H.R. 6361

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6361 Introduced in House (IH)]

<DOC>

119th CONGRESS
1st Session
H. R. 6361

To prohibit the Secretary of Health and Human Services from testing the 
WISeR model, and to amend title XI of the Social Security Act to 
prohibit the implementation of payment models testing prior 
authorization under traditional Medicare.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

December 2, 2025

Mr. Landsman (for himself and Mrs. Watson Coleman) introduced the 
following bill; which was referred to the Committee on Ways and Means, 
and in addition to the Committee on Energy and Commerce, for a period 
to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
committee concerned

_______________________________________________________________________

A BILL

To prohibit the Secretary of Health and Human Services from testing the 
WISeR model, and to amend title XI of the Social Security Act to 
prohibit the implementation of payment models testing prior 
authorization under traditional Medicare.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Ban AI Denials in Medicare Act''.

SEC. 2. PROHIBITING IMPLEMENTATION OF CENTER FOR MEDICARE AND MEDICAID 
INNOVATION MODELS TESTING PRIOR AUTHORIZATION UNDER 
TRADITIONAL MEDICARE.

(a) Prohibiting Implementation of WISeR Model.--The Secretary of 
Health and Human Services may not implement the innovative payment and 
service delivery model described in the notice titled ``Medicare 
Program; Implementation of Prior Authorization for Select Services for 
the Wasteful and Inappropriate Services Reduction (WISeR) Model'' (90 
Fed. Reg. 28749 (July 1, 2025)), or any substantially similar model.
(b) Prohibiting Implementation of Future CMI Models Testing Prior 
Authorization (including Through the Use of AI) Under Traditional 
Medicare.--Section 1115A(b)(2) of the Social Security Act (42 U.S.C. 
1315a(b)(2)) is amended--
(1) in subparagraph (A), by striking ``The Secretary shall 
select'' and inserting ``Subject to the limitation under 
subparagraph (D), the Secretary shall select''; and
(2) by adding at the end the following new subparagraph:
``(D) Limitation on models to be tested.--Beginning 
on the date of the enactment of this subparagraph, the 
Secretary may not select a model to be tested under 
subparagraph (A) if such model would provide for the 
implementation of prior authorization (including 
through the use of artificial intelligence) with 
respect to items or services for which payment may be 
made under part A or part B of title XVIII.''.
<all>