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Ends Medicare Prior Approval Test Program
Recent Bills/Ends Medicare Prior Approval Test Program

Ends Medicare Prior Approval Test Program

IntroducedMay 19, 2026
In Senate4 months ago
Intro
Senate
House
Pres
Waiting for a House floor vote.
It has cleared committee and can be brought up at any time, though no date is set.
Health
More:Bills in the SenateHealthcareResolutions
Why This Matters

This resolution would cancel a Medicare test program in six states that has private companies review certain procedures in traditional Medicare, through advance approval requests or checks of claims before payment. It takes effect only if both the House and Senate pass it and the President signs it, or Congress overrides a veto.

If you have traditional Medicare in Arizona, New Jersey, Ohio, Oklahoma, Texas, or Washington, your doctor would no longer face the program's extra approval or payment reviews for procedures like knee arthroscopy or certain spinal injections.
Who this affects
Traditional Medicare patients · Doctors and hospitals · Medicare review contractors
What does this resolution do?
  1. 1The Wasteful and Inappropriate Services Reduction (WISeR) test program adds advance approval, or review of claims before payment, for select procedures in traditional Medicare in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.
  2. 2Under the program, private technology companies, some using artificial intelligence, screen requests for services like knee arthroscopy, nerve stimulator implants, and certain spinal injections.
  3. 3Ending the rule means claims for these services in those states would no longer face the program's extra review, as before the program started.
  4. 4Under the Congressional Review Act, Medicare could not later issue a substantially similar prior approval rule unless Congress specifically authorizes it.
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Last changed today · checked hourly

Bill Progress3 of 4
Bills must pass the House, Senate, and be signed by the President to become law.
Intro
Senate
House
Pres
IntroducedMay 19
Sponsors
See all 21 sponsors
Senate
HouseCurrent

Waiting for a House floor vote.

It has cleared committee and can be brought up at any time, though no date is set.

President

The President

Donald Trump
President
Awaiting Vote
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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".
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