House Appropriations Committee Halts Implementation of CMS WISeR Model

This week, the House Appropriations Committee unanimously passed an amendment that would effectively halt the Centers for Medicare & Medicaid Services’ (CMS) Wasteful and Inappropriate Service Reduction (WISeR) Model. The provision, added to a broader appropriations bill to fund the Department of Health and Human Services (HHS) in FY 2027, would prohibit CMS from using federal funds to implement WISeR or any similar model that introduces prior authorization requirements in Medicare.

The committee’s action reflects growing bipartisan concern about the impact of prior authorization on patient access and provider burden. Lawmakers specifically cited concerns that the WISeR model could create delays in care and increase administrative complexity for providers.

ASA has previously expressed concerns with the WISeR Model. Last month, ASA sent a formal correspondence urging CMS to reform the WISeR Model to protect patient care and last year, ASA joined a coalition of leading surgical and specialty organizations to urge modifications to the AI-driven prior authorization program.

The unanimous and bipartisan support for this provision signals increasing congressional concern with prior authorization expansion in Medicare and raises serious questions about the future of the WISeR Model. The amendment represents a major step toward halting implementation of the WISeR model, but must still be voted on by the full House of Representatives, reconciled with the Senate’s spending package, and signed into law before taking effect.