A group of Senate Democrats introduced a resolution on May 20, 2026, aimed at overturning a Medicare pilot program that utilizes artificial intelligence for prior authorization. The legislation, supported by 20 senators including Ron Wyden, D-Ore., Maria Cantwell, D-Wash., Richard Blumenthal, D-Conn., and Kirsten Gillibrand, D-N.Y., seeks to invoke the Congressional Review Act to terminate the Wasteful and Inappropriate Service Reduction (WISeR) model.

The WISeR pilot, which launched earlier this year in six states, was initiated by the Centers for Medicare and Medicaid Services (CMS) to mitigate fraud and wasteful spending in traditional Medicare. The program contracts with private entities to apply AI-driven prior authorization for specific services deemed vulnerable to misuse, such as epidural steroid injections and skin substitutes. However, critics argue the system adds administrative burdens, delays necessary treatments, and inappropriately denies care to seniors.

The legislative push follows a determination by the Government Accountability Office (GAO) that the WISeR pilot constitutes agency rulemaking, despite the Department of Health and Human Services (HHS) previously classifying it as non-binding guidance. Because the model creates new requirements for providers and beneficiaries, the GAO ruling permits Congress to review and potentially repeal the program. Under the Congressional Review Act, the determination initiates a 60-day window for lawmakers to force a floor vote on the resolution. Previous efforts to address these concerns included a report from Sen. Cantwell in April 2026, which indicated that services subject to the model experienced significant approval delays, and failed legislative attempts by House Democrats last year to repeal the program.

A group of Senate Democrats introduced a resolution on May 20, 2026, aimed at overturning a Medicare pilot program that utilizes artificial intelligence for prior authorization. The legislation, supported by 20 senators including Ron Wyden, D-Ore., Maria Cantwell, D-Wash., Richard Blumenthal, D-Conn., and Kirsten Gillibrand, D-N.Y., seeks to invoke the Congressional Review Act to terminate the Wasteful and Inappropriate Service Reduction (WISeR) model.

The WISeR pilot, which launched earlier this year in six states, was initiated by the Centers for Medicare and Medicaid Services (CMS) to mitigate fraud and wasteful spending in traditional Medicare. The program contracts with private entities to apply AI-driven prior authorization for specific services deemed vulnerable to misuse, such as epidural steroid injections and skin substitutes. However, critics argue the system adds administrative burdens, delays necessary treatments, and inappropriately denies care to seniors.

The legislative push follows a determination by the Government Accountability Office (GAO) that the WISeR pilot constitutes agency rulemaking, despite the Department of Health and Human Services (HHS) previously classifying it as non-binding guidance. Because the model creates new requirements for providers and beneficiaries, the GAO ruling permits Congress to review and potentially repeal the program. Under the Congressional Review Act, the determination initiates a 60-day window for lawmakers to force a floor vote on the resolution. Previous efforts to address these concerns included a report from Sen. Cantwell in April 2026, which indicated that services subject to the model experienced significant approval delays, and failed legislative attempts by House Democrats last year to repeal the program.