SJRES-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".

YourVoice.Now Summary

Your MoneyCorporate BenefitsTransparency & Accountability

Would end a new step where traditional Medicare must okay certain care first — in six states.

Your Money

Advance approval before some Medicare procedures — in six states

Since January 2026, doctors in six states must get Medicare's okay before certain care. Steroid shots for back pain and spine fusion are on the list. This measure would end that step, so claims would be checked after the care.

AI review of Medicare coverage requests — six states

Private firms hired by Medicare use AI and other tools to screen these requests. A doctor or other licensed clinician must sign off before a request is turned down.

Corporate Benefits

Contractor pay based on Medicare savings — share of avoided costs

The firms running these reviews earn a cut of the money Medicare does not end up spending. Ending the test would end that pay deal, which was set to last through 2031.

Transparency & Accountability

Limits on reviving the blocked Medicare rule — new law needed

A rule that Congress cancels cannot come back in nearly the same form. Only a new law can revive it. In May 2026, the GAO watchdog office ruled this Medicare notice counted as such a rule.

More about this bill

If you have traditional Medicare in one of six states, an extra approval step would end. Since January 2026, doctors there must get Medicare's okay first for about 15 kinds of care. The list covers nerve stimulators, steroid shots for back pain, spine fusion, and knee scopes. The six states are New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. This measure would cancel that test, called the WISeR Model. Under it, private firms hired by Medicare screen the requests with computer tools, including AI. Those firms are paid a share of the money Medicare does not spend. The test was set to run through 2031. Congress can cancel agency rules like this one. If that happens, the agency cannot bring the rule back without a new law.

Congressional Summary

Congress's official summary of this bill still describes an earlier version of the text, so we have left it out here. You can read it on Congress.gov.

Congress.gov →

Details

Congress: 119th
Chamber: Senate
Status: summarized
Action: Introduced in Senate
Action Date: 2026-06-24
Date Added: 2026-07-18
Source: Congress.gov →

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