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tngld.bsky.social
@tngld.bsky.social
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luckyloo.bsky.social
Thank you for posting this information.
It's absolutely horrifying - and even worse - this is the only place I have heard of the obviously misnamed "Wiser" program.
Transcript below & Alt Text for all those interested in having affordable healthcare for vulnerable populations and every American.
CMS (Center for Medicare Services) slipped something into 2026 that Medicare patients need to hear. Starting Jan.01.2026, Medicare patients in 6 states will be REQUIRED to get PRIOR AUTHORIZATION for certain procedures. Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. This is part of a new pilot called the “WISER” model – and the goal isn’t a mystery. CMS wants to test the same tactics that private insurance uses; that delays, paperwork, and approval hoops will reduce ‘wasteful’ spending. Seventeen categories of procedures are included, but here is the part no one is explaining - these states were chosen on purpose. They all have large Medicare populations, high rates of chronic illness, areas with severe provider shortages (especially specialists), big socioeconomic and racial disparities, and major Medicare advantage plan market penetration that already use aggressive prior authorization. So, in other words, CMS picked states where older adults are already fighting through barriers to get care. If delays happen in these environments, the impact shows up fast. More ER visits, more complications, higher mortality. The WISER program is basically a stress test on vulnerable populations to see how far Medicare can push prior authorization without causing political backlash. If CMS reports cost savings – this will expand nationwide. If it increases hospitalizations or worsens outcomes, patients will pay the price long before policy makers admit it.
December 9, 2025 at 2:57 AM