A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services of the Department of Health and Human Services relating to "Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model".

This joint resolution would nullify a rule from the Centers for Medicare & Medicaid Services (CMS) that established the Wasteful and Inappropriate Services Reduction (WISeR) Model. The resolution would prohibit CMS from continuing to test this payment model, which uses third-party contractors and artificial intelligence to process prior authorization requests for Medicare claims in six states. By disapproving the rule, the resolution would stop the use of this model, which was designed to evaluate whether enhanced technology and performance-based contractor payments could streamline coverage determinations and reduce costs.

This resolution affects the Centers for Medicare & Medicaid Services (CMS) and third-party contractors hired to process prior authorization requests using enhanced technology. It also impacts healthcare providers and Medicare beneficiaries in the six states selected for the WISeR model: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. Additionally, the measure affects contracted companies that are currently paid based on a share of savings generated through the model's claims determination process.

• Nullification of the WISeR Medicare payment model. The resolution nullifies a Centers for Medicare & Medicaid Services (CMS) rule titled 'Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model.' This action effectively prohibits the agency from continuing to test or implement the model, which began on January 1, 2026.
• Termination of prior authorization technology testing. The measure stops the use of third-party contractors and enhanced technology, such as artificial intelligence, to process prior authorization requests for specific Medicare services. This prevents the testing of a system where contracted companies are compensated based on a share of the savings generated by their coverage determinations.
• Cessation of model operations in six states. The resolution halts the six-year pilot program specifically within the states selected for participation: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington.

The joint resolution would take effect immediately upon enactment, as it nullifies the agency rule and prohibits the Centers for Medicare & Medicaid Services from continuing to implement the model that began on January 1, 2026.

This joint resolution utilizes the Congressional Review Act to nullify a July 1, 2025, notice from the Centers for Medicare & Medicaid Services regarding the Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model. By disapproving this rule, the resolution prohibits the agency from continuing to implement or test this specific Medicare payment model.

This joint resolution seeks to nullify a Centers for Medicare & Medicaid Services (CMS) rule and prohibit the agency from continuing to test the Wasteful and Inappropriate Services Reduction (WISeR) Medicare payment model. The resolution specifically aims to stop the use of third-party contractors and enhanced technology, such as artificial intelligence, in the prior authorization process for Medicare claims across six selected states.