HR6361-119

2. Prohibiting implementation of Center for Medicare and Medicaid Innovation models testing prior authorization under traditional Medicare The Secretary of Health and Human Services may not implement the innovative payment and service delivery model described in the notice titled Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model (90 Fed. Reg. 28749 (July 1, 2025)), or any substantially similar model. Section 1115A(b)(2) of the Social Security Act (42 U.S.C. 1315a(b)(2)) is amended— in subparagraph (A), by striking The Secretary shall select and inserting Subject to the limitation under subparagraph (D), the Secretary shall select; and by adding at the end the following new subparagraph: Beginning on the date of the enactment of this subparagraph, the Secretary may not select a model to be tested under subparagraph (A) if such model would provide for the implementation of prior authorization (including through the use of artificial intelligence) with respect to items or services for which payment may be made under part A or part B of title XVIII. (D)Limitation on models to be testedBeginning on the date of the enactment of this subparagraph, the Secretary may not select a model to be tested under subparagraph (A) if such model would provide for the implementation of prior authorization (including through the use of artificial intelligence) with respect to items or services for which payment may be made under part A or part B of title XVIII..