S.J.Res. 198, Healthcare Deregulation / Prior Authorization Rollback. Quorum's AI analysis reads it as a net cost — and names who bears it.
S.J.Res. 198 · Net cost
What it does
This is a Congressional Review Act resolution that would block a Medicare rule called the WISeR Model, which requires prior authorization (advance approval from insurers) before certain medical services are provided. The rule was designed to reduce wasteful or inappropriate services. If passed, this resolution would kill the rule entirely, allowing Medicare providers to deliver those services without pre-approval requirements.
The analysis names pharmaceutical companies — and 4 more groups — among the beneficiaries.
The cost
Blocking prior authorization may increase unnecessary medical procedures and tests, raising Medicare costs and potentially exposing beneficiaries to overtreatment risks.
The analysis put a high warning level on this bill. Transparency scores 95%, and the analysis found no provisions unrelated to the bill's subject.
Who is behind it
Filed by Ron Wyden. Cosponsored by Andy Kim, Ben Luján, Bernie Sanders and Chris Van Hollen.