EFF Releases New Records Showing Operational Failures in Medicare's AI Prior Authorization Pilot

The Electronic Frontier Foundation (EFF), a U.S. digital rights organization, published over 800 pages of new documents on October 27, 2026, obtained through litigation against the Centers for Medicare & Medicaid Services (CMS). These records expose serious issues within the 'Wasteful and Inappropriate Service Reduction' (WISeR) model, a Medicare program that uses artificial intelligence to evaluate prior authorization requests for certain medical services.

The newly released documents include Requests for Information (RFIs) or Corrective Action Plan (CAP) requests sent by CMS to four of the six WISeR vendors, along with the vendors' responses. They also contain applications from 66 companies seeking to participate in the model, as well as task orders and contracts for the evaluation, implementation, and monitoring of WISeR.

The files indicate that the WISeR rollout was rushed and rocky. CMS launched the program just six months after announcing it, ignoring calls from medical providers to delay. In the first three months, CMS issued notices regarding delays, technical failures, and lack of communication to at least four vendors. For instance, CMS requested information from Virtix about issues including 'determination turnaround times that exceed established guidelines' and 'denials that appear inaccurate or inconsistent with applicable criteria.' Zyter, a vendor using Palantir software infrastructure, was cited for not issuing determination letters in a timely manner.

Vendor responses further confirm that the compressed timeline contributed to problems. Innovaccer claimed it warned CMS months in advance that it might not be ready to provide full portal functionality by the launch date. Another vendor noted 'technical and workflow stabilization challenges' due to the compressed implementation timeframe.