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Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model

Source
Federal Register
Date
Jun 30, 2025
Summary
Pre-publication notice from the Centers for Medicare & Medicaid Services (CMS) announcing a 6-year model, the Wasteful and Inappropriate Services Reduction (WISeR) Model. This model will test the implementation of technology-enabled prior authorization processes for select services, with the aim of reducing fraud, waste (including low-value care), and abuse in Medicare fee-for-service (FFS) in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. This notice is effective January 1, 2026.
Tagged as
Access · Healthcare business and finance · Medicare · Policy · Technology for health and human services · Arizona · New Jersey · Ohio · Oklahoma · Texas · Washington