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Medicare, Prior Authorization, and a Six-State Trial of AI

September 8, 2025 Blog / Breaking News / Medicare / patient rights / US Health System

The US government is preparing to trial the use of artificial intelligence, large language models, and machine learning in a prior authorization review process for medical procedures under the Medicare program.The New York Times reports (Reed Abelson and Teddy Rosenbluth, "Medicare Will Require Prior Approval for Certain Procedures," NY Times, August 28, 2025):"The federal government plans to hire private companies to use artificial intelligence to determine whether patients would be covered for some procedures, like certain spine surgeries or steroid injections. Similar algorithms used by insurers have been the subject of several high-profile lawsuits, which have asserted that the technology allowed the…

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