Notice2026-06616
Medicare Program; Delayed Implementation of Certain Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
Primary source
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Published
April 6, 2026
Effective
April 6, 2026
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
This notice announces a delay in the implementation of two services from the list of Wasteful and Inappropriate Services Reduction (WISeR) model items and services.
Full Text
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<title>Federal Register, Volume 91 Issue 65 (Monday, April 6, 2026)</title>
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[Federal Register Volume 91, Number 65 (Monday, April 6, 2026)]
[Notices]
[Page 17282]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-06616]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-5056-N2]
Medicare Program; Delayed Implementation of Certain Prior
Authorization for Select Services for the Wasteful and Inappropriate
Services Reduction (WISeR) Model
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Notice.
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SUMMARY: This notice announces a delay in the implementation of two
services from the list of Wasteful and Inappropriate Services Reduction
(WISeR) model items and services.
DATES: The notice is effective April 6, 2026.
FOR FURTHER INFORMATION CONTACT: Kate Blackwell (844) 711-2664, Option
8 or <a href="/cdn-cgi/l/email-protection#a5f2ecf6c0f7e5c6c8d68bcdcdd68bc2cad3"><span class="__cf_email__" data-cfemail="61362832043321020c124f0909124f060e17">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION:
I. Background
In the July 1, 2025, Federal Register (90 FR 28749), we published a
notice titled ``Medicare Program; Implementation of Prior Authorization
for Select Services for the Wasteful and Inappropriate Services
Reduction (WISeR) Model''. The notice announced a 6-year model focused
on reducing fraud, waste (including low-value care), and abuse in
Medicare fee-for-service (FFS) via the implementation of technology-
enabled prior authorization processes for select services. For more
detailed information regarding the WISeR Model, see the July 2025
notice (90 FR 28749).
II. Delayed Implementation of Select Services
In the July 2025 notice (90 FR 28751), we specified that the prior
authorization process under the model will be implemented in the
selected states for the listed items and services with affiliated
national coverage decisions (NCDs) or local coverage decisions (LCDs)
beginning January 1, 2026. We are delaying implementation of two of the
services announced in the July 2025 notice to allow additional time for
operational readiness. Implementation of the prior authorization or
pre-payment review process for these two services is delayed until a
future date that will be announced in a subsequent Federal Register
notice. Until the future implementation date is announced, neither the
prior authorization nor the pre-payment review processes described in
our earlier notice will be available for these services. The two
services for which we are delaying implementation of the prior
authorization or pre-payment review process are as follows:
<bullet> Deep Brain Stimulation for Essential Tremor and
Parkinson's Disease (NCD 160.24).
<bullet> Percutaneous Image-Guided Lumbar Decompression for Spinal
Stenosis (NCD 150.13).
The Administrator of the Centers for Medicare & Medicaid Services
(CMS), Dr. Mehmet Oz, having reviewed and approved this document,
authorizes Chyana Woodyard, who is the Federal Register Liaison, to
electronically sign this document for purposes of publication in the
Federal Register.
Chyana Woodyard,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2026-06616 Filed 4-3-26; 8:45 am]
BILLING CODE 4120-01-P
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