Lawmakers Seek to Overturn CMS AI Prior Authorization Model
- •Democratic lawmakers introduced resolutions to overturn the CMS WISeR AI prior authorization pilot program.
- •The GAO determined the model is subject to the Congressional Review Act, enabling a 60-day window for a repeal vote.
- •Legislators and hospitals report the AI-driven pilot has doubled to quadrupled wait times for patient treatments.
Democratic lawmakers in the U.S. Senate and House of Representatives introduced resolutions on May 20, 2026, to repeal the Wasteful and Inappropriate Service Reduction (WISeR) model implemented by the Centers for Medicare & Medicaid Services (CMS). The initiative aims to invoke the Congressional Review Act (CRA) following a U.S. Government Accountability Office (GAO) determination that the model required congressional submission before implementation. Legislators now have 60 days to force a vote on the disapproval resolution.
The WISeR program, a year-long pilot launched on Jan. 1, 2026, utilizes artificial intelligence to automate prior authorizations for 13 medical services classified as vulnerable to misuse. The pilot currently operates in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.
Critics of the program, including Rep. Suzan DelBene, claim the model denies necessary patient care and risks privatizing traditional Medicare. An April report from Sen. Maria Cantwell, citing data from 16 hospitals, indicated that procedure completion times increased by two to four times following implementation. Provider groups including the American Hospital Association and the American Medical Association have also expressed concerns regarding administrative burdens and potential conflicts of interest within the program's structure.