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Block Medicare Prior-Authorization Rule

Full Title:
Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services of the Department of Health and Human Services relating to "Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model".

Summary#

This joint resolution would overturn a Centers for Medicare & Medicaid Services (CMS) rule that implements prior authorization for certain services under the Wasteful and Inappropriate Services Reduction (WISeR) model. The resolution says that the CMS rule (published July 1, 2025) and related notice shall have no force or effect. A Government Accountability Office (GAO) opinion dated May 12, 2026, concluded the CMS notice counts as a rule under chapter 8 of title 5, U.S. Code (the Congressional Review Act).

  • Main change: if the resolution becomes law, it would nullify the CMS prior-authorization rule for select WISeR services.
  • Who issued the rule: Centers for Medicare & Medicaid Services, Department of Health and Human Services.
  • Legal route used: the resolution uses the disapproval procedure under chapter 8 of title 5 (the Congressional Review Act).
  • Sponsor: Rep. Greg Landsman and several co-sponsors introduced the resolution on May 19, 2026.

What it means for you#

  • Medicare beneficiaries (patients): This could mean the specific services covered by the WISeR prior-authorization rule would not require prior approval from Medicare if the resolution becomes law. The bill does not list which services are affected here.
  • Health care providers and suppliers: This could mean providers would not need to submit prior-authorization requests for the select services covered by the WISeR rule while the rule has no force. That may change billing and administrative work linked to those services.
  • Medicare program / CMS: If enacted, CMS could not enforce the specific prior-authorization rule described in the resolution. The agency might keep looking for other ways to address wasteful or inappropriate services, but this resolution would remove this particular rule.
  • Taxpayers / federal budget: The practical budget effects are not stated in the bill text. See Expenses below for what is known and unknown.

Expenses#

No publicly available information.

  • The bill text and published material supplied do not include a fiscal note or cost estimate.
  • This resolution itself does not authorize new spending. However, removing a prior-authorization rule could change Medicare spending (for example, by affecting how often certain services are paid for). The bill does not estimate any change in spending or savings.
  • Administrative costs or savings for providers or Medicare contractors are not estimated in the available material.

Proponents' View#

  • The bill appears intended to stop CMS from enforcing a specific prior-authorization rule under the WISeR model.
  • Supporters may argue that nullifying the rule would prevent added administrative burdens or delays for patients and providers caused by prior-authorization requirements. (This is an inferred possible argument based on the bill’s action; no supporter statements are included in the supplied material.)
  • The resolution relies on the GAO opinion that the CMS notice is a rule that Congress can disapprove under chapter 8 of title 5.

Opponents' View#

  • One concern is that removing the prior-authorization rule may reduce CMS’s tools to curb wasteful or inappropriate services, which could lead to higher Medicare spending or more unnecessary care. The bill text does not address spending effects.
  • The bill does not specify which services are covered by the WISeR prior-authorization rule, so it is unclear who would be affected in practice.
  • It is unclear whether CMS would adopt other policies or rules to address the same issue after this disapproval. The resolution only nullifies the specific rule named; it does not prevent other rulemaking on the topic.