Oklahoma's Medicare pilot sparks backlash over rushed approval delays

In January 2025, Oklahoma became one of six states to trial a new Medicare pilot program called WISeR. The scheme requires preapproval for certain medical procedures, tests, and prescriptions to curb costs and prevent unnecessary care. Some healthcare professionals, however, argue the rollout was rushed and flawed. The program was announced in June 2024 and launched in mid-January 2025. Doctors and their staff submit medical records through online portals to justify procedures under the new rules. Decisions are supposed to arrive within 72 hours, but participants report delays, denials, and errors instead.

Epidurals are among 13 services now requiring approval, as they are considered prone to fraud or misuse. Bill Curry, a 65-year-old cattle farmer from rural Oklahoma, drives 2.5 hours to Oklahoma City every three months for spinal epidurals to manage his back pain. His treatment now falls under the new system.

The use of AI in processing approvals has added to the concerns. Reports suggest the technology may produce errors or fabricate information, complicating decisions. More rejections have also led to a rise in appeals, increasing costs for the government rather than reducing them. The WISeR program aims to save federal funds and protect patients from unnecessary or unsafe care. Yet, its implementation has led to administrative hurdles, higher costs, and frustration among patients and providers. The pilot continues as officials assess its impact on Medicare and those it serves.