This is not an official government website.
© 2026 PLEJ LC. All rights reserved.
Congressional Daily Record
This section captures a floor statement or debate entry. It mentions legislation such as Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services of the Department of Health and Human Services relating to "Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model"., members such as Ronald Lee Wyden.
Issued
July 16, 2026
senate side of the record
People
3
Linked members mentioned in this section
Legislation
1
Bills and resolutions linked from this section
Committees
0
No linked committees in this section
Senate Holds
0
No hold activity linked here
Source Document
Connected Data
People mentioned
Bills and resolutions
Source Control
Reader mode is for comprehension. The linked government PDF is the official published source.
Download official Senate Record PDFReturn to issue contextUNITED STATES CODE, OF THE RULE SUBMITTED BY THE CENTERS FOR MEDICARE &
RELATING TO “MEDICARE PROGRAM; IMPLEMENTATION OF PRIOR AUTHORIZATION
FOR SELECT SERVICES FOR THE WASTEFUL AND INAPPROPRIATE SERVICES
REDUCTION (WISeR) MODEL”—Motion to Proceed
The PRESIDING OFFICER. The clerk will report.
The bill clerk read as follows:
Motion to proceed to Calendar No. 447, S.J. Res. 198, a
joint resolution providing for congressional disapproval
under chapter 8 of title 5, United States Code, of the rule
submitted by the Centers for Medicare & Medicaid Services of
the Department of Health and Human Services relating to
“Medicare Program; Implementation of Prior Authorization for
Select Services for the Wasteful and Inappropriate Services
Reduction (WISeR) Model”.
Mr. WYDEN. I ask for the yeas and nays.
The PRESIDING OFFICER. Is there a sufficient second?
The yeas and nays are ordered.
S.J. Res. 198
Mr. WYDEN. Mr. President, colleagues, at the beginning of this year, the Trump administration empowered unaccountable AI companies to delay and deny certain types of care in traditional Medicare.
Medicare, and, today, it is clear that that Trump promise has been broken.
years, and they did so with an expectation they would have an ironclad guarantee of affordable healthcare.
their doctor has recommended for them has been slowed or halted by a shadowy AI-driven third party.
The consequences are not abstract. Seniors with severe back pain have to wait weeks for relief, upending their lives and leaving them suffering because of the bureaucracy of healthcare.
frivolous: knee arthroscopies, nerve stimulations, steroid injections, cervical fusion. These types of procedures are the care that seniors rely on to stay mobile and pain-free in the aging process.
profit AI contractors. The Trump administration's only defense of this model has been to point to the rapid rise of skin substitute procedures to justify their flawed experiment.
The Trump administration's work doesn't pass the smell test. First, the Centers for Medicare and Medicaid Services already have now lowered payment rates for this procedure; in doing so, closed the loophole driving the dramatic increase.
(Mrs. CAPITO assumed the Chair.)
fraction of care under the model. In the case of Oregon's neighbor to the north, Washington State, skin substitutes account for less than 1 percent of services—less than 1 percent of the services, Madam Chair— subject to the prior authorization under this model. So the excuses hold no water.
system. For-profit insurance companies are increasingly using this business tactic to block and deter care in order to increase their profits.
I want to put a fine point on this. In 2024, insurance companies that sell Medicare Advantage plans denied more than 4 million prior authorization requests—just think about that: 4 million prior authorization requests. Of those denials, only 1 in 10 were appealed by a senior or their doctor. But when the denial was appealed, it was overturned 8 times out of 10. What this tells me is that prior authorization is being used to deny legitimate care, often acting as a bureaucratic hurdle meant to discourage seniors and their doctors from pursuing a course of treatment that might impact insurance company's bottom line.
Advantage, but now the Trump administration is trying to import insurance company tactics into traditional Medicare. And that would mean that seniors who selected it precisely because they don't want to deal with the headaches and complexity of an insurance company would suffer.
This is not a partisan issue. Many of my Republican colleagues have expressed concern about prior authorizations and the state of Medicare Advantage. I hope that they will stand with those of us today who want to tell the Trump administration to abandon an ill-advised experiment that seniors don't want. They didn't ask for it. It doesn't make sense.
Medicare and Medicare Advantage for seniors that count on the Medicare guarantee.
when I was a codirector of the Oregon Gray Panthers. Let's work on that together, and we can start by ending this AI-driven prior authorization experiment. It is a mistake. We can't run the risk of it being sent to other parts of the healthcare system. I urge a “yes” vote.
I yield the floor.
The PRESIDING OFFICER. The Senator from Idaho.
