When issues arise, board-certified clinicians--not technological
machines, board-certified clinicians--intervene to make the final
decision. The potential benefit of this ``detect and prevent strategy''
is substantial. For example, Medicare spending on skin substitutes, one
of the chosen WISeR model services, increased and--hear this--increased
from $256 million in 2019 to $10 billion in 2024. It doesn't even take
a technological machine to tell you that something is wrong there.
  Proactive, technology-based scrutiny could have detected this outlier
spending growth and protected both patients and taxpayers.
  Regrettably, misinformation about this model has sparked fears of
delays in essential patient care and additional burdens on providers.
  Later today, the Senate will proceed to a resolution to stop this
important work of the WISeR model. Every Member of this body agrees
that patients should have access to high-quality care, providers
deserve predictable payment for services, and avoidable waste, fraud,
and abuse in Medicare should be stopped. Ending this pilot program
prematurely will deprive CMS of a useful tool to accomplish each of
those goals.
  And I urge my colleagues to consider the facts and oppose this
resolution.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.
  Mr. WYDEN. Madam President, we don't take a back seat to anybody in
terms of fighting inefficiency, fighting fraud. We have been working on
those issues, as the chair of the Finance Committee knows, together
wherever possible.
  Unfortunately, what we have seen in this experiment is that we are
not dealing with inefficiency and fraud. We are forcing patients to
come back again and again and again. That just defies common sense.
  And on the issues like skin substitutes, that has been addressed
through a payment process, payment policy reform, to get at the
incentives and wasteful utilization.
  So on the points that the minority is making, the reality is patients
are not going to get care, and we are not going to make sensible
changes as we have in other areas to deal with fraud and inefficiency.
  That is why we ought to be voting for what we are trying to do today
on the Democratic side.
  I yield back and hope we will have a bipartisan vote.
  The PRESIDING OFFICER. The Senator from Washington.
  Mrs. MURRAY. Madam President, I wanted to talk today about not just
how Republicans are making healthcare more expensive but also how they
are making it just plain worse for seniors.
  President Trump came into office saying he would not cut Medicare,
but that was clearly a lie because right now his administration is
trying to privatize Medicare; in part, by putting AI between Medicare
beneficiaries and their healthcare.
  In January of this year, under Secretary Kennedy and Dr. Oz's
leadership, CMS began this pilot program that uses AI to require prior
authorization in traditional Medicare for the first time ever, and it
is set to run for 6 years. They call it the Wasteful and Inappropriate
Service Reduction Model. Well, they got the wasteful and inappropriate
part right.
  The WISeR Model uses AI to deny vulnerable seniors the care they need
and that their doctors recommend.
  Not only that, but the for-profit contractors that conduct this prior
authorization are paid a percentage of the cost of care that they deny.
They are literally incentivized to rip healthcare away from seniors
because that is best for their bottom line. When your business model
relies on denials, denials are what seniors are going to get, and that
is perverse.
  WISeR was rolled out in the beginning of this year in my home State
of Washington and five other States without safeguards and without any
transparency and without the best interests of Medicare beneficiaries
at the heart of this program.
  President Trump is saying: Forget the doctors who went to medical
school and took an oath to do no harm. AI knows better when it comes to
healthcare decisions for our seniors.
  The consequences of that poor judgment are real, and they are life-
threatening. I hear from Medicare patients in Washington State all the
time. They are suffering debilitating pain for weeks because they are
not getting the care they need, thanks to this harmful model--patients
like Joanne. She is a Medicare beneficiary from Quilcene, WA.
  She went to her doctor for severe pain. An MRI showed that a
herniated disk was pressing on her sciatic nerve. Joanne's doctor
prescribed an epidural injection to help ease that pain. This was
standard, routine care--care that, before this year, she would have
been able to get quickly after it had been recommended by her doctor.
But because of this WISeR Model, she had to wait 6 weeks to get
approval. That means, thanks to WISeR, Joanne had to deal with
unnecessary, unrelated pain for 6 weeks. Because of this nonsense
delay, her day-to-day life was disrupted and the burden fell on her
then to fight for the care she needed.
  This is simply outrageous, but that is also WISeR working by design,
and that is a direct impact of the Trump administration's actions.
  We have seen way too many stories like Joanne's from States that have
been selected for this pilot program. No way should an algorithm decide
if seniors should get the care they need. That is exactly why I join my
colleagues here in introducing a resolution to overturn this model. And
I want all of my colleagues to join me in voting for it so we can make
sure seniors in my State and all over the country can, once again,
receive their healthcare on time and without interruption.
  Let's just use our common sense. It is clear as day that some AI
models should never be at the wheel making healthcare decisions left
and right. And it is not just patients I have heard from. I have met
with healthcare providers all over my State. Whether it is a rural
hospital or a doctor in Seattle, no one--no one--has had anything good
to tell me about prior authorization in traditional Medicare.
  Now, I ran for office because I believe regular people deserve a say
in how their government is run, and that is especially true when it
comes to the government deploying AI technology. I don't know any
senior--Republican or Democrat--who asked President Trump to let AI
decide if their doctor-recommended treatment was necessary. Of course,
AI can help make things more efficient or do good things. That is not
what the WISeR Model is doing.
  So let's get to the crux of it. As a country, we make a promise to
American seniors: If they paid their taxes throughout their careers,
they earned their Medicare coverage. Full stop. WISeR breaks that
promise to seniors with these senseless AI-driven prior authorizations
that deny and delay care.
  Let me be clear, many seniors choose traditional Medicare over other
options because traditional Medicare rarely requires prior
authorizations. People choose traditional Medicare because they want to
make their healthcare decisions with their doctor, not with a private
company that is out to make a profit.
  Simply put, the WISeR Model--which, again, delays and denies
necessary care to Medicare patients--is reckless, and it is
irresponsible.
  I want my Republican colleagues to join us in voting to get rid of
WISeR once and for all because this should not be a partisan issue. We
all have seniors in our States that deserve the highest level of care
without having to deal with redtape and delay. Thanks to Trump, AI is
getting in between our seniors and their healthcare in Arizona, in New
Jersey, in Ohio, in Oklahoma, in Texas, and in my State of Washington.
We have an opportunity to stop this harmful experimental pilot program
before more seniors are harmed. No senior in America should have to
appeal their pain and suffering to a machine.
  To my colleagues, if it were your spouse or parent who needed care,
whom would you want to decide if they get their treatment, their doctor
or a for-profit algorithm? Would you want them to suffer in pain for
weeks for care that they are entitled to? I know what my answer is.
  Let's maintain the promise of Medicare. Let's pass this resolution.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Oregon.