AI-Powered Prior Authorization Comes to Traditional Medicare

Medicare will pilot AI-driven prior authorization in 2026 across six states, targeting high-risk services while clinicians make final decisions.

Traditional Medicare will pilot AI-assisted prior authorization in 2026 across six states, focusing on high-risk outpatient services. Clinicians retain final say, but incentives and access concerns loom as CMS tests fraud reduction and “gold card” exemptions. Here’s what providers and patients should know.

Qure.ai

Qure.ai software analyzes X-rays and CT scans to detect tuberculosis, lung cancer and stroke. Doctors use it for faster diagnosis on new or old machines.

Qure.ai develops software that examines chest X-rays and head scans to identify tuberculosis, lung cancer, stroke and other issues. The tools work with existing hospital equipment to flag abnormalities right away, speeding up referrals and treatment. Partnerships with groups like AstraZeneca screen millions for TB, while products like qXR aid lung checks and qER support stroke care.