Cardiology groups strongly oppose expansion of Medicare AI prior authorization model

June 23, 2026 - 04:32

Three major cardiology organizations are raising alarms over a federal proposal to expand the use of artificial intelligence in Medicare prior authorization. The American Society of Echocardiography, the American Society of Nuclear Cardiology, and the Society for Cardiovascular Angiography and Interventions have formally opposed the so-called WiSER model, which would apply automated decision-making to traditional Medicare claims.

In a joint statement, the groups argued that the current system already creates significant administrative burdens and delays in patient care. They warned that replacing human medical reviewers with AI algorithms could lead to inappropriate denials, especially for complex cardiac cases where clinical nuance is critical. The societies expressed concern that the model lacks transparency, making it difficult for physicians to understand why a procedure was denied or how to appeal effectively.

The WiSER model, short for "Widespread Implementation of Standardized Evaluation and Review," aims to streamline prior authorization using predictive analytics. However, the cardiology groups contend that the technology is not yet ready for such high-stakes decisions. They cited potential risks to patient safety, particularly for those needing time-sensitive interventions like stress tests or coronary angiography.

The organizations are urging the Centers for Medicare and Medicaid Services to pause the expansion and instead focus on improving the existing process through better communication and standardized criteria. They also call for a pilot program that includes physician oversight before any AI-driven system is widely deployed. Without these safeguards, they argue, the model could undermine the doctor-patient relationship and compromise the quality of cardiovascular care.