ASA Advocacy Prompts Direct CMMI Engagement on WISeR Concerns

ASA is ensuring physician and patient experiences are heard directly by federal policymakers.

Following a letter from ASA outlining significant concerns with the Wasteful and Inappropriate Service Reduction (WISeR) Model, officials from the Center for Medicare & Medicaid Innovation (CMMI) requested a meeting to discuss those concerns in greater detail. On July 10, 2026, ASA convened the American Academy of Physical Medicine and Rehabilitation (AAPM&R), the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine), and the International Pain and Spine Intervention Society for a high-level meeting with CMMI leadership to discuss the model's impact on patient access to care and physician practices.

During the meeting, physician leaders shared firsthand examples of patient care disruptions, treatment delays, and barriers to medically necessary services resulting from the model's prior authorization requirements. The coalition urged CMMI to address these concerns and implement reforms that protect timely access to care for Medicare beneficiaries.

Key Takeaways from the Discussion

• Physicians provided real-world examples of patients experiencing delays and disruptions in care due to prior authorization requirements under the WISeR Model.
• CMMI officials were highly engaged and requested additional information on specific cases for further review.
• ASA and coalition partners raised concerns regarding discrepancies between Local Coverage Determination (LCD) policies and vendor review requirements, issues that CMMI indicated it had not previously heard and will investigate further.
• CMMI signaled a willingness to continue discussions with physician organizations on opportunities to improve the model and reduce unnecessary administrative burdens.
• Follow-up reviews are already underway. CMMI is currently investigating several cases brought forward by physician leaders involving denials and barriers to medically necessary services, including requests for physical therapy and diagnostic imaging.

ASA is continuing to work with coalition partners and engage directly with CMMI to advocate for reforms that reduce unnecessary administrative burden, preserve physician decision-making, and protect patient access to timely, medically necessary care. ASA will keep members informed as these discussions progress and additional information becomes available.