This resolution expresses the House’s disapproval of the proposed Wasteful and Inappropriate Services Reduction (WISeR) Model. It says the model would expand prior authorization requirements in traditional Medicare by 30 percent, use private companies and automated tools to review requests, and could undermine access to timely, necessary care. It asks the Centers for Medicare and Medicaid Services to terminate the model.
If adopted, the resolution would state the House’s position and request that the agency end the WISeR Model. It does not itself describe changes to an individual’s health coverage or care.
No publicly available information.
The resolution’s sponsors argue that expanded prior authorization could delay needed care. It cites reports of physician burnout linked to prior authorization and of Medicare Advantage denials being overturned on appeal. It also cites reported high error rates in some artificial intelligence tools used for coverage reviews.
No publicly available information.