WASHINGTON, D.C. — Senate and House Democrats introduced resolutions Wednesday to overturn a Medicare pilot that uses artificial intelligence to approve or deny care. The measures invoke the Congressional Review Act to halt the Wasteful and Inappropriate Service Reduction program, known as WISeR.

Senators Ron Wyden, Patty Murray, Maria Cantwell, Richard Blumenthal and Kirsten Gillibrand sponsored the Senate resolution, which has the backing of 20 Senate Democrats. Representatives Suzan DelBene and Greg Landsman introduced a similar resolution in the House. The resolution requires 30 Senate signatures to move out of committee and to the Senate floor for a simple majority vote. If both chambers pass the resolution, the WISeR pilot will immediately become ineffective.

"Americans are sick and tired of abusive prior authorization tactics putting needed health care out of reach," said Senate Finance Committee ranking member Ron Wyden. The WISeR pilot is implemented in Arizona, New Jersey, Oklahoma, Ohio, Texas and Washington. At least one of those states has allegations of delayed care for seniors. Providers must submit certain supplies and procedures to WISeR contractors that use AI to approve or deny care. The contractors are paid based on an undisclosed formula that includes the number of procedures they have denied.

"WISeR is a dangerous program that is denying care to Medicare patients so companies can profit. If scaled up, it would be a back door to privatizing Medicare," said Representative Suzan DelBene. She raised concerns about the WISeR payment scheme to Centers for Medicare and Medicaid Services administrator Mehmet Oz. Last year, DelBene introduced a bill to stop the Medicare experiment, and a similar bill was introduced in the Senate.

According to CMS, the program targets a set number of supplies and procedures largely associated with fraud and excludes inpatient-only services, emergency services and services that pose a substantial risk to patients if delayed. In a recent letter, Oz said the agency will audit participants to ensure their decisions are consistent with existing Medicare coverage criteria. He said vendors with a high inaccuracy rate will be terminated.

The Government Accountability Office ruled last week that WISeR is subject to congressional approval and should have been submitted to Congress before going into effect in January. "WISeR remains an active Innovation Center model, and CMS will continue to review the opinion and assess any appropriate next steps consistent with applicable law and administrative processes," a CMS spokesperson said.

More than 250 rules have been challenged under the Congressional Review Act. A handful have been successfully overturned, including 16 rules from the end of the Obama administration that were stopped at the beginning of the first Trump administration.