New Video With Additional Details on WISeR Model

As APMA previously reported in July, the Centers for Medicare & Medicaid Services (CMS) announced the creation of the Wasteful and Inappropriate Service Reduction (WISeR) Model. The WISeR Model is designed to target services within Medicare that are considered vulnerable to fraud, waste, and abuse, including the use of skin substitutes for diabetic foot ulcers and venous leg ulcers.

CMS has released additional information related to how the new prior authorization process will work in impacted states, effective January 5, 2026. APMA Health Policy Advisor Jeffrey Lehrman, DPM, CPC, recorded an extended video detailing the new information available. Dr. Lehrman outlines several aspects of the WISeR Model, including its objectives, the timeline for implementation, and the impacted states (Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington).

APMA will continue to voice strong opposition to the WISeR Model and will provide CMS with recommendations. Previously, APMA expressed opposition to the expansion of prior authorization under the new model and warned of potential threats to beneficiary access to medically necessary care.

To assist members in impacted states, APMA has created a WISeR Model resource page, and APMA will continue to update members as new details emerge.

Contact the APMA Advocacy Department with any questions or concerns.