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".
- Sponsor
- Sen. Ron Wyden (D-OR) (D)
- Introduced
- 2026-06-24
- Latest action
- Motion to proceed to consideration of measure rejected in Senate by Yea-Nay Vote. 46 - 50. Record Vote Number: 199. (2026-07-16)
No recorded vote yet
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# Summary of SJRES 198
The resolution allows Congress to disapprove of a Medicare rule that would expand prior authorization requirements for certain medical services under the Centers for Medicare & Medicaid Services' "Wasteful and Inappropriate Services Reduction" (WISeR) Model. Prior authorization is a process where doctors must get approval from insurance companies before providing specific treatments to patients. The measure directly affects Medicare patients, healthcare providers, and insurers by potentially blocking or delaying the implementation of this particular prior authorization expansion.
Congress introduced this disapproval tool in response to concerns about the WISeR Model rule and its potential effects on patient care and physician practices. The rule was designed to reduce unnecessary medical spending and inappropriate services within Medicare, but critics argue that expanded prior authorization can delay necessary care and increase administrative burdens on doctors. If passed, the resolution would prevent the rule from taking effect, though whether this reflects broader concerns about prior authorization policy or specific issues with this particular model's implementation remains a matter of debate among lawmakers and healthcare stakeholders.
Key provisions
- Disapproves the Medicare rule expanding prior authorization requirements for select services under the WISeR Model.
- Blocks implementation of the Centers for Medicare & Medicaid Services' prior authorization expansion rule.
- Prevents doctors from needing insurance company approval before providing treatments covered by the WISeR Model.
- Affects Medicare patients, healthcare providers, and insurers by halting the prior authorization requirement expansion.
- Uses congressional disapproval authority under chapter 8 of title 5 to reject the CMS rule.
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