Sens. Patty Murray (D-Wash.) and Maria Cantwell (D-Wash.) introduced a Congressional Review Act resolution to overturn a federal pilot program that uses artificial intelligence to conduct prior authorization for Medicare patients — a system that hospitals and physicians say is overriding doctors’ medical decisions, delaying care, and denying procedures for seniors experiencing debilitating pain.
The resolution targets the Wasteful and Inappropriate Service Reduction model, known as WISeR, which launched on Jan. 1, 2026, and operates in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. Under the program, Traditional Medicare claims for certain procedures must pass through an AI-driven review system operated by for-profit contractors who are compensated based on a share of “averted expenditures” — meaning they are financially incentivized to deny prior authorization requests.
“AI should not get to decide what health care patients can and can’t receive,” Murray said. She noted that she “constantly hears from patients who are suffering because they are not getting the care they need soon enough thanks to a rushed and inappropriate deployment of this harmful model.”
The legislative move gained momentum after the Government Accountability Office confirmed last week that the WISeR model meets the definition of a rule subject to the CRA and should have been submitted to Congress before it could take effect. That determination opened a 60-day window for lawmakers to force a vote to repeal the program by simple majority.
Prior authorization — in which a claim must be approved before a procedure can proceed — is common in Medicare Advantage and private insurance but has been rare in Traditional Medicare, which is often a key reason seniors choose it. The WISeR pilot subjects 13 categories of procedures to the new AI-driven review, including treatments for chronic pain such as epidural steroid injections and skin and tissue substitutes.
As Healthcare Dive reported, CMS regulators have described the model as targeting a narrow set of services to prevent patient harm from inappropriate care and reduce unnecessary spending. But a report released by Cantwell in April, based on data from 16 Washington state hospitals, found that procedures subject to WISeR’s prior authorization requirements were taking two to four times longer to complete — adding weeks of delay for patients who previously could have received treatment within days.
Twenty senators have signed onto the resolution, led by Sen. Ron Wyden (D-Ore.) and co-sponsored by members including Sens. Bernie Sanders (I-Vt.), Elizabeth Warren (D-Mass.), and Cory Booker (D-N.J.). A companion resolution was introduced in the House by Reps. Suzan DelBene (D-Wash.) and Greg Landsman (D-Ohio). Provider groups including the American Hospital Association and the American Medical Association have also raised concerns about the pilot.
The resolution faces a steep path in a Republican-controlled Senate, but its CRA framework requires only a simple majority to pass — and the issue of AI overriding physician decisions on patient care carries cross-party resonance. Whether the resolution can attract Republican co-sponsors, particularly from senators in the six affected states, will determine its viability in the coming weeks.