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pat_k

(12,451 posts)
4. Tech Co's getting a share of the money saved by denying services. What could possibly go wrong??
Mon Sep 29, 2025, 11:11 PM
Sep 29

According to this article, "Medicare has historically used prior authorization in a limited way, with contractors who aren’t incentivized to deny services."

If there is an actual need for prior authorization, payment for processing should absolutely NOT be tied to denial of service if you actually want to serve Medicare recipients.

The article also notes that WISer "ultimately depends on contractors to assess their own results, a choice that makes the results potentially suspect."

So, these technology company contractors, who are incentivized for denying care, are also responsible for assessing their own results???!!!

With that combination, they practically guarantee harm to patients and theft of public funds.

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