Mr. CRAPO. Madam President, in response to the discussion that my colleague from Oregon has just engaged in, far too often, our Nation's healthcare system incentivizes low-value, high-cost services. For years, bipartisan policy makers throughout Capitol Hill and across administrations have endeavored to disrupt this flawed paradigm, especially in the Medicare Program. Unfortunately, despite progress to incorporate new value-based payment arrangements, Medicare's underlying reimbursement structure continues to rely heavily on the volume of services provided, rather than the quality of care.
financial incentives contribute to massive waste and abuse. Well- meaning clinicians often face opaque coverage guidelines that can result in denied reimbursements, while malicious actors exploit bureaucratic vulnerabilities to defraud the program.
WISeR—CMS is testing whether enhanced technology can help address these systemic failures. For a limited set of nonemergency services with a documented history of abuse and overuse, providers in select States must submit claims for review. Claims that meet existing Medicare coverage requirements are quickly approved, offering providers payment predictability.
machines, board-certified clinicians—intervene to make the final decision. The potential benefit of this “detect and prevent strategy” is substantial. For example, Medicare spending on skin substitutes, one of the chosen WISeR model services, increased and—hear this—increased from $256 million in 2019 to $10 billion in 2024. It doesn't even take a technological machine to tell you that something is wrong there.
important work of the WISeR model. Every Member of this body agrees that patients should have access to high-quality care, providers deserve predictable payment for services, and avoidable waste, fraud, and abuse in Medicare should be stopped. Ending this pilot program prematurely will deprive CMS of a useful tool to accomplish each of those goals.
I yield the floor.
The PRESIDING OFFICER. The Senator from Oregon.
Mr. WYDEN. Madam President, we don't take a back seat to anybody in terms of fighting inefficiency, fighting fraud. We have been working on those issues, as the chair of the Finance Committee knows, together wherever possible.
not dealing with inefficiency and fraud. We are forcing patients to come back again and again and again. That just defies common sense.
through a payment process, payment policy reform, to get at the incentives and wasteful utilization.
are not going to get care, and we are not going to make sensible changes as we have in other areas to deal with fraud and inefficiency.
I yield back and hope we will have a bipartisan vote.
The PRESIDING OFFICER. The Senator from Washington.
Mrs. MURRAY. Madam President, I wanted to talk today about not just how Republicans are making healthcare more expensive but also how they are making it just plain worse for seniors.
but that was clearly a lie because right now his administration is trying to privatize Medicare; in part, by putting AI between Medicare beneficiaries and their healthcare.
In January of this year, under Secretary Kennedy and Dr. Oz's leadership, CMS began this pilot program that uses AI to require prior authorization in traditional Medicare for the first time ever, and it is set to run for 6 years. They call it the Wasteful and Inappropriate Service Reduction Model. Well, they got the wasteful and inappropriate part right.
authorization are paid a percentage of the cost of care that they deny. They are literally incentivized to rip healthcare away from seniors because that is best for their bottom line. When your business model relies on denials, denials are what seniors are going to get, and that is perverse.
of Washington and five other States without safeguards and without any transparency and without the best interests of Medicare beneficiaries at the heart of this program.
President Trump is saying: Forget the doctors who went to medical school and took an oath to do no harm. AI knows better when it comes to healthcare decisions for our seniors.
threatening. I hear from Medicare patients in Washington State all the time. They are suffering debilitating pain for weeks because they are not getting the care they need, thanks to this harmful model—patients like Joanne. She is a Medicare beneficiary from Quilcene, WA.
She went to her doctor for severe pain. An MRI showed that a herniated disk was pressing on her sciatic nerve. Joanne's doctor prescribed an epidural injection to help ease that pain. This was standard, routine care—care that, before this year, she would have been able to get quickly after it had been recommended by her doctor. But because of this WISeR Model, she had to wait 6 weeks to get approval. That means, thanks to WISeR, Joanne had to deal with unnecessary, unrelated pain for 6 weeks. Because of this nonsense delay, her day-to-day life was disrupted and the burden fell on her then to fight for the care she needed.
been selected for this pilot program. No way should an algorithm decide if seniors should get the care they need. That is exactly why I join my colleagues here in introducing a resolution to overturn this model. And I want all of my colleagues to join me in voting for it so we can make sure seniors in my State and all over the country can, once again, receive their healthcare on time and without interruption.
