House Appropriations Committee Votes to End WISeR Model

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Policymakers and stakeholders have raised concerns about delays in care and increased administrative burden for providers, as well as limited oversight and transparency regarding the WISeR model's costs and impacts.

The House Appropriations Committee voted unanimously on June 9, 2026, to amend the Fiscal Year (FY) 2027 Labor, Health and Human Services, and Education (Labor-H) bill to prohibit the Centers for Medicare and Medicaid Services (CMS) from using any funds to implement the Wasteful and Inappropriate Services Reduction (WISeR) model or another model that seeks to use prior authorization practices in the traditional Medicare program.

As part of CMS's efforts to address fraud, waste, and abuse, the WISeR demonstration launched on January 1 in New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. The model tests the use of artificial intelligence in prior authorization decisions for select Part B items and services in traditional fee-for-service Medicare. Policymakers and stakeholders have raised concerns about delays in care and increased administrative burden for providers, as well as limited oversight and transparency regarding the model's costs and impacts. In response, the amendment to the bill directs CMS to submit a report to Congress in FY 2028 detailing the model's impact and the criteria used to select participating states.

While the provision was included in FY27 Labor-H bill, the bill still must be passed by the full House and included in a final bill also adopted by the Senate and then signed by the President.

LeadingAge will continue to monitor developments related to the future of the WISeR model. Watch for a forthcoming article on additional aspects of the House Committee's Labor-H funding bill.