Press ReleaseNeutral2026-06-22

DelBene, Patients, Providers Raise Alarm About Medicare AI Denial Experiment

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This press release from Representative Suzan K. DelBene (D-WA) was published on 2026-06-22 and titled "DelBene, Patients, Providers Raise Alarm About Medicare AI Denial Experiment".

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DelBene, Patients, Providers Raise Alarm About Medicare AI Denial Experiment

Today, Congresswoman Suzan DelBene (WA-01) hosted health care providers and Medicare patients at UW Medical Center to raise growing concerns about the Trump administration’s Wasteful and Inappropriate Service Reduction (WISeR) program, which pays private companies to use AI to delay and deny care to Washington seniors. Since the program began in January, patients have been left in severe pain as they are unable to access the care prescribed by their doctors. During the event, patients and providers shared firsthand stories about the impact these delays and denials have had on their health and ability to provide care. DelBene announced that Virtix, the company handling WISeR claims in Washington, has been ordered by CMS to submit a corrective action plan for “noncompliance” with the program’s 72-hour prior authorization review requirement. CMS previously maintained that all participating companies were meeting this benchmark. DelBene also announced the release of a letter to CMS Administrator Mehmet Oz demanding detailed data on the program’s impact and seeking greater transparency around it. So far, no information has been released about denial or appeals rates for the program. WISeR implements a similarly flawed prior authorization process that exists in Medicare Advantage in traditional Medicare, which has rarely required prior authorization before. Medicare Advantage data shows that only 11.5% of denials are appealed but 80% of those appeals are overturned, demonstrating that the care should never have been denied in the first place. “Seniors deserve to get the care they need when they need it,” said DelBene . “But the Trump administration’s WISeR program is delaying and denying care for Medicare patients, leaving them in severe pain and increasing red tape for providers. Make no mistake, in addition to hurting patients, WISeR is also a Trojan horse for privatizing Medicare. That’s why I’m conducting Congressional oversight and demanding transparency from CMS Administrator Oz to get to the bottom of this harmful program.” Also speaking at the event were: Keith Magnuson, a Seattle resident who had his care delayed because of this program Jita Bruno, CEO, UW Medical Center Dr. Christopher McMullen, Physiatrist, UW Medical Center Dr. Bindu Nayak, Vice President, Washington State Medical Association DelBene was the first in the Washington delegation to raise the alarm about the program. In August 2025, she urged the administration to explain how the program would be implemented on such a short timeline. She has led several legislative efforts to repeal the program and confronted HHS Secretary Kennedy about how the program is leaving Washington patients in pain. She also wrote an op-ed about the impacts of this program. DelBene was also joined by Representatives Ami Bera (CA-06), Lloyd Doggett (TX-37), Lois Frankel (FL-22), Alexandria Ocasio-Cortez (NY-14), and Mark Pocan (WI-02) along with 25 of their colleagues in the letter. The text can be found here . You can watch the video of the event here .

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DelBene, Patients, Providers Raise Alarm About Medicare AI Denial Experiment Today, Congresswoman Suzan DelBene (WA-01) hosted health care providers and Medicare patients at UW Medical Center to raise growing concerns about the Trump administration’s Wasteful and Inappropriate Service Reduction (WISeR) program, which pays private companies to use AI to delay and deny care to Washington seniors. Since the program began in January, patients have been left in severe pain as they are unable to access the care prescribed by their doctors. During the event, patients and providers shared firsthand stories about the impact these delays and denials have had on their health and ability to provide care. DelBene announced that Virtix, the company handling WISeR claims in Washington, has been ordered by CMS to submit a corrective action plan for “noncompliance” with the program’s 72-hour prior authorization review requirement. CMS previously maintained that all participating companies were meeting this benchmark. DelBene also announced the release of a letter to CMS Administrator Mehmet Oz demanding detailed data on the program’s impact and seeking greater transparency around it. So far, no information has been released about denial or appeals rates for the program. WISeR implements a similarly flawed prior authorization process that exists in Medicare Advantage in traditional Medicare, which has rarely required prior authorization before. Medicare Advantage data shows that only 11.5% of denials are appealed but 80% of those appeals are overturned, demonstrating that the care should never have been denied in the first place. “Seniors deserve to get the care they need when they need it,” said DelBene . “But the Trump administration’s WISeR program is delaying and denying care for Medicare patients, leaving them in severe pain and increasing red tape for providers. Make no mistake, in addition to hurting patients, WISeR is also a Trojan horse for privatizing Medicare. That’s why I’m conducting Congressional oversight and demanding transparency from CMS Administrator Oz to get to the bottom of this harmful program.” Also speaking at the event were: Keith Magnuson, a Seattle resident who had his care delayed because of this program Jita Bruno, CEO, UW Medical Center Dr. Christopher McMullen, Physiatrist, UW Medical Center Dr. Bindu Nayak, Vice President, Washington State Medical Association DelBene was the first in the Washington delegation to raise the alarm about the program. In August 2025, she urged the administration to explain how the program would be implemented on such a short timeline. She has led several legislative efforts to repeal the program and confronted HHS Secretary Kennedy about how the program is leaving Washington patients in pain. She also wrote an op-ed about the impacts of this program. DelBene was also joined by Representatives Ami Bera (CA-06), Lloyd Doggett (TX-37), Lois Frankel (FL-22), Alexandria Ocasio-Cortez (NY-14), and Mark Pocan (WI-02) along with 25 of their colleagues in the letter. The text can be found here . You can watch the video of the event here .