(NewsNation) — Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, believes a pilot program using artificial intelligence to deny or approve some Medicare claims will ultimately help patients.
Starting Jan. 1, Medicare beneficiaries in select states could see decisions about whether they qualify for certain procedures made by AI. Arizona, New Jersey, Ohio, Oklahoma, Washington and Texas are part of a federal pilot program called Wasteful and Inappropriate Service Reduction.
“The purpose of these is not to deny care. It’s to make sure you get the care you need and deserve, not the care that some unscrupulous doctor wants to use on you because he can talk you into having spine surgery or knee surgery,” Oz told “Morning in America” on Tuesday.
One downside of the program is that treatments may be delayed or denied, as Medicare has typically avoided prior authorization.
Oz acknowledged “any tool that can help could also be problematic,” and said he and other agency officials will continue to audit AI technology to “make sure that these are used appropriately.”
Procedures decided by AI will include steroid injections for pain management, arthroscopic knee surgery and impotence treatment.
Oz said he doesn’t want the tech to interfere with doctor-patient relationships, but rather enhance a provider’s abilities.
“We want AI to be used by the doctor, if the doctor wants, to help them take better care of patients, to allow the AI to help with scheduling tests, to give them some better ideas about a diagnosis,” Oz said.
Medicare open enrollment ends Sunday
Nearly 70 million Americans have until the end of the week to make changes to their Medicare plan.
Making the right choice can save hundreds, if not thousands, of dollars in out-of-pocket expenses.
“You do have to go do a little bit of work. Which programs do you want to be in? Which ones do your doctors belong to? Which of the doctors are the most important ones for you to make sure you keep seeing?” Oz said.
Oz touted decreasing payments for Medicare Part D and Part C, adding that “there are other places where we’re actually paying more, unfortunately.”
Premium hikes for some Medicare plans are expected next year, with the standard Part B premium slated to rise $17.90, nearly 10%, to $202.90 per month, beginning in 2026.
The annual deductible for Medicare Part B beneficiaries will increase $26 to $283 in 2026, the Centers for Medicare and Medicaid Services announced. Beneficiaries must pay the deductible for Part B expenses before Medicare covers the costs.
Also approaching is Congress’ deadline to vote on extending subsidies tied to the Affordable Care Act.
The tax credits are set to expire on Dec. 31, which could cause premiums to skyrocket for 24 million Americans, according to a preview of the available plans released by the Trump administration.