HB5940, titled the Seniors Deserve SMARTER Care Act of 2025, would bar the Secretary of Health and Human Services from implementing the Medicare WISeR model, a federal innovation model announced in a July 1, 2025 Federal Register notice. The bill also prohibits implementation of any substantially similar model. In practical terms, it would stop Medicare from moving forward with this specific prior-authorization-based demonstration for select services.
The measure is narrowly drafted and does not amend Medicare broadly; instead, it targets one named payment and service delivery model. By blocking the WISeR model, the bill would preserve the status quo for Medicare beneficiaries and providers with respect to the services covered by that model and the prior authorization process described in the notice. It would also constrain HHS’s ability to substitute a closely related model in its place.
Impact
If enacted, the bill would limit the Department of Health and Human Services’ authority to launch the WISeR model under Medicare and would prevent use of any substantially similar prior authorization demonstration. That would affect Medicare administration, particularly CMS’s ability to test utilization-management approaches for select services. The bill would not change Medicare eligibility or benefits generally, but it would affect how certain services are reviewed and approved for payment under the program.
Sentiment
The bill’s title and sponsor list suggest a strongly protective stance toward seniors and Medicare beneficiaries, emphasizing faster access to care and opposition to administrative delays. Because there are no recorded committee transcripts or votes in the provided material, there is no documented floor or committee debate to show formal support or opposition. The available context indicates the bill is framed positively by its sponsors as a patient-access measure.
Contention
The main point of contention is likely the use of prior authorization in Medicare. Supporters appear to view the WISeR model as a barrier to timely care and an unnecessary administrative burden on seniors and providers. Opponents, if any, would likely argue that the model is intended to reduce wasteful or inappropriate services and improve program integrity. The bill’s broad ban on not only the named model but also any “substantially similar” model could also be a point of concern for those who favor CMS demonstration authority and flexibility.