What happened
On 5 October 2026, Rep. Suzan DelBene (D-WA) announced she is filing a Freedom of Information Act request to force the Trump administration to release internal audit and corrective-action documents on the Wasteful and Inappropriate Service Reduction (WISeR) program — which pays private companies to use AI to review Medicare claims — after a Ways & Means Committee amendment to compel release failed 18-19. EFF-obtained documents show the administration plans to expand WISeR to cancer treatments, cardiology procedures and air ambulances.
Why it matters
WISeR is a live federal program using AI for automated Medicare claims review with significant patient-access consequences (over half of Washington-state claims initially denied in Jan-Mar). This signals rising congressional scrutiny of government AI claims adjudication and potential expansion of AI-based claims review affecting healthcare AI vendors and payers.
Action needed
Healthcare AI and claims-processing vendors should track WISeR expansion plans and rising congressional demands for transparency on AI-based claims adjudication performance and audit trails.