Let's just use our common sense. It is clear as day that some AI models should never be at the wheel making healthcare decisions left and right. And it is not just patients I have heard from. I have met with healthcare providers all over my State. Whether it is a rural hospital or a doctor in Seattle, no one—no one—has had anything good to tell me about prior authorization in traditional Medicare.
in how their government is run, and that is especially true when it comes to the government deploying AI technology. I don't know any senior—Republican or Democrat—who asked President Trump to let AI decide if their doctor-recommended treatment was necessary. Of course, AI can help make things more efficient or do good things. That is not what the WISeR Model is doing.
So let's get to the crux of it. As a country, we make a promise to American seniors: If they paid their taxes throughout their careers, they earned their Medicare coverage. Full stop. WISeR breaks that promise to seniors with these senseless AI-driven prior authorizations that deny and delay care.
options because traditional Medicare rarely requires prior authorizations. People choose traditional Medicare because they want to make their healthcare decisions with their doctor, not with a private company that is out to make a profit.
necessary care to Medicare patients—is reckless, and it is irresponsible.
WISeR once and for all because this should not be a partisan issue. We all have seniors in our States that deserve the highest level of care without having to deal with redtape and delay. Thanks to Trump, AI is getting in between our seniors and their healthcare in Arizona, in New Jersey, in Ohio, in Oklahoma, in Texas, and in my State of Washington. We have an opportunity to stop this harmful experimental pilot program before more seniors are harmed. No senior in America should have to appeal their pain and suffering to a machine.
whom would you want to decide if they get their treatment, their doctor or a for-profit algorithm? Would you want them to suffer in pain for weeks for care that they are entitled to? I know what my answer is.
Let's maintain the promise of Medicare. Let's pass this resolution.
I yield the floor.
The PRESIDING OFFICER. The Senator from Oregon.
Mr. WYDEN. Fortunately, for—let me say to Senator Murray that I so appreciate your presentation, and particularly talking about the algorithms. And, also, the fact is that under what you have described very clearly, the big winner under this flawed experiment is a bunch of middlemen who are trying to profit off denials, and not the people who really desperately need care.
with Washington State in leading the country to get rid of this very flawed idea. And I thank you for your remarks.
Mrs. MURRAY. Thank you. Thank you.
Mr. WYDEN. I yield the floor.
The PRESIDING OFFICER. The Senator from Oregon.
Mr. WYDEN. Madam President, I would ask consent to start the 1:30 vote now.
The PRESIDING OFFICER. Without objection, it is so ordered.
Vote on Motion to Proceed
The PRESIDING OFFICER. The question is on agreeing to the motion.
The yeas and nays were previously ordered.
The clerk will call the roll.
The senior assistant executive clerk called the roll.
Mr. BARRASSO. The following Senators are necessarily absent: the Senator from Tennessee (Mr. Hagerty), the Senator from Kentucky (Mr. McConnell), and the Senator from Mississippi (Mr. Wicker).
Further, if present and voting: the Senator from Tennessee (Mr. Hagerty) would have voted “nay” and the Senator from Mississippi (Mr. Wicker) would have voted “nay.”
The result was announced—yeas 46, nays 50, as follows:
Rollcall Vote No. 199 Leg.
YEAS—46
Alsobrooks
Baldwin
Bennet
Blumenthal
Blunt Rochester
Booker
Cantwell
Coons
Cortez Masto
Duckworth
Durbin
Fetterman
Gallego
Gillibrand
Hassan
Heinrich
Hickenlooper
Hirono
Kaine
Kelly
Kim
King
Klobuchar
Lujan
Markey
Merkley
Murray
Ossoff
Padilla
Peters
Reed
Rosen
Sanders
Schatz
Schiff
Schumer
Shaheen
Slotkin
Smith
Van Hollen
Warner
Warnock
Warren
Welch
Whitehouse
Wyden
NAYS—50
Armstrong
Banks
Barrasso
Blackburn
Boozman
Britt
Budd
Capito
Cassidy
Collins
Cornyn
Cotton
Cramer
Crapo
Cruz
Curtis
Daines
Ernst
Fischer
Graham
Grassley
Hawley
Hoeven
Husted
Hyde-Smith
Johnson
Justice
Kennedy
Lankford
Lee
Lummis
Marshall
McCormick
Moody
Moran
Moreno
Murkowski
Paul
Ricketts
Risch
Rounds
Schmitt
Scott (FL)
Scott (SC)
Sheehy
Sullivan
Thune
Tillis
Tuberville
Young
NOT VOTING—4
Hagerty
McConnell
Murphy
Wicker
The motion was rejected.
The PRESIDING OFFICER (Mr. Armstrong). The majority leader.