Gillibrand Urges End to Medicare AI Pilot
The Senate Aging Committee's ranking member says the WISeR pilot, which uses artificial intelligence in coverage reviews, should be terminated.
Updated on Nov. 2, 2026 in Senior Health
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Sen. Kirsten Gillibrand called for ending the Medicare WISeR pilot, which applies artificial intelligence to coverage reviews in six states, excluding New York. Senate Republicans blocked her May resolution to end the pilot in July.
Why it matters
The pilot affects how Original Medicare beneficiaries in participating states access certain services, including skin and tissue substitutes and knee arthroscopy. Gillibrand argues that paying participating technology companies for avoided spending creates an incentive to deny care.
The WISeR pilot runs in six states and is scheduled to end December 31, 2031, with Medicare Advantage excluded. Reported declines in services have not been quantified in the source material available for this story.
The players
Kirsten Gillibrand
A U.S. senator from New York who serves as ranking member of the Senate Aging Committee and has pressed for ending the WISeR pilot.
Senate Republicans
The Republican caucus in the U.S. Senate, which blocked Gillibrand's resolution to end the Medicare pilot in July.
The details
WISeR applies to selected Original Medicare services and excludes emergency care, inpatient-only services, and procedures where delay would pose substantial risk. Providers can seek prior authorization before a service or have claims reviewed after treatment but before payment.
Timeline
January 1, 2026: WISeR pilot begins operating.
May 2026: Gillibrand introduces a resolution to end the pilot.
July 2026: Senate Republicans block the resolution.
October 30, 2026: Gillibrand issues a statement calling for the pilot's end.
December 31, 2031: WISeR pilot is scheduled to end.
Big Picture
The WISeR pilot extends Medicare's existing prior authorization process into AI-assisted coverage review for selected Original Medicare services in six states. Its scheduled end in 2031 leaves its long-term future tied to the outcome of the congressional dispute over the program.
Medicare beneficiaries in participating states may encounter prior authorization or post-treatment claim review for certain Original Medicare services. Those in Medicare Advantage plans are not covered by the WISeR pilot.
The takeaway
Medicare beneficiaries should know whether a planned service falls under the WISeR pilot, since review requirements differ by state and by coverage type. Checking with a provider about prior authorization can help avoid delays.
Further reading
Explore more in Senior Health coverage of Medicare policy and access.
Source note: This article includes information reported by Fingerlakes1.
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