119-hres704

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 704 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
H. RES. 704

Expressing the sense of the House of Representatives that the Wasteful 
and Inappropriate Service Reduction Model undermines beneficiary access 
 to health care and should not be implemented.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 September 11, 2025

Mr. Pocan (for himself, Ms. Schakowsky, Mr. Doggett, Ms. Ocasio-Cortez, 
 Ms. Tlaib, Mrs. Watson Coleman, Mr. Landsman, and Ms. Goodlander) 
submitted the following resolution; which was referred to the Committee 
 on Ways and Means, and in addition to the Committee on Energy and 
Commerce, for a period to be subsequently determined by the Speaker, in 
 each case for consideration of such provisions as fall within the 
 jurisdiction of the committee concerned

_______________________________________________________________________

 RESOLUTION

Expressing the sense of the House of Representatives that the Wasteful 
and Inappropriate Service Reduction Model undermines beneficiary access 
 to health care and should not be implemented.

Whereas the Center for Medicare and Medicaid Innovation proposed a program 
 called the Wasteful and Inappropriate Services Reduction

    (WISeR) Model 
 to commence on January 1, 2026;
Whereas the WISeR Model proposes to increase the number of services that require 
 prior authorization in traditional Medicare by 30 percent;
Whereas the WISeR Model proposes to contract with private companies that are 
 currently administering prior authorization processes for private 
 insurance companies, including Medicare Advantage companies;
Whereas the WISeR Model proposes to use enhanced technologies, including 
 artificial intelligence and machine learning, to process the expanded 
 prior authorizations in traditional Medicare;
Whereas prior authorization has become an obstacle to needed medical care for 
 patients;
Whereas, according to the American Medical Association, 89 percent of physicians 
 report that prior authorization contributes to physician burnout;
Whereas, according to the Medicare Limited Data Set published by the Centers for 
 Medicare and Medicaid Services, private companies targeted for 
 participation in this model have a demonstrated record of incorrect 
 decisions on prior authorization requests, are 81.7 percent of denials 
 made by Medicare Advantage insurers overturned once appealed, according 
 to the Kaiser Family Foundation; and
Whereas, according to an article in Fierce Healthcare, tools using artificial 
 intelligence to review coverage decisions developed by private health 
 insurance companies, like those targeted for participation in the WISeR 
 model, are reported to have 90 percent error rates: Now, therefore, be 
 it
 Resolved, That the House of Representatives--

    (1) expresses disapproval of the Wasteful and Inappropriate 
 Service Reduction

    (WISeR) Model;

    (2) finds that expanding prior authorization processes used 
 in Medicare Advantage into the publicly administered 
 traditional Medicare Program undermines beneficiary access to 
 timely and necessary medical care; and

    (3) strongly requests that the Centers for Medicare and 
 Medicaid Services terminate the WISeR Model.
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