Last week, the CMS Innovation Center announced a new model, known as the Wasteful and Inappropriate Service Reduction Model or WISeR Model, which aims to harness enhanced technologies like artificial intelligence and machine learning to streamline the review process for certain items and services that are vulnerable to fraud, waste, and abuse under Medicare. The model is voluntary and will run for six performance years from January 1, 2026, to December 31, 2031.
Note that the WISeR model will exclude inpatient-only services, emergency services, and services that would pose a substantial risk to patients if substantially delayed. Members should also note that the model does not apply to Medicare Advantage.