Regulation & Policy Surfaced late · published October 15
CMS official says "a lot of things about WISeR" are not working as the agency pilots AI to flag Medicaid fraud
What happenedPer Nextgov/FCW, CMS's Kimberly Brandt said "a lot of things about WISeR" are not working, as CMS pilots AI to flag Medicaid fraud before payment.
Why it mattersIndirect for SNF and AL/SL operators: WISeR does not cover SNF stays, but pre-payment AI flags for upcoding and phantom services could reach their Medicaid claims.
For leadersWatch for the Indiana pilot results CMS says it will publish; ask what documentation would answer an AI fraud flag before payment stops.