Join leaders from the Centers for Medicare and Medicaid Services’ (CMS’) Center for Medicare & Medicaid Innovation (CMMI) and the American Medical Association on Oct. 22 at 7 pm CT in discussing the Wasteful and Inappropriate Service Reduction (WISeR) pilot, which will test new prior authorization processes for select services in the Medicare fee-for-service program in Texas and five other states.
Abe Sutton, CMMI director and CMS deputy administrator, and John Whyte, MD, CEO and executive vice president of AMA, will discuss WISeR model policies, operational details, and implications for impacted physicians and patients. Attendees will have a chance to submit questions during registration and during the webinar to be answered directly by CMMI.
Register now.
CMS says WISeR will test the ability of enhanced technology such as artificial intelligence to expedite the utilization review process – including prior authorization – for a select group of Medicare services the agency has identified as “particularly vulnerable to fraud, waste, and abuse, or inappropriate use,” such as skin and tissue substitutes, electrical nerve stimulator implants, and knee arthroscopy for knee osteoarthritis. CMS notes exceptions for inpatient-only services, emergency services, and “services that would pose a substantial risk to patients if significantly delayed.”
The full list of impacted services is included in the Federal Register notice detailing the program.
Although not officially part of the proposed 2026 Medicare physician fee schedule, the Texas Medical Association took the opportunity in its comments on the payment proposal to implore CMS to pause WISeR’s implementation pending additional stakeholder input, more thorough analysis, and clearer guidelines for physicians and patients.
Continue to read Texas Medicine Today for program updates and learn more about TMA’s federal advocacy work.
Last Updated On
October 15, 2025
Originally Published On
October 15, 2025