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Ban AI Denials in Medicare Act
To prohibit the Secretary of Health and Human Services from testing the WISeR model, and to amend title XI of the Social Security Act to prohibit the implementation of payment models testing prior authorization under traditional Medicare.
Summary
The bill prohibits the Secretary of Health and Human Services from implementing the WISeR (Wasteful and Inappropriate Services Reduction) Model, which was designed to test prior authorization requirements for certain Medicare services. It also amends the Social Security Act to prohibit the Centers for Medicare and Medicaid Innovation from testing any models that would require prior authorization, including those using artificial intelligence, for items or services covered under traditional Medicare Parts A and B.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
- Rep. Landsman, Greg [D-OH-1] (D-OH)
3 cosponsors
Actions (2)
- Dec 2, 2025 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. · house
- Dec 2, 2025 Introduced in House
Similar bills (6)
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Text versions (1)
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Committee action
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Meetings where this bill was on the agenda
Full text
IN THE HOUSE OF REPRESENTATIVES
December 2, 2025
Mr. Landsman (for himself and Mrs. Watson Coleman) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
A BILL
To prohibit the Secretary of Health and Human Services from testing the WISeR model, and to amend title XI of the Social Security Act to prohibit the implementation of payment models testing prior authorization under traditional Medicare.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Ban AI Denials in Medicare Act”.
SEC. 2. PROHIBITING IMPLEMENTATION OF CENTER FOR MEDICARE AND MEDICAID INNOVATION MODELS TESTING PRIOR AUTHORIZATION UNDER TRADITIONAL MEDICARE.
(a) Prohibiting Implementation of WISeR Model.—The Secretary of Health and Human Services may not implement the innovative payment and service delivery model described in the notice titled “Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model” (90 Fed. Reg. 28749 (July 1, 2025)), or any substantially similar model.
(b) Prohibiting Implementation of Future CMI Models Testing Prior Authorization (including Through the Use of AI) Under Traditional Medicare.—Section 1115A(b)(2) of the Social Security Act (42 U.S.C. 1315a(b)(2)) is amended—
(1) in subparagraph (A), by striking “The Secretary shall select” and inserting “Subject to the limitation under subparagraph (D), the Secretary shall select”; and
(2) by adding at the end the following new subparagraph:
“(D) Limitation on models to be tested.—Beginning on the date of the enactment of this subparagraph, the Secretary may not select a model to be tested under subparagraph (A) if such model would provide for the implementation of prior authorization (including through the use of artificial intelligence) with respect to items or services for which payment may be made under part A or part B of title XVIII.”. <all>
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