Ban AI Denials in Medicare Act
Sponsored By: Representative Landsman
Introduced
Summary
Ban on prior-authorization models in traditional Medicare is the core action of the Ban AI Denials in Medicare Act. The bill would block the WISeR model and bar the CMS Innovation Center from testing any future models that add prior authorization, including systems that use artificial intelligence.
Show full summary
- Medicare beneficiaries would not be subject to prior-authorization requirements being tested under WISeR or similar pilots for items and services paid under Parts A and B.
- Providers in traditional Medicare would avoid new prior-authorization processes and AI-driven authorization checks that those models could impose.
- The bill would amend section 1115A of the Social Security Act to prevent the Secretary from selecting models that implement prior authorization, limiting the Innovation Center's ability to pilot such approaches.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
Blocks new AI prior authorization in Medicare
This bill would stop HHS from implementing the WISeR prior-authorization test described on July 1, 2025 (90 Fed. Reg. 28749). It would also bar the CMS Innovation Center from testing any model that adds prior authorization for Medicare Part A or Part B, including through AI tools. That means you would not face new prior-authorization rules from these test models under traditional Medicare. The limit would take effect upon enactment.
Sponsors & CoSponsors
Sponsor
Landsman
OH • D
Cosponsors
Watson Coleman
NJ • D
Sponsored 12/2/2025
Roll Call Votes
No roll call votes available for this bill.
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