Traditional Medicare has announced that they are going to require prior authorization for certain procedures. Apparently, the decision will be made by AI.
The good news is that it is a pilot program that will last six years and it will only apply to six states - New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington.
And it only applies to 17 procedures.
Skin and tissue substitutes
Nerve stimulators
Stimulation devices
Epidural steroid injections
Cervical fusion
Knee arthroscopy
Incontinence control devices
Facet joint interventions
Blepharoplasty
Botulinum toxin injection
Rhinoplasty
Panniculectomy
Vein ablation
Implanted neurostimulators
Cervical fusion with disc removal
Osteogenic stimulators
Knee orthoses
I don't know what most of those are so perhaps the doctors on TOTV can comment on whether the procedures are necessary.
https://www.cms.gov/files/document/wiser-fact-sheet.pdf
Prior Authorization Coming to Traditional Medicare Starting in 2026 | Kiplinger