New Act Blocks Controversial WISeR Medicare Model, Aiming to Protect Seniors' Care Access

The newly introduced "Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery Care Act of 2025," thankfully shortened to the Seniors Deserve SMARTER Care Act of 2025, is laser-focused on one thing: stopping a specific, proposed Medicare payment change. Specifically, Section 2 of this bill prohibits the Secretary of Health and Human Services (HHS) from implementing the "Wasteful and Inappropriate Services Reduction (WISeR) model" or any model that is “substantially similar” to it under Medicare. This model, identified by a Federal Register notice (90 Fed. Reg. 28749), is essentially being blocked before it even starts, aiming to preserve current payment structures for senior healthcare.

The WISeR Block: What It Means for Your Parents

When the government talks about "payment and service delivery models," they are usually talking about ways to save money—often by changing how doctors and hospitals get reimbursed for treating Medicare patients. The fact that Congress is moving to ban the WISeR model suggests that the model was viewed as potentially harmful to seniors’ access to care, perhaps by limiting certain services or reducing payments so severely that providers might stop offering specific treatments. For everyday people, this bill is a proactive shield: it prevents a potentially restrictive cost-cutting measure from hitting Medicare beneficiaries, which means fewer headaches and less paperwork if a senior needs timely medical services or recovery care.

Who’s Happy (and Who’s Not) About This Ban

Medicare beneficiaries are the clear winners here. By banning WISeR, the bill maintains the status quo, ensuring that seniors don't suddenly face hurdles or service denials related to a new, experimental payment system designed to reduce "waste." Think of it this way: if you’re a retired construction worker relying on Medicare for physical therapy after a surgery, this bill ensures that access isn't suddenly constrained by a new rule trying to cut costs on that therapy. Healthcare providers who treat seniors are also likely breathing easier, as they avoid the administrative burden and potential payment cuts that often accompany these new cost-reduction models.

The Fine Print: The “Substantially Similar” Problem

While this bill is clear about banning WISeR, Section 2 also bans any model that is “substantially similar” to it. This is where things get tricky for the Centers for Medicare & Medicaid Innovation (CMMI), the agency tasked with finding ways to make Medicare more efficient. While the intent is to prevent the WISeR model from being rebranded, this broad language could create a chilling effect. CMMI might hesitate to propose genuinely beneficial, cost-saving models in the future if they fear a legal challenge claiming they are too similar to the banned WISeR model. If the WISeR model actually had components that did reduce unnecessary spending—like blocking clearly fraudulent claims—then taxpayers and the Medicare Trust Fund could miss out on potential savings down the road, simply because the door is now shut on that entire category of reform.