A.I. To Approve Or Deny Medicare Procedures For New Yorkers?

New Yorkers on Medicare may see their procedures denied by artificial intelligence in the not so distant future. Every day, it seems like the new administration finds a new way to screw New Yorkers. They have long claimed that they wouldn't touch Medicare, just Medicaid. But that seems to be quite untrue.

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Medicaid recipients in New York State are in for a rude awakening soon. Trump and Republicans' 'Big Beautiful Bill' will implement many changes that will force them to lose coverage. Others will have to meet stricter requirements to keep their coverage. In New York, there are 6,912,571 people enrolled in Medicaid as of February 2025. Massive changes to the federal-state health care program will impact these New Yorkers soon.

Beginning in 2027, as the federal government slashes Medicaid funding, it will also implement stricter rules. Medicaid recipients will be subject to mandatory, twice-yearly eligibility checks. There will also be new work requirements for New Yorkers on Medicaid. Per Health Management, "These requirements cannot be waived."

There will also be new cost-sharing requirements,

"Starting in 2028, states must apply cost-sharing requirements to Medicaid expansion adults with incomes greater than 100 percent of the federal poverty level."

Medicare Healthcare Decisions Will Be Made By Artificial Intelligence

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New Yorkers on Medicare should get ready for their procedures to be approved or denied by artificial intelligence. Nothing screams "protecting Medicare" like having a non-human making decisions that could affect a human's life or death. Beginning in January, an AI program will be used to make decisions about patient procedures. The Centers for Medicare & Medicaid Services is launching a pilot program using AI to help make prior authorization decisions using a new Wasteful and Inappropriate Service Reduction Model. The agency claims that any final decisions about procedures will be made by a human. Seeing as though the Federal Government has cut thousands of employees, I don't have a lot of confidence in their claim.

Experts state that using AI could speed up coverage decisions, but it could also lead to higher denials of coverage. The six-year pilot program will take place in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. Based on the results, Medicare recipients in New York and the rest of the country could face the same fate.