Medicare AI prior authorization pilot causing care delays in Washington

A CMS AI-driven prior authorization pilot in Washington state is delaying care for seniors, according to a report cited by Senator Maria Cantwell. The pilot, which uses algorithms to review PA requests for certain durable medical equipment and procedures, has generated denials and lengthy review times that exceed Medicare's mandated 14-day decision window. For practices in Washington, this means increased administrative burden to track and appeal delayed PA decisions for Medicare patients. Immediately audit any outstanding PA requests for Medicare patients in your Washington state panels; prepare for appeals and document all communication timelines.