ASA Raises Concerns with CMS WISeR Model Calls for Immediate Reforms to Protect Patient Care

The American Society of Anesthesiologists (ASA) recently urged the Centers for Medicare & Medicaid Services (CMS) to address significant concerns with the early implementation of the Wasteful and Inappropriate Service Reduction (WISeR) Model. Our comments reflect growing concerns from anesthesiologists, pain medicine physicians, and patients about delays in care, administrative burden, and risks to patient safety.

In a formal correspondence to CMS Administrator Mehmet Oz, ASA described how the WISeR Model in its current form is falling short of its intended goals. Instead of streamlining prior authorization, anesthesiologists and pain medicine physicians report that the model is creating inefficiencies and barriers that delay medically necessary care for Medicare beneficiaries. The document also offered ASA’s support of efforts to reduce fraud, waste, and abuse.

ASA highlighted that anesthesia services face unique documentation and billing complexities due to reliance on multiple care settings and providers. These challenges complicate participation in WISeR’s prior authorization processes and increase the likelihood of inappropriate denials or delays. Physicians have also reported insufficient accountability among WISeR technology vendors, contributing to inconsistent reviews and prolonged approval timelines.

To address these concerns, ASA called on CMS to implement a series of targeted reforms to improve the model’s functionality and safeguard patient care. Key recommendations include establishing exemptions for time-sensitive pain management services, enforcing strict review timelines for WISeR contractors, and requiring automatic approvals when deadlines are not met. ASA also urged CMS to create a meaningful “Gold Card” program to reduce administrative burden for physicians with a proven track record of compliance.

Additionally, the Society recommended aligning WISeR documentation requirements to established Medicare coverage policies and ensuring that vendor compensation is tied to accuracy and timeliness not approval or denial rates. ASA stressed the importance of transparency, calling for public reporting on vendor performance.

ASA warned that without swift action, ongoing issues with the WISeR Model could undermine its objectives and increase costs across the health care system due to delayed care and avoidable complications. The Society reaffirmed its commitment to working with CMS to refine the model so it better supports high-quality, timely care for patients.

If you or your group have questions on or have experienced administrative burdens, delays of care, or other issues with the WISeR model, please contact ASA Payment and Practice Management at [email protected].