Following the release of the new Wasteful and Inappropriate Service Reduction (WISeR) model by the CMS, APMA promptly engaged with CMS to share the association's concerns and provide its recommendations. Now, House Democratic lawmakers, led by Representatives Susan DelBene (D-WA-01) and Ami Bera, MD (D-CA-06), have sent a letter seeking further information on the WISeR model from CMS as well.
The group of 17 House Democrats highlighted the burden of expanded prior authorization and prepayment medical review, which introduces new administrative burden, documentation requirements, and possible care delays. The letter also contained questions about the criteria for state selection criteria for the model, patient and provider education for the new requirements, impact on provider burnout, the impact of compensation for "averted expenditures," and time requirements for prior authorization decisions.
APMA has shown early leadership on the WISeR model including a video by APMA Health Policy Advisor Jeffrey Lehrman, DPM, that breaks down the new model and its potential impact on podiatrists. APMA has proposed strategies to reduce administrative burden and ensure continued access to essential foot and ankle care should CMS move forward with implementing the WISeR model as well. APMA will continue to communicate its concern and opposition to the expanded use of prior authorization within Medicare with CMS if it continues to move forward with the WISeR model.
Members can read APMA's letter to CMS on the WISeR model at www.apma.org/CommentLetters. Contact the APMA Advocacy Department with any questions or concerns.