EFF – Little Is Known About AI That Could Affect Millions of Seniors’ Care: The Electronic Frontier Foundation (EFF) today filed a Freedom of Information Act (FOIA) lawsuit against the Centers for Medicare & Medicaid Services (CMS) seeking records about a multi-state program that is using AI to evaluate requests for medical care. “Tasking an algorithm with making determinations about treatment can create unwarranted—and even discriminatory—delays or denials of necessary medical care,” said Kit Walsh, EFF’s Director of AI and Access-to-Knowledge Legal Projects. “Given these serious risks, the public requires transparency that it hasn’t gotten. We’re suing to get badly needed answers about how Medicare’s AI experiment works.” Announced by CMS Administrator Dr. Mehmet Oz last year, the pilot program known as WISeR (Wasteful and Inappropriate Service Reduction) uses AI to assess prior authorization requests from Medicare beneficiaries. Previously rare in original Medicare, prior authorization requires medical providers to obtain advance approval from a patient’s health insurer before delivering certain treatments or services as a condition of coverage. Unfortunately, there is little information about how the AI algorithms used in WISeR work, including what training data they rely on. It remains unclear whether WISeR has any safeguards against systemic flaws such as algorithmic bias, privacy violations, and wrongful denials of care. Healthcare experts, care providers, and lawmakers have all raised alarms that WISeR may cause serious harm to patients by relying on AI unless it has the necessary safeguards. Despite this widespread criticism, WISeR was rolled out in six states in January, potentially affecting as many as 6.4 million Medicare beneficiaries, according to one estimate…”

For the complaint: https://www.eff.org/document/complaint-eff-v-cms-medicare-wiser-foia