Short answer (updated Oct 17, 2026): CMS's Wasteful and Inappropriate Service Reduction (WISeR) model uses AI and machine learning, with human clinical review, to run prior authorization for selected Original Medicare services in six states from Jan 1, 2026 to Dec 31, 2031. GAO concluded on May 12, 2026 that the model's notice is a rule under the Congressional Review Act, and a Senate attempt to disapprove it failed on July 16, 2026.
Key facts
| Model | WISeR (CMS Innovation Center) |
|---|---|
| Notice | Federal Register, July 1, 2025 (2025-12195), effective Jan 1, 2026 |
| Period | Jan 1, 2026 to Dec 31, 2031 |
| States | Arizona, New Jersey, Ohio, Oklahoma, Texas, Washington |
| How it works | Providers can request prior authorization for the selected services or face pre-payment medical review |
| Participants | Cohere Health, Genzeon, Humata Health, Innovaccer, Virtix Health, Zyter (one per state) |
| GAO opinion | B-337994, May 12, 2026: the notice is a rule subject to the Congressional Review Act |
| Senate vote | Motion to proceed to S.J. Res. 198 rejected 46 to 50, July 16, 2026 |
States
Several states have passed laws in 2026 limiting insurers' use of AI in coverage decisions, for example Alabama SB 63, effective Oct 1, 2026, which bars basing coverage decisions solely on AI. See issue #1 for the list and sources.
Related
Sources
- CMS: WISeR model
- Federal Register 2025-12195
- GAO B-337994
- U.S. Senate roll call vote 199 (July 16, 2026)
FAQ
What is the WISeR model?
A CMS Innovation Center model that tests technology-enabled prior authorization and pre-payment review, using AI and machine learning with human clinical review, for selected services in Original Medicare.
Which states are in WISeR?
Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington.
Did Congress overturn WISeR?
No. A Senate motion to proceed to S.J. Res. 198, which would have disapproved it, was rejected 46 to 50 on July 16, 2026.