WISeR: ASA Actions

ASA is extremely concerned about the WISeR model and its effects on anesthesiologists, pain medicine physicians, and patients. This prior authorization model has increased the volume of items and services subject to prior authorization, which has historically not been ;used in traditional Medicare. In addition, WISeR has contribute to an already high administrative burden on physician practices and introduced barriers to care that have negatively impacted patients’ access to timely care.

On May 21, 2026, the ASA urged the Centers for Medicare & Medicaid Services to address significant issues with the early implementation of WISeR Model. Our comments reflect growing concerns anesthesiologists, pain medicine physicians, and patients have about delays in care, administrative burden, and risks to patient safety.

ASA recommended CMS:

• ASA urged the Centers for Medicare & Medicaid Services to address significant issues with the early implementation of WISeR Model . Our comments reflect growing concerns anesthesiologists, pain medicine physicians, and patients have about delays in care, administrative burden, and risks to patient safety. Read the details at ASA Raises Concerns with CMS WISeR Model Calls for Immediate Reforms to Protect Patient Care (May 2026)
• Create time-sensitive care exemptions for pain medicine services, including acute, cancer-related, and palliative pain management, where delays pose a clear risk of patient harm.
• Enforce CMMI-established review timelines for WISeR technology company participants. Apply financial penalties for WISeR participants who do not meet those timelines.
• Require automatic approval of procedures and anesthesia care when WISeR technology company participants fail to meet required review timelines.
• Implement a meaningful Gold Card Program that exempts compliant physicians and providers.
• Require WISeR technology company participants to provide timely technical support of less than 24 hours for clinically urgent and time-sensitive requests (e.g., patient safety needs for pain, oncology, post-operative care) and 72 hours for non-urgent requests to physicians that need assistance with the vendor’s platform.
• Instruct WISeR technology company participants to not impose conflicting documentation or clinical criteria, or additional requirements beyond those governed by National or Local Coverage Determinations (NCDs/LCDs).
• Ensure compensation for WISeR technology company participants is tied to timely, accurate reviews consistent with Medicare coverage standards instead of tied to approval or denial decision outcomes.
• Require transparent and public reporting of performance for WISeR technology company participants.

ASA is putting ASA member experiences front and center with CMS.

• On March 30, 2026, ASA convened a member town hall on Medicare’s WISeR Model for practices in the six mandatory participation states. Members from 15 states participated. The discussion surfaced real time implementation challenges, emerging operational issues, and areas of concern including delays in care due to the model rollout. ASA has used member experiences with WISeR to inform our advocacy and in the development of practical resources for members navigating WISeR requirements.

ASA WISeR Advocacy also functions as part of a coalition of organizations whose members are affected by WISeR. Here is ASA’s response:

• ASA joined a coalition of surgical and specialty organizations in a letter to CMS expressing concerns with this model.

• ASA joined a coalition in a letter to the House Appropriations Committee to express support of an amendment to halt funding for WISeR.