ARTICLE SUMMARY:
CMS will launch a model in January to test AI-enabled prior authorization review for 15 devices and procedures to reduce "wasteful care" under fee-for-service Medicare.
CMS says it will launch a prior authorization model in six states that will feature artificial intelligence review of planned medical services January 1 to help weed out “wasteful care.” The agency has identified 15 items and services to target for scrutiny, including electrical nerve stimulators, deep brain stimulation for Parkinson’s disease, knee arthroscopy, cervical spinal fusions, and 11 other device-heavy procedures linked to national or local coverage policies (see box below, “Targeted Items and Services”).
