Senate Votes 50 to 46 to Keep CMS Artificial Intelligence Prior Authorization Pilot Running in Traditional Medicare

On July 16, 2026, the United States Senate voted to preserve the Centers for Medicare and Medicaid Services Wasteful and Inappropriate Service Reduction model, known as WISeR. A procedural vote on Senate Joint Resolution 198, a Congressional Review Act resolution to overturn the program, failed 46 to 50, with 50 senators voting against advancing it.

Democrats sponsored the resolution after the Government Accountability Office ruled in May 2026 that the CMS implementation notice for WISeR qualified as a rule subject to congressional review. Supporters of the resolution argued that the AI system could delay or deny medically necessary care for traditional Medicare beneficiaries without adequate consumer protections.

WISeR launched January 1, 2026 as a six-year pilot in six states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. Under the model, CMS partners with vendors that use AI and machine learning to conduct prior authorization reviews for services identified as carrying higher risk of fraud, waste, or abuse in fee-for-service Medicare. Any non-affirmation decision must be reviewed by a licensed clinician before it stands.

Traditional Medicare historically has operated without prior authorization requirements. WISeR is the first program to bring AI-assisted utilization review into original fee-for-service Medicare at scale. The Medicare Rights Center urged Congress on July 16 to protect beneficiary access to care, warning that AI-driven reviews can hinder access for people who need treatment. With the resolution defeated, the pilot continues while broader debates about AI oversight in Medicare proceed.