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Sense of the House

A resolution passed by the House of Representatives expressing its collective opinion or sentiment on a particular issue. It is non-binding and does not create law.

Wasteful and Inappropriate Services Reduction (WISeR) Model

A proposed new program by the Center for Medicare and Medicaid Innovation designed to reduce unnecessary healthcare services by expanding prior authorization requirements in traditional Medicare.

Prior Authorization

A process required by some health insurance companies where a healthcare provider must get approval from the insurer before a patient can receive certain medical services, treatments, or medications.

Traditional Medicare

The original Medicare program, managed by the federal government, which includes Part A (hospital insurance) and Part B (medical insurance). This is different from Medicare Advantage plans, which are offered by private companies.

Center for Medicare and Medicaid Innovation (CMMI)

A part of the Centers for Medicare & Medicaid Services (CMS) that tests new payment and service delivery models to reduce program expenditures while maintaining or improving the quality of care for Medicare, Medicaid, and CHIP beneficiaries.

Medicare Advantage

A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. These plans often have their own rules for how you get services, like requiring prior authorization.