Details
January 12, 2026
12:00PM - 1:00PM EST
The New WISeR Model's Details - with Innovaccer
Live Zoom
FREE for OSMA Members & Staff
$99 for NON-members
Do you have questions regarding the new WISeR program? Join us as we talk about the WISeR Model with Innovaccer, Ohio’s participant in the Model for the MAC Jurisdiction of J15 CGS.
We will discuss what the WISeR Model does, the role of CGS, participants, categories of services, processes, share important resources, and answer any questions.
Background:
The Wasteful and Inappropriate Service Reduction (WISeR) Model is a multi-year pilot program developed by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. Beginning in 2026, the WISeR Model will launch in Ohio as part of a six-state pilot program and will introduce new prior authorization and service review requirements for certain services furnished under traditional fee-for-service Medicare.
The model is designed to test whether a more structured, technology-supported review process can reduce inappropriate utilization of certain medical services in traditional fee-for-service Medicare, while maintaining patient access and preserving existing Medicare coverage rules. WISeR represents a notable shift for Original Medicare, which historically has relied far less on prior authorization than Medicare Advantage plans. Rather than changing what services Medicare covers or how they are paid, the model focuses on how coverage determinations for certain services are reviewed before payment.
Resources:
- Innovaccer WISeR Website
- WISeR Prior Authorization Form (PAR 457) (Included in PDF)
- WISeR Provider & Supplier Operational Guide (PDF)
If you have questions about your membership,
please email info@osma.org.