Test Your Knowledge of AI, Medicare, and Prior Authorization Reform

Interested in testing your knowledge about the intersection of prior authorization (PA), Medicare costs, and artificial intelligence (AI)? Perhaps learning about crucial reforms and innovations, such as the American health care system working to remedy the PA crisis by incorporating the use of AI? There is strong consensus among providers and policy makers that the current PA process creates a significant barrier to patient care and must be overhauled to address the national affordability crisis in health care. The American Journal of Managed Care® (AJMC®) has put together a brief slide show quiz on recent developments in this space:

• The PA reform pledge, made by more than 50 major health insurers, outlining concrete actions intended to reduce administrative burden and speed up care approvals by January 20261
• CMS’ new WISeR model, which is testing the use of AI for PA to reduce waste and fraud in traditional Medicare2

References

1. Shaw M. From red tape to relief: rewriting the rules of prior authorization. AJMC. June 23, 2025. Accessed November 6, 2025. https://www.ajmc.com/view/from-red-tape-to-relief-rewriting-the-rules-of-prior-authorization
2. Shaw M, Doddamani. AI meets Medicare: inside CMS’ WISeR Model with Sanjay Doddamani, MD, MBA, part 2. AJMC. August 5, 2025. Accessed November 6, 2025. https://www.ajmc.com/view/ai-meets-medicare-inside-cms-s-wiser-model-with-sanjay-doddamani-md-mba-part-2