Healthcare pilot program WISeR begins Jan 1 in 6 states, including Arizona. Private for-profit contractors will use AI to decide whether Traditional Medicare (TM) patients get treatments their doctors recommend. Contractor profits are based on denying care.
Center for Medicare and Medicaid Innovation (CMMI) proposed WISeR (Wasteful and Inappropriate Service Reduction). Yet, it uses the same private for-profit contractors that Medicare Advantage (MA) programs use to help them get higher government payments by adding medical codes to make patients appear sicker than they are (the notorious fraudulent "upcoding") resulting in overpayments to MA since 2008 (predicted to be about $1 trillion from 2025 to 2034).
The AZ contractor is Virtix Health. Its website discloses no physical address, phone, names of executives, or board members. There are strong ties between CMMI leadership and the health insurance and venture capital industries that profit from this program. Demand Congress stop WISeR by passing HR 5940, HR 6361, and S 3480.
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Lee Stanfield
East side
Disclaimer: As submitted to the Arizona Daily Star.
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