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HR 6361119th CongressIn Committee
Ban AI Denials in Medicare Act
Introduced: Dec 2, 2025
Sponsor: Rep. Landsman, Greg [D-OH-1] (D-Ohio)
Standard Summary
Comprehensive overview in 1-2 paragraphs
H.R. 6361, the Ban AI Denials in Medicare Act, prohibits the Secretary of Health and Human Services from testing the WISeR model and amends the Social Security Act to bar the implementation of any Medicare payment model that incorporates prior authorization—particularly those using artificial intelligence—for Part A or Part B services.
Key Points
- 1Prohibits HHS from implementing the WISeR model and any substantially similar model.
- 2Amends Section 1115A(b)(2) of the Social Security Act to restrict future CMI models testing prior authorization.
- 3Adds a new limitation that such models cannot provide prior authorization for Medicare Part A or Part B services.
- 4Strikes the phrase “The Secretary shall select” and inserts a limitation clause.
- 5Effectively bars the use of AI‑based prior authorization in traditional Medicare payment testing.
Impact Areas
Medicare beneficiariesHealth and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS)Healthcare providers and insurersAI developers and technology vendorsMedicare payment and policy researchers
Generated by openai/gpt-oss-20b:free on Dec 6, 2025