CMS quietly penalized four Medicare AI vendors, records show

Documents obtained by the EFF through a FOIA lawsuit show CMS sent corrective action requests to four of six AI vendors in WISeR's first three months without public disclosure. Internal records acknowledge the payment structure gives vendors an incentive to deny as many claims as possible.

• WISeR launched January 1, 2026 in six states, covering 6.4 million Medicare beneficiaries
• In Texas AI approved 62% of requests, rising to 84% after human review
• Innovaccer received two CAPs and a non-compliance notice over a nonfunctional portal
• One request went 83 days without an answer against a 72-hour requirement