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
- Rep. Landsman, Greg [D-OH-1]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- May 19, 2026
Bottom line
H.J. Res. 187 seeks to block a CMS rule that would introduce prior authorization requirements for specific Medicare services under the WISeR Model, thereby preventing new administrative burdens and potential delays in patient care.
What it actually does
This joint resolution utilizes the Congressional Review Act (CRA) to formally disapprove a final rule issued by the Centers for Medicare & Medicaid Services (CMS). The rule, titled "Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model," would establish new prior authorization requirements for certain Medicare services. By enacting this resolution, Congress would nullify the CMS rule, preventing it from taking effect, and prohibit CMS from issuing a substantially similar rule in the future without specific congressional reauthorization.
Proponents argue
Proponents of this resolution argue that the CMS rule imposes unnecessary administrative burdens on healthcare providers, potentially delaying access to critical care for Medicare beneficiaries. They contend that prior authorization processes often lead to increased paperwork, denials, and appeals, which can negatively impact patient outcomes and provider efficiency, ultimately hindering the delivery of timely and appropriate medical services.
Opponents contend
Opponents of this resolution (and proponents of the CMS rule) assert that the CMS rule is a necessary measure to reduce wasteful and inappropriate services within the Medicare program, thereby protecting taxpayer dollars and ensuring the program's long-term sustainability. They argue that prior authorization helps prevent fraud, abuse, and medically unnecessary procedures, ultimately improving the quality and cost-effectiveness of care for all beneficiaries.
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Resolved by the Senate and House of Representatives... That Congress disapproves the rule...
Disapproval of CMS Prior Authorization Rule for WISeR Model
This provision explicitly states that Congress disapproves the rule submitted by the Centers for Medicare & Medicaid Services (CMS) regarding the implementation of prior authorization for select services under the Wasteful and Inappropriate Services Reduction (WISeR) Model. If enacted, this resolution would nullify the CMS rule, preventing it from taking effect. Furthermore, under the Congressional Review Act, CMS would be prohibited from reissuing a substantially similar rule in the future without specific congressional authorization, thereby permanently blocking this particular regulatory approach.
Supporters argue
Supporters of this disapproval resolution argue that the CMS rule would create unnecessary bureaucratic hurdles, leading to delays in patient care and increased administrative costs for providers. They believe that prior authorization can be a significant barrier to timely access for medically necessary services, potentially harming vulnerable Medicare beneficiaries and diverting resources from direct patient care.
Critics contend
Opponents of this disapproval resolution (i.e., proponents of the CMS rule) contend that the prior authorization model is a crucial tool for combating fraud, waste, and abuse within Medicare. They argue that it ensures services are medically necessary, thereby protecting the program's financial integrity and ensuring resources are used appropriately, ultimately benefiting taxpayers and the long-term sustainability of Medicare.
Tradeoffs
This provision highlights a fundamental tension between reducing administrative burden and ensuring timely patient access to care versus implementing cost-saving measures and preventing fraud within the Medicare system. It forces a choice between prioritizing provider autonomy and patient access on one hand, and program integrity and fiscal responsibility on the other.