WISeR Introduces Prior Authorization Requirements into Traditional Medicare, Citizens' Council for Health Freedom Warns

Report confirms CCHF’s 2024 warning to President Trump

ST PAUL, MN, UNITED STATES, May 4, 2026 /EINPresswire.com/ -- An April 22 report presented at a U.S. Senate hearing shows that a new Medicare pilot program is importing prior authorization requirements into traditional Medicare — requirements that Citizens' Council for Health Freedom says mirror the rationing mechanisms used in Medicare Advantage.

Citizens’ Council for Health Freedom (CCHF) says the report findings underscore concerns it raised in a December 2, 2024 letter to then President-Elect Donald J. Trump opposing the nomination of Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services (CMS).

"Prior authorization traps seniors in delays they specifically paid to avoid. They chose to pay higher premiums for Original Medicare to escape Medicare Advantage restrictions, but now the administration is importing Medicare Advantage rationing into Original Medicare. closing on the very senior citizens who chose traditional Medicare to escape rationing," said Twila Brase, RN, PHN, Co-founder and President of CCHF. "Dr. Oz’s preference for establishing a Medicare Advantage for All program in America is why we told President Trump in our December 2024 letter not to choose Dr. Oz to lead CMS. Our concerns were justified."

U.S. Senator Maria Cantwell (D-WA) presented to Senate Finance Committee members data from 16 Washington state hospitals on the Wasteful and Inappropriate Service Reduction (WISeR) Model, a CMS pilot launched January 1, 2026, to limit access to a defined list of services. Findings include:

Procedures previously approved in one to three days now take 15 to 20 days

Procedures previously approved in two weeks now take four to eight weeks

Nearly 100 patients in the University of Washington Medical System are waiting for epidural steroid injections

More than 18,600 Washington seniors used these services in 2024 and are now subject to prior authorization

The WISeR model applies to approximately 6.4 million Medicare beneficiaries across Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington.

Cantwell said artificial intelligence is being used by the prior authorization system as “a denial device.” Robert F. Kennedy Jr., Secretary of the U.S. Department of Health and Human Services, Robert F. Kennedy Jr. acknowledged there are “probably kinks” but defended the program.

CCHF says the structure of the new six-year pilot mirrors Medicare Advantage, where prior authorization is routinely used to delay or deny care, according to a 2018 HHS OIG report. The report found that Medicare Advantage plans have denied medically necessary, Medicare-approved services.

The organization also points to financial incentives embedded in the WISeR model. Contractors operating the program, including Virtix Health, are paid based on a share of the savings generated from denied claims.

“The door is closing on Medicare, and seniors do not realize that insolvency is just seven years away.” Brase said. "Prior authorization in Original Medicare is not ‘wiser,’ it’s deadlier. The fix is not more AI delays and denials. The fix is giving seniors the freedom they need, including the freedom to opt out of Medicare and buy affordable major medical insurance that puts them and their doctors in charge.”

CCHF is calling for an end to the WISeR pilot and a return to patient-centered coverage.

For more information or to schedule an interview with Twila Brase, contact Alexandra de Scheel at media@cchfreedom.org.

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About Citizens’ Council for Health Freedom:   

Since 1998, CCHF has existed to protect patient and doctor freedom. As a national, independent, non-partisan, non-profit health freedom organization, CCHF maintains a patient-centered, privacy-focused, free-market perspective. For more information, visit: www.cchfreedom.org. 

Alexandra de Scheel
Citizens' Council for Health Freedom
media@cchfreedom.org
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