Medicare's new AI experiment sparks alarm among doctors, lawmakers

[Ms. Toad]

21. Requiring conservative therapy is a Medicare Advantage/Insurance concept - it has no place in Standard Medicare

The procedures which already require prior approval are those which are predominantly not medically necessary - but occasionally are. That is not the standard for this new list. Requiring prior approval for one of the items on the new list would likely have resulted in denial - and my death.

When Medicare denies something AFTER the fact, it is the medical provider who pays the cost - not the patient. My spouse's blepharoplasty was medically necessary (her eyelids were severely impairing her vision). That procedure was recently added to the list, and the doctor who performed it didn't obtain prior approval. The doctor was prohibited from passing any costs on to my spouse.

In this new list, it is the patient who will bear the cost - in human suffering and potentially death - because when the medically necessary procedures, with no cosmetic use, on this new list are inappropriately denied, the time it takes to win an appeal may well mean the difference between life and death.

Punish the doctors who are misbehaving. Don't take it out on their patients.

This is NOT appropriate, so please stop trying to justify it.