
Harm type
Not publicly disclosed
Scale
Not publicly disclosed
Financial impact
Not publicly disclosed
Regulatory action
Not publicly disclosed

Classification

Organization
Not publicly disclosed
AI system
Not publicly disclosed
Industry
Not publicly disclosed
Country
Not publicly disclosed
Provider
Not publicly disclosed
Incident type
Not publicly disclosed

Relevant governance controls

Governance control mapping is not available for this record.

  • No controls mappedNot publicly disclosed

Control mapping is analytical. It does not state that any control would have prevented the incident.

Sources and evidence

OECD AI Incidents Monitor
Primary source
Medicare AI Prior Authorization Pilot Causes Harm Through Delays and Denials
2026-09-14