H.R. 6361 — Ban AI Denials in Medicare Act

This section (1) prohibits the Secretary of Health and Human Services from implementing the Wasteful and Inappropriate Services Reduction (WISeR) model described in the July 1, 2025, notice (90 Fed. Reg. 28749), or any substantially similar model; and (2) amends the Center for Medicare and Medicaid Innovation (CMI) model selection criteria to prohibit, beginning on the date of enactment, the testing of any model under Medicare part A or B that implements prior authorization (including through artificial intelligence) for items or services paid under those parts. (As background, the CMI tests innovative payment and service delivery models to reduce Medicare and Medicaid expenditures while preserving or enhancing care quality; thus, this limitation prevents CMS from using the CMI to test prior authorization in traditional Medicare.)