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Home / Resources / Key Resources / Blog

Senate Democrats Move to Repeal CMS's WISeR AI Prior Authorization Model

May 28, 2026

Senate Democrats have introduced a Congressional Review Act (CRA) resolution seeking to overturn CMS’s Wasteful and Inappropriate Service Reduction (WISeR) model — an AI-supported prior authorization program currently operating in traditional Medicare.

Led by Sens. Ron Wyden, Maria Cantwell, Richard Blumenthal, and Kirsten Gillibrand, the resolution follows a May 12 Government Accountability Office ruling determining that WISeR is subject to congressional review. A companion House resolution was also introduced.

The WISeR model launched January 1, 2026, in six states and currently applies prior authorization to selected services CMS considers vulnerable to fraud and waste. Although GI procedures are not currently included, the model is expected to expand through 2031.

Why it matters for GI: The expansion potential and contractor compensation structure — tied in part to claim denials — raise broader concerns about future prior authorization burdens in traditional Medicare. An April 2026 Senate report also found the program contributed to delays in care approvals in Washington state.

ASGE is monitoring the legislation and will continue to keep members informed.

 

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