The Electronic Frontier Foundation has filed a Freedom of Information Act (FOIA) lawsuit to obtain records from the Centers for Medicare & Medicaid Services (CMS) about a multi-state program using AI to evaluate requests for medical care.

Launched January 2026, the program known as WISeR (Wasteful and Inappropriate Service Reduction) uses AI to assess prior authorization requests from Medicare beneficiaries. Healthcare experts, care providers, and lawmakers have all raised alarms that WISeR may cause serious harm to patients by relying on AI unless it has the necessary safeguards.

Little is known about how the AI algorithms used in WISeR work, including what training data they rely on. It remains unclear whether WISeR has any safeguards against systemic flaws such as algorithmic bias, privacy violations, and wrongful denials of care.

EFF’s FOIA request seeks, among other records, agreements with software vendors participating in WISeR; records related to any tests for accuracy, bias, or hallucinations in vendors' technology; and records related to any audits, monitoring, or evaluation of WISeR and participating vendors.

Documents Released in Response to EFF Lawsuit 

Documents obtained through this FOIA litigation are linked in the “Legal Documents” section below. The records are also available on DocumentCloud here. These records include: 

• Participation Agreements between CMS and the six WISeR model participants (the tech companies selected to assess prior authorization requests). These agreements include requirements for the companies, financial payment structures, oversight processes, and grounds for remedial action ("WISeR FOIA Response - Participation Agreements").

• WISeR’s Innovation Center Investment Plan (ICIP), an internal document that outlined the plan for WISeR in June 2025. This document includes the program's evidence base, strategy, path to expansion, and legal framework ("WISeR FOIA Response - Combined Records", pages 1-38).

• The WISeR Reviewer Guidebook outlines the criteria used to review applications and select companies for the WISeR model ("WISeR FOIA Response - Combined Records", pages 82-93).

• The WISeR Data Reporting Guide describes audit processes and quality metrics for vendors ("WISeR FOIA Response - Combined Records", pages 94-116). 

• Status report emails about WISeR from Medicare Administrative Contractors (MACs) involved in the program. These reports include technical difficulties and data about request volume and timeliness of decisions. ("WISeR FOIA Response - Combined Records", pages 130-443).

• Medical providers’ responses to feedback surveys about one of the WISeR vendors ("WISeR FOIA Response - Feedback Survey Responses").