New records obtained by the **Electronic Frontier Foundation (EFF)** expose additional issues with Medicare’s AI-driven prior authorization program and show why stronger legal limits are needed around government use of automated decision-making. The **EFF** sued the government in March for information about the **Wasteful and Inappropriate Service Reduction (WISeR)** model, a new Medicare program that uses AI to evaluate prior authorization requests for certain medical services. Previously released records already indicated that **WISeR** has resulted in delays and denials of care, operational chaos, and reports of patient harm. Now, over 800 new pages of records have been published, including: * Requests for information (RFIs) or requests for corrective action plans (CAPs) sent from the **Centers for Medicare & Medicaid Services (CMS)** to four of the six **WISeR** vendors, along with their responses. * Applications of 66 companies to the **WISeR** model, including those of the 6 selected companies. * Task orders and contracts for the evaluation, implementation, and monitoring of the **WISeR** model. Documents obtained through **EFF**’s lawsuit are available [here](https://www.eff.org/cases/eff-v-cms). These newly released documents reveal that the **WISeR** rollout was rushed and rocky from the start, underscoring the dangers that arise when governments treat AI as a 'silver bullet' for complex problems. The documents also highlight the need for more transparency about safeguards against inappropriate, AI-driven denials. The public still lacks the information needed to assess whether clinician review provides meaningful oversight of AI systems and whether appropriate data is being used to evaluate prior authorization requests. **EFF** has long argued that AI has no place in consequential government decisions about peoples’ rights or access to benefits, such as immigration enforcement and policing decisions. This is because using automated decision-making in these contexts risks decisions that violate people’s rights or deprive them of benefits they’re entitled to, based on biased or inappropriate considerations and without proper due process or accountability if an error occurs. By outsourcing decision-making to private AI companies without sufficient transparency, testing, or legal limits, **WISeR** jeopardizes seniors’ access to medical care. Congress should intervene to place greater legal limits on the use of automated decision-making in Medicare. ## WISeR’s Rollout Was Rushed and Rocky **CMS** launched the **WISeR** program just six months after announcing it, ignoring calls from medical providers to delay its rollout. In records previously released by **EFF**, **CMS** acknowledged this “extremely condensed timeline.” New records suggest that **WISeR**’s unusually rapid rollout contributed to widespread problems in the first few months of the program. **CMS** did not disclose the extent of these issues to the public, even as agency employees privately contacted vendors about potential noncompliance with program requirements. In the first three months of the program, **CMS** sent RFIs or requests for CAPs to at least four of the six **WISeR** vendors. These requests, which describe delays, technical failures, and a lack of communication with providers, suggest that widespread problems during the program’s rollout were not limited to one vendor or state. These letters underscore the severity of the problems with the program. For example, **CMS** requested information from one vendor, **Virtix**, about numerous reported issues, including “determination turnaround times that exceed established guidelines,” “denials that appear inaccurate or inconsistent with applicable criteria,” and “inadequate customer service.” **CMS**’s RFI to **Zyter**—a vendor that uses **Palantir** software infrastructure—observed that the agency had received reports that “**Zyter** is not issuing determination letters in a timely manner” and communications indicating that it “may lack adequate processes for responding to and escalating provider/supplier concerns.” The vendor **Innovaccer** received two CAP requests and a “Performance Notice of Non-Compliance” over its failure to implement a fully functional portal for **WISeR** providers and suppliers. Vendors’ responses to **CMS** provide further evidence that **WISeR**’s rushed rollout contributed to its problems. **Innovaccer** claimed it warned **CMS** months in advance that it might not be ready to provide full portal functionality by the launch date, even before signing a Participation Agreement. Another vendor claimed that “technical and workflow stabilization challenges were encountered due to the compressed implementation timeframe” it faced after joining the **WISeR** program a month after the other vendors. The issues reflected in **CMS**’s letters to vendors, and the vendors’ responses, illustrate the risks of deploying automated decision-making systems without proper testing or safeguards. While vendors’ responses describe fixes for the problems **CMS** identified, after-the-fact remedies cannot undo the harms that patients and providers already experienced during **WISeR**’s rushed rollout. ## More Transparency Needed About AI Safeguards The public still knows far too little about any safeguards that **WISeR** vendors may have adopted—in part because the government chose to conceal some of this information. Transparency about these safeguards is critical to protecting patients, especially because **WISeR**’s payment structure gives vendors, as the government put it, “an incentive to deny as many claims as possible.”  *Information provided by a vendor about safeguards that it says "ensure the responsible and clinically appropriate application of automation” appears to have been redacted from records released to **EFF*** The public has limited means to evaluate the effectiveness of even the safeguard