Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services…

Summary

This joint resolution prohibits the Centers for Medicare & Medicaid Services (CMS) from testing a new Medicare payment model in certain states that involves a prior authorization process and the use of enhanced technology by third-party contractors to determine whether certain claims should be paid. Specifically, the joint resolution nullifies a notice issued by the CMS on July 1, 2025, titled Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model . (On May 12, 2026, the Government Accountability Office issued a letter of opinion stating that this notice constituted an agency rule and is therefore subject to the Congressional Review Act.) The CMS selected six states to participate in this model over a six-year period: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. Under the model, contracted companies must process prior authorization requests (i.e., requests for coverage determinations before a service is furnished) for certain services using enhanced technology (e.g., artificial intelligence). Contracted companies are paid based on the share of resulting savings. The CMS aims to test the model's ability to produce accurate results while streamlining the prior authorization process for Medicare claims. The model is based in part on similar processes used for Medicare Advantage claims. CMS began implementing the model on January 1, 2026. This joint resolution prohibits the CMS from continuing to do so.

Summary from the Congressional Research Service. How we handle summaries

Where it stands

Assigned to a committee for review.

House Committee on Energy and Commerce · U.S. House of Representatives

Also referred to House Committee on Ways and Means · U.S. House of Representatives.

Your position on this bill

Choose the position closest to yours. You'll sign in or create an account to save it.

Cosponsors

Related bills

• S.J.Res. 192A 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".Identical bill
• S.J.Res. 198A 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".Identical bill

As identified by Congress.gov.

Full history

1. Jul 6, 2026

   Introduced

   Introduced in U.S. House

   U.S. House

2. May 19, 2026

   Introduced

   Introduced in House

   U.S. House of Representatives

3. May 19, 2026

   In committee

   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.

   U.S. House

4. May 19, 2026

   Referred to committee

   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.

5. May 19, 2026

   Referred to committee

   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.

Read the record

• Read on Congress.gov (opens in a new tab) The official record on Congress.gov.