Your doctor says you need pain treatment, but Medicare’s AI might disagree

CLEVELAND, Ohio — Ohioans on Medicare who rely on steroid injections to manage pain may have to wait longer for treatment next year while an AI program approves or declines care.

That’s because claims for this and several types of health care will need prior approval when submitted to traditional Medicare — a change from the current policy— under an upcoming pilot program aimed at curbing waste, fraud and abuse.

Ohio, along with five other states, is part of the pilot program called the Wasteful and Inappropriate Service Reduction (WISeR) Model.

The six-year trial program is slated to start in January, but congressional opposition has placed its funding in question.

Physicians and patient rights groups also are critical of the program, predicting it will restrict and delay nece