06/15/2026    Paul Kesselman, DPM

WISeR Model Days May be Numbered

Rumblings are growing in Washington that threaten
any further funding of the WISeR program. For
those unfamiliar, the WISeR program was set up as
a pilot program to perform prior authorization
(P/A) is a few states for a few medical policies.
For podiatrists, WISeR has since earlier this year
been conducting P/A for Cellular Tissue Products
(CTP) primarily in New Jersey, Ohio, Oklahoma and
Texas.

The U.S. House Appropriations Committee has moved
forward with an amendment blocking further funding
during a June 9 vote on their 2027 spending bill.
Under the provisions of this proposal, none of the
funds could be allocated to WISeR or any similar
program.

The rationale offered by clinicians and receiving
committee members’ bipartisan support to block
further funding is quite simple. There are
increased allegations and proof that approval and
denial of P/A for CTP (and other topics subject to
P/A by WISeR) are being performed increasingly by
AI.

Additionally, not previously considered prior to
WISeR implementation, is that the Government
Accountability Office decided that WISeR is by law
subject to the Congressional Review Act. This
gives the government 60 days (from early May) to
elicit a final approval or disapproval to of the
WISeR program.

While something needed to be done to curtail the
exponential growth and abuse of CTP, a “WISER” not
totally using AI, program needs to be implemented.
Whether the current WISeR goes the way of “New
Coke” or is remodeled requiring some human touch
remains to be seen.

Also unknown is whether the House Appropriations
bipartisan vocal vote will make its way into the
final version of the 2027 spending bill or if the
GAO will prior to that nix the program altogether.
None of this fixes the fee schedule issue which
all wound care physicians must accept.
Who said being a wound care doc was boring?

For more information on this please visit:
https://www.beckershospitalreview.com/finance/hous
e-committee-votes-to-defund-wiser-prior-
authorization-pilot/?
origin=BHRE&utm_source=BHRE&utm_medium=email&utm_c
ontent=newsletter&oly_enc_id=2558E3860112B6W

Paul Kesselman, DPM, Oceanside, NY

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