CMS announces ePA acceleration initiative, democrats seek to repeal WISeR Model

The Centers for Medicare & Medicaid Services (CMS) is advancing its electronic prior authorization (ePA) efforts through a newly established Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements. To date, 29 health care organizations – including health systems, electronic health record developers, physician practices, networks, and digital health developers – have signed on as early adopters in this cross-sector effort, joining payers, including The Cigna Group, that have already committed to working with CMS to improve ePA. Through this effort, participating organizations are working to: integrate ePA into clinical and administrative systems; reduce reliance on manual processes such as fax and portal-based workflows; increase visibility into authorization status and decisions; and close workflow gaps and improve technical handoffs across systems. 

Relatedly, Sen. Roy Wyden (D-OR) and Reps. Greg Landsman (D-OH) and Suzan DelBene (D-WA), along with 24 other Senate Democrats, introduced a Congressional Review Act (CRA) resolution to disapprove the Wasteful and Inappropriate Service Reduction (WISeR) Model that tests the use of technology-enabled PA for a select set of services in Medicare. The announcement comes after the Government Accountability Office (GAO) released a determination that WISeR is subject to the CRA as a rule, starting a 60-day period during which Democrats can force a vote on the resolution. The model has consistently received significant pushback from Congressional Democrats, with several bills introduced to prohibit implementation of the model or any substantially similar model.