Ban AI Denials in Medicare Act

HR 6361, the Ban AI Denials in Medicare Act, prohibits the U.S. Department of Health and Human Services from implementing or testing Medicare models that use artificial intelligence for prior authorization of covered services under traditional Medicare. Specifically, it blocks the existing WISeR model (described in a 2025 federal notice) and prevents future models from using AI to deny coverage for Medicare Part A or Part B services. This bill directly affects Medicare beneficiaries and healthcare providers who would otherwise face AI-driven coverage decisions. The key mechanism is an amendment to the Social Security Act, explicitly banning the use of AI in prior authorization systems within Medicare's innovation models.