OKLAHOMA — The Centers for Medicare & Medicaid Services (CMS) launched a pilot program in mid-January 2026, introducing prior authorization requirements for 13 medical services in traditional Medicare across six states. The program, named the Wasteful and Inappropriate Service Reduction Model (WISeR), includes Oklahoma, Arizona, New Jersey, Ohio, Texas, and Washington.

Traditional Medicare, which provides health insurance for individuals 65 and older or with disabilities, did not previously require prior authorization for most procedures. Epidural injections for back pain are among the services now subject to the WISeR program's prior authorization. The Trump administration states the 13 medical services included in the program are prone to fraud or misuse. The WISeR program also imposes prior authorization for kyphoplasty, a surgery for spinal fractures, which a Medicare Payment Advisory Commission report flagged as overused. The stated intent of WISeR is to save the federal government money and protect patients from potentially unsafe or unneeded care.

Bill Curry, a 65-year-old cattle rancher in rural Oklahoma, was informed in February that he needed preapproval for his epidural procedure after receiving the injection. His clinic later requested a third appointment to complete paperwork, which Curry did not attend. In Washington, the University of Washington's medical system had nearly 100 patients waiting earlier this year for epidural injections due to WISeR-related delays, according to an April report from the office of U.S. Sen. Maria Cantwell. The report stated, "Now, patients are subject to delays or denials which did not exist prior to the WISeR Model."

Clinicians must log into online portals to submit medical records to justify procedures through WISeR. "The model aims to reduce inappropriate care without delaying appropriate care," said Abe Sutton, director of the Center for Medicare and Medicaid Innovation, which administers WISeR. Mehmet Oz, leader of the Centers for Medicare & Medicaid Services, said in a podcast interview, "The purpose of these is not to deny care." Oz added, "It's to make sure you get the care you need and deserve, not the care some unscrupulous doctor wants to use on you."

James Webb, a musculoskeletal radiologist in Tulsa, Oklahoma, said, "Six- to eight-week delays is what we've been seeing." Jerry Sobel, a pain management physician in the Phoenix area, had not been paid by Medicare for nine epidurals as of May. During an April webinar, an executive from Zyter, which holds the contract for WISeR in Arizona, acknowledged a large backlog in payments stretching back to January. Sutton said those backlogs "are currently being resolved."