CMS is launching a six-year pilot of the WISeR Model, starting January 2026 in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington, which will use AI and human review to expand prior ...

The letter to the CMS from Democrats is the latest salvo from lawmakers concerned that WISeR is delaying care to Medicare ...

Medicare is testing the use of artificial intelligence to preapprove several healthcare services.

The Centers for Medicare and Medicaid Services has announced a prior authorization program pilot for original Medicare. The six-year voluntary Wasteful and Inappropriate Service Reduction Model (WISeR ...

In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on ...

On June 27, 2025, the Centers for Medicare & Medicaid Services (“CMS”), through its Innovation Center (“CMMI”), released the Request for Applications (“RFA”) for a new payment and service delivery ...

For now, the most reasonable stance is watchful waiting: acknowledging the real problems WISeR seeks to address, recognizing the equally real risks it introduces, and insisting on transparency and ...

Thirty-one House Democrats are seeking more information on CMS’ Wasteful and Inappropriate Service Reduction model. The lawmakers sent a letter to CMS Administrator Mehmet Oz, MD, June 22, requesting ...

The Society for Cardiovascular Angiography and Interventions has come out in support of a legislative vote that would bar CMS from expanding the Wasteful and Inappropriate Service Reduction (WISeR) ...

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The Trump Administration is bringing prior authorizations (PAs), the mandatory preapproval before insurance covers health care services, to Traditional Medicare. The government plans on using ...