The CMS will soon make it more difficult for providers in six states to get reimbursed in Medicare for certain medical procedures it has deemed “ low value ,” but some stakeholders worry it could lead to worse healthcare access and quality.

Doctors in a select group of states will be required to secure artificial intelligence-powered prior authorization for some services in traditional Medicare as part of a new CMS pilot program, dubbed the Wasteful and Inappropriate Service Reduction, or WISeR, model. The program has lawmakers, provider groups and experts worried it could harm healthcare access, reduce care quality and increase the administrative burden on providers.

Prior authorization requires providers to obtain pre-approval for certain procedures, medications, devices or other hea

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