01/17/2026
WISeR? Let's hope so. On January 1st Texas become one of six states participating in a Medicare pilot program requiring authorization for 17 procedures. The program will impact those folks who only have Medicare A and B as well as those with Supplements, Plan G, N etc. Advantage plans have been doing this, on a much broader scale for a long time.
Is it a good idea, will it work? I really don't know. Well, there's my thoughts and there's reality. Neither has been proved out yet. I understand the premise, several medical treatments are over prescribed for those over 65. Success rates aren't typically split out by age. However, will the list of procedures stop here, or will it grow? And just how successful will AI be at assessing the nuance needed to determine an individual's needs. TBD....
I'd like to hear your thoughts And I think I'll tag it to revisit in 18 months when the results trickle in. Until then, it's best to wait for the authorization to avoid paying the entire procedure out of pocket. Be your own advocate, always, in every medical situation.
The Wasteful and Inappropriate Service Reduction (WISeR) Model is set to debut in Texas and five other states in January 2026. It would require certain Medicare services to undergo “enhanced technology” review.
