What you Need to Know About the CMS’s WISeR Model and Impact on Prior-Authorization Requirements

For years, prior authorization has been a defining feature of Medicare Advantage and commercial health plans. Traditional Medicare, however, has largely avoided it — until now. Beginning Jan. 1, 2026, the Centers for Medicare & Medicaid Services (CMS) will launch one of its most significant oversight experiments yet: the Wasteful and Inappropriate Services Reduction (WISeR) […]