Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery Care Act of 2025; Seniors Deserve SMARTER Care Act of 2025
Summary
H.R. 5940, also known as the "Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery Care Act of 2025" or the "Seniors Deserve SMARTER Care Act of 2025", aims to prohibit the implementation of the Wasteful and Inappropriate Services Reduction (WISeR) model under the Medicare program. The bill was introduced in the House of Representatives and referred to the Committees on Ways and Means and Energy and Commerce.
The WISeR model involves prior authorization for select services under Medicare. The bill seeks to prevent the Secretary of Health and Human Services from implementing this model or any substantially similar model.
This action reflects a congressional effort to potentially streamline medical approvals for seniors and prevent perceived inefficiencies or burdens associated with the WISeR model.
Expected Effects
If enacted, H.R. 5940 would prevent the implementation of the WISeR model, maintaining the existing prior authorization processes (or lack thereof) within Medicare.
This could lead to continued instances of wasteful or inappropriate service utilization, but it may also prevent delays in necessary medical care for seniors.
The overall effect hinges on the actual impact and effectiveness of the WISeR model, which is a point of contention reflected in the bill's introduction.
Potential Benefits
- Prevents potential delays in medical care for seniors due to prior authorization requirements.
- Reduces administrative burden on healthcare providers who would otherwise need to comply with the WISeR model.
- Addresses concerns about the appropriateness and effectiveness of the WISeR model as perceived by the bill's sponsors.
- Maintains the status quo regarding Medicare service approvals, which some may prefer.
- Could lead to further evaluation and refinement of alternative approaches to reducing wasteful spending in Medicare.
Potential Disadvantages
- May result in continued wasteful or inappropriate utilization of Medicare services, as the WISeR model was intended to address.
- Could limit the ability of the Secretary of Health and Human Services to implement innovative payment and service delivery models aimed at improving efficiency.
- Misses the opportunity to test and evaluate the potential benefits of the WISeR model in reducing healthcare costs.
- May not address underlying issues related to healthcare spending and service utilization within the Medicare program.
- Could be perceived as hindering efforts to improve the financial sustainability of Medicare.
Most Disadvantaged Areas:
Constitutional Alignment
The bill falls under the legislative powers granted to Congress in Article I, Section 8 of the US Constitution, which includes the power to provide for the general welfare and regulate commerce. Specifically, this bill relates to the regulation of Medicare, a federal program established under the Social Security Act, and thus falls within the purview of Congress's authority to legislate on matters of healthcare and social welfare.
There are no apparent conflicts with specific constitutional amendments or principles. The bill does not infringe on individual liberties, rights, or privacy, nor does it relate to religious freedom, freedom of speech, or other constitutionally protected rights.
The bill's focus on Medicare and healthcare spending aligns with the constitutional mandate to provide for the general welfare, although the specific approach of prohibiting the WISeR model is a policy choice subject to debate and evaluation.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).