Senate Rejects Motion to Proceed to Disapprove AI-Driven Medicare Prior Authorization Rule (WISeR Model) 46-50
The Senate convened on July 16, 2026, and engaged in a significant debate regarding a joint resolution (S.J. Res. 198) to disapprove the Centers for Medicare & Medicaid Services' (CMS) Wasteful and Inappropriate Services Reduction (WISeR) Model. This model introduces AI-driven prior authorization for select services in traditional Medicare. The motion to proceed to the resolution ultimately failed by a vote of 46-50. The Senate also confirmed a large batch of military and International Trade Commission nominations and voted to invoke cloture on a judicial nomination.
The failure to proceed with S.J. Res. 198 means the Trump administration's WISeR Model, which introduces AI-driven prior authorization into traditional Medicare, will continue its pilot program in six states and potentially expand nationwide. This decision has direct implications for Medicare beneficiaries and healthcare providers, affecting access to and approval processes for certain medical services.
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"
S.J. Res. 198Question before the chamber
Motion to proceed to Calendar No. 447, S.J. Res. 198, a joint resolution providing for congressional disapproval of the WISeR Model rule.
The case for
Senators Wyden and Murray argued that the WISeR Model, implemented by the Trump administration, empowers "unaccountable AI companies" and "for-profit AI contractors" to delay and deny care in traditional Medicare, breaking a promise to seniors. They highlighted that these contractors are incentivized by a percentage of denied care costs, leading to "perverse" outcomes. They cited cases of seniors waiting weeks for necessary pain relief and pointed out that prior authorization in Medicare Advantage often denies legitimate care, with 8 out of 10 appealed denials being overturned. They asserted that the model is "reckless" and "irresponsible," especially as many procedures included are nonopioid pain treatments, and that the issue of skin substitute overuse has already been addressed by payment rate changes.
The case against
Senator Crapo argued that the WISeR model is an important tool to address "massive waste and abuse" in Medicare, where the system often incentivizes low-value, high-cost services. He noted that Medicare spending on skin substitutes, a service covered by WISeR, dramatically increased from $256 million in 2019 to $10 billion in 2024, indicating a need for proactive scrutiny. He emphasized that the model uses "board-certified clinicians--not technological machines" to make final decisions when issues arise, and that it aims to offer providers payment predictability while detecting and preventing fraud. He urged colleagues to oppose the resolution, stating that ending the pilot program prematurely would deprive CMS of a useful tool.
Disposition
Motion to proceed rejected. · recorded vote
The Senate did not proceed to consider S.J. Res. 198.
yeas 46, nays 50
Who is affected
- Medicare beneficiaries (seniors): Potential delays or denials of doctor-recommended care due to AI-driven prior authorization.
- Healthcare providers: Increased bureaucratic hurdles and potential for delayed patient treatment approvals.
- Private insurance companies and AI contractors: Continued opportunity to operate and profit from prior authorization services in traditional Medicare.
Motion to Disapprove Medicare AI Prior Authorization Fails
highThe Senate rejected the motion to proceed to S.J. Res. 198, a joint resolution aiming to disapprove the CMS WISeR Model, by a vote of 46-50. This outcome allows the AI-driven prior authorization pilot program in traditional Medicare to continue its operation in six states, impacting patient care and provider autonomy.
Cloture Invoked on Judicial Nomination
mediumThe Senate successfully invoked cloture on the nomination of Kara Marie Westercamp to be a Judge of the United States Court of International Trade with a vote of 49-48, advancing her nomination towards a final confirmation vote and limiting further debate.
Cloture Motion Filed for Circuit Judge Nomination
mediumA cloture motion was filed for the nomination of Benjamin M. Flowers to be United States Circuit Judge for the Sixth Circuit, a procedural step that will lead to a future vote to limit debate on his confirmation and expedite the process.
Extensive Military and Trade Commission Nominations Confirmed
lowThe Senate confirmed en bloc a large number of military nominations across various branches, including several general and flag officers, alongside five nominations to the United States International Trade Commission, ensuring continuity in leadership and policy roles.