Senate Republicans have blocked an effort to advance a Democratic-led resolution to repeal CMS’ Wasteful and Inappropriate Service Reduction model, an AI-assisted prior authorization pilot within the traditional Medicare program.
On July 16, senators voted 46-50 along party lines against a motion to move the measure forward.
Oregon Sen. Ron Wyden, the ranking Democrat on the Senate Finance Committee, introduced the resolution in June. The effort followed a May determination from the Government Accountability Office that WISeR qualifies as a rule subject to the Congressional Review Act, opening a 60-day window for lawmakers to force a vote.
CMS launched WISeR on Jan. 1 in Arizona, Washington, New Jersey, Texas, Ohio and Oklahoma. The model, set to run through the end of 2031, applies prior authorization to certain traditional Medicare services and relies on for-profit vendors that use AI tools to process requests and reviews. The contractors are compensated based on a share of “averted expenditures,” which some lawmakers have argued creates an incentive to deny care.
CMS Administrator Mehmet Oz, MD, has said WISeR will “help root out waste in original Medicare” while testing a faster prior authorization process, and the agency has said clinicians, not algorithms, have final authority to deny services.
The vote is the latest in a string of Democratic attempts to unwind the pilot. The House Appropriations Committee adopted an amendment June 9 to block WISeR funding in its fiscal 2027 spending bill, and 31 House Democrats pressed CMS for implementation data in a June 22 letter.
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