Medicare Enhances Oversight for Key Procedures in Six States

A new Medicare pilot program called WISeR, launched in six states, requires prior authorization or post-service review for 15 categories of outpatient procedures under Original Medicare. Providers can seek advance approval or proceed with post-payment review, but denied requests may shift costs to patients if an Advance Beneficiary Notice is signed. The program aims to reduce wasteful spending by reviewing care for coverage compliance before payment.