The federal government is moving forward with a major plan to bring Artificial Intelligence (AI) into the healthcare system. The official goal is to use this technology to lower costs and make the system more efficient. However, because this plan affects Medicare, Medicaid, and private insurance, it is important to understand how it might change your medical care.
The Big Goal: Accelerating AI
The Department of Health and Human Services (HHS) recently announced they want to speed up the use of AI in clinical care for all Americans. They believe AI can help in three main ways:
- Improving patient care: Helping doctors find health issues faster.
- Reducing paperwork: Cutting down the “provider burden” for doctors and nurses.
- Lowering costs: Saving money for both the government and patients.
The government has stated they are willing to change current rules and regulations to make this AI transition happen quickly.
Concerns Over Denials of Care
One of the biggest worries for patients is “automated denials.” This happens when a computer program, rather than a doctor, decides if a treatment should be covered.
Recent data shows why this is a concern. A 2024 Senate Committee report found that some Medicare Advantage plans using automated systems had 16 times more denials for care than those that didn’t. While the government says humans should make the final decision on whether to deny care, it is not yet clear how that will work in practice.
The “Wiser” Pilot Program
We are already seeing AI move into the real world. A new system called Wiser is scheduled to start on January 1, 2026. This is an AI-powered “prior authorization” system that will test how computers can screen for fraud and waste.
- Where: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.
- When: January 1, 2026, through December 31, 2031.
- What: It focuses on 17 specific medical services identified as “high risk” for waste.
How to Share Your Opinion
The government has issued a Request for Information (RFI). This is a formal way for you to tell the government what you think before they make final decisions.
You do not need to be a doctor or a tech expert to respond. Your experience as a patient is what matters most. While there are 10 technical questions, two are most important for everyday people:
- Question 3 (Accountability): If an AI gives wrong medical advice, who is responsible? Is it the doctor or the software company?
- Question 9 (Your Needs): What parts of going to the doctor are so frustrating that you wish a computer could fix them? What parts of AI are you afraid of?
How to Send Your Feedback
Currently, the easiest way to respond is by mail. Your letter must be received by February 23, 2026.
- The Subject Line: You must include the phrase “HHS-OS-2024-0014” at the top of your letter.
- The Rule of Three: You must include three copies of your letter in the same envelope.
- Where to Mail: > Centers for Medicare & Medicaid Services
Department of Health and Human Services
Attention: HHS-OS-2024-0014
P.O. Box 8013
Baltimore, MD 21244-8013
Relief Recap
The government is asking for your input on using AI to manage your healthcare and insurance coverage. By sending a letter, you can help ensure that new technology makes healthcare easier rather than creating more denials and confusion. Your voice is the best tool to make sure the “human” element stays in medicine.
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