activevoluntaryprior-authorization

WISeR

Wasteful and Inappropriate Service Reduction (WISeR) Model

The Wasteful and Inappropriate Service Reduction (WISeR) Model helps protect American taxpayers by leveraging enhanced technologies, such as Artificial Intelligence (AI) and Machine Learning (ML), along with human clinical review, to ensure timely and appropriate Medicare payment for select items and services. The voluntary model encourages care navigation, encouraging safe and evidence-supported best practices for treating people with Medicare.

Active Since2026-01-01
Application Deadline2025-07-25

Innovation

Leveraging enhanced technologies, such as Artificial Intelligence (AI) and Machine Learning (ML), along with human clinical review, to expedite and improve the prior authorization review process for a pre-selected set of services.

The Problem

Waste in health care can not only harm patients but also contributes to up to 25% of health care spending in the United States. Wasteful, low-value services often have limited clinical evidence of effectiveness, may not align with an individual’s specific health condition or needs, or can lead to complications and further unneeded services.

The Solution

The WISeR Model helps reduce clinically unsupported care by working with companies experienced in using enhanced technologies to expedite and improve the review process for a pre-selected set of services that are vulnerable to fraud, waste and abuse.

Expected Outcomes

The WISeR Model helps ensure people with Medicare receive the most appropriate care that supports the best health outcomes while decreasing costs and easing administrative burden on providers and suppliers who go through the prior authorization process.

Strategy

The WISeR Model empowers patients to partner with their health care providers on the most clinically appropriate care plan; protects the taxpayer by decreasing fraud, waste and abuse; and focuses providers on care that has the most impact on the well-being of people with Medicare.

Model Goals

  • Promote evidence-based prevention by introducing clinical review with enhanced technology to ensure patients are receiving the most appropriate and effective care
  • Empower people to achieve their health goals by setting the stage for beneficiaries partnering with their clinicians on the most effective care plans
  • Drive choice and competition for people by applying new tools in Original Medicare and incentivizing participating companies to deliver fast, accurate, transparent prior authorization decisions

Patient Eligibility

People with Original Medicare receiving select nonemergent services.

  • Enrolled in Original Medicare
  • Receiving select items and services such as skin substitutes, knee arthroscopy, or electrical nerve stimulation

Provider Eligibility

Providers and suppliers delivering selected services in participating states.

  • Located in New Jersey, Ohio, Oklahoma, Texas, Arizona, or Washington
  • Delivering services in Hospital Outpatient Departments (HOPDs), Ambulatory Surgery Centers (ASCs), office, or home settings

Care Categories

Dermatology

Skin substitutes

Orthopedics

Knee arthroscopy for knee osteoarthritis

Pain Management

Electrical nerve stimulation

Program Benchmarks & Thresholds

financial

Healthcare Waste Percentage0.25%

operational

Units of Service Timeframe for Prior Authorization120
Standard Prior Authorization Determination Time3
Expedited Prior Authorization Determination Time2
Participants Announced DateNovember 6, 2025
Gold Carding Program Launch Year2,026
Real-Time Approvals Target Year2,027
Typical Implementation Timeline72
Model Duration in Years6
Model Start DateJanuary 1, 2026
Model End DateDecember 31, 2031
Number of Model Participants6
Participant Electronic Portal Implementation DeadlineJanuary 5, 2026
Pre-Payment Medical Review Start DateJanuary 15, 2026
Prior Authorization Turnaround Time72
Prior Authorization Turnaround Time Start DateJanuary 5, 2026
Application Period Close DateJuly 25, 2025
Prior Authorization Request Acceptance Start DateJanuary 5, 2026

population

Number of Participating States6

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