A Medicare pilot program that uses artificial intelligence to make coverage decisions will continue to be used in Washington state for the time being. 

The U.S. Senate on July 16 rejected a resolution that would have halted the Wasteful & Inappropriate Services, or WISeR, model being tested by the Centers of Medicare and Medicaid Services in a handful of states. Senate Republicans rallied to defeat the resolution, which was introduced by U.S. Sen. Maria Cantwell, D-Washington. 

“This model inserts a black box computer algorithm into the decisions that should be being made by a physician and the patient,” Cantwell said in a statement. “I’m asking my colleagues to please get educated on how devastating this can be for individual lives and ask yourselves if you believe in traditional Medicare and the doctor-patient relationship. If you do, I guarantee you we will force this administration to stop using this A.I. tool to deny care for our seniors.” 

WISeR reviews requests for some of the most costly procedures. They include epidural steroid injections for pain management, skin and tissue substitutes, less invasive treatments for spinal stenosis and osteoarthritic knees, nerve stimulation for issues like sleep apnea and incontinence, among others.  

Federal health officials have said the program’s goal is to root out fraud, waste and abuse with Medicare, the federal program that provides health coverage to people older than 65 and younger people with disabilities. But seniors, healthcare providers and lawmakers have said they have evidence WISeR is delaying or thwarting care without reasonable justification. 

Cantwell issued a report earlier this year based on patient feedback and healthcare provider data that found WISeR significantly increased wait times for seniors to receive care and prioritized care denials over a patient’s doctor’s recommendation. The U.S. Government Accountability Office also recently found that the pilot program required review by Congress before being implemented. 

At least one other effort to suspend WISeR remains active. Earlier this summer, the U.S. House Appropriations Committee passed its appropriations bill for the departments of Labor, Health & Human Services, Education and related agencies. It includes a rider introduced by U.S. Rep. Robert Aderholt, R-Alabama, which would prohibit the Centers for Medicare & Medicaid Services from further implementing WISeR, with lawmakers noting concern it “may create burdens and delays for patients and providers.” 

That appropriations bill is awaiting consideration on the House floor.