FDA Highlights Programs for Innovators at ACR DSI Summit
The FDA joined the ACR®️ Data Science Summit June 9 to give an update about its Total Product Life Cycle Advisory Program.
Read moreThis article was updated April 16 with an updated checklist.
Updated information related to implementation of the CMS Innovation Center’s Wasteful and Inappropriate Service Reduction (WISeR) Model was released Dec. 31, through Change Request 14205 and CMS Transmittal 13570. The purpose of this document is to implement the WISeR Model Prior Authorization and Medical Review Process that began Jan. 1, and establish a recurring quarterly process to allow for updates to the CPT® code change files and documentation requirements. Additionally, the CMMI WISeR team has provided an updated Frequently Asked Questions and WISeR Provider and Supplier Guide (version 3.0) documents. ACR® members are encouraged to review the latest documents to ensure compliance with the demonstration model. Starting on Jan. 5, for dates of service on or after Jan.15, select items and services covered under Original Medicare will be subject to prior authorization or pre-payment medical review under the WISeR Model. Claims with dates of service between 1/1/26 and 1/14/26 are exempted from the WISeR model requirements to allow for operational set up.
Of importance to ACR members, CMS decided to delay implementation of the Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis (PILD) in WISeR (related coverage documents NCD 150.13 and codes 0275T “now reported with 62330 and 62331", and G0276). These services will not be subject to prior authorization or pre-payment review under the WISeR Model. CMS explains PILD has multiple clinical study approvals under its Coverage with Evidence Development program. CMS will re-evaluate implementing prior authorization or pre-payment review of PILD under WISeR in a future model performance year.
ACR staff prepared a checklist to help members navigate this new program. Continue to monitor CMS and ACR for additional updates as CMS continues to refine WISeR requirements.
For more information about the Wiser Model or questions, contact Alicia Blakey, ACR Manager of Economic Policy.
FDA Highlights Programs for Innovators at ACR DSI Summit
The FDA joined the ACR®️ Data Science Summit June 9 to give an update about its Total Product Life Cycle Advisory Program.
Read moreLower Fee Now in Effect to File No Surprises Act Disputes
Federal agencies released a final rule that updates the No Surprises Act independent dispute resolution process. The rule lowers the IDR administrative or filing fee from $115 to $15.
Read moreACR Urges Funding for NIH All of Us Program
ACR urges Congress to provide dedicated funding for NIH’s All of Us Research Program, a leader in precision medicine technologies and a valuable tool for researchers.
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