WISeR Prior Authorization Implementation Delay

Content

ACTION:

Notice.

SUMMARY:

This notice announces a delay in the implementation of two services from the list of Wasteful and Inappropriate Services Reduction
(WISeR) model items and services.

DATES:

The notice is effective April 6, 2026.

FOR FURTHER INFORMATION CONTACT:

Kate Blackwell (844) 711-2664, Option 8 or WISeR@cms.hhs.gov.

SUPPLEMENTARY INFORMATION:

I. Background

In the July 1, 2025,
Federal Register
(90 FR 28749), we published a notice titled “Medicare Program; Implementation of Prior Authorization for Select Services for
the Wasteful and Inappropriate Services Reduction (WISeR) Model”. The notice announced a 6-year model focused on reducing
fraud, waste (including low-value care), and abuse in Medicare fee-for-service (FFS) via the implementation of technology-enabled
prior authorization processes for select services. For more detailed information regarding the WISeR Model, see the July 2025
notice (90 FR 28749).

II. Delayed Implementation of Select Services

In the July 2025 notice (90 FR 28751), we specified that the prior authorization process under the model will be implemented
in the selected states for the listed items and services with affiliated national coverage decisions (NCDs) or local coverage
decisions (LCDs) beginning January 1, 2026. We are delaying implementation of two of the services announced in the July 2025
notice to allow additional time for operational readiness. Implementation of the prior authorization or pre-payment review
process for these two services is delayed until a future date that will be announced in a subsequent
Federal Register
notice. Until the future implementation date is announced, neither the prior authorization nor the pre-payment review processes
described in our earlier notice will be available for these services. The two services for which we are delaying implementation
of the prior authorization or pre-payment review process are as follows:

• Deep Brain Stimulation for Essential Tremor and Parkinson's Disease (NCD 160.24).
• Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis (NCD 150.13). The Administrator of the Centers for Medicare & Medicaid Services (CMS), Dr. Mehmet Oz, having reviewed and approved this document, authorizes Chyana Woodyard, who is the Federal Register Liaison, to electronically sign this document for purposes of publication in the Federal Register .

Chyana Woodyard, Federal Register Liaison, Centers for Medicare & Medicaid Services. [FR Doc. 2026-06616 Filed 4-3-26; 8:45 am] BILLING CODE 4120-01-P

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