# CMS Reports WISeR Pilot Problems

CMS’s WISeR Medicare coverage-review pilot has encountered delayed determinations, questionable denials, incomplete provider communications, and portal-readiness problems affecting several participating technology firms. CMS says there are no active corrective action plans and plans to provide a fuller performance update in a forthcoming six-month report. Congressional scrutiny and a proposed funding suspension leave the pilot’s future scope and requirements uncertain for agencies, providers, and contractors.

- Technology firms involved in or pursuing similar work should account for portal readiness, timely determinations, and complete provider communications as operational performance concerns raised by the pilot.
- Procurement teams and contractors should treat the pilot’s scope and requirements as uncertain; CMS has not announced active corrective action plans, and the fuller performance report is still forthcoming.
- The reported problems and proposed funding suspension may affect planning for Medicare coverage-review technology and related services. Companies should use the available pilot details to assess delivery risks and avoid assuming the model will continue unchanged.

**Jurisdictions:** federal
**Industries:** Healthcare, Information Technology
**Topics:** Artificial Intelligence
**Published:** November 02, 2026

### Government Entities
- Centers for Medicare and Medicaid Services (CMS)
- CMS Innovation Center
- House Appropriations Committee
- U.S. Senate Finance Committee
- U.S. Department of Health and Human Services (HHS)

### Vendors
- Genzeon Corporation ()
- Virtix Health ()
- Zyter ()
- Innovaccer ()

### Key Quotes
> Our provider portal has been operating successfully for more than six months, with authorization determinations routinely processed within minutes or near real time, and timely issuance of determination letters to providers and beneficiaries.
> — Sundar Subramanian, Zyter Chief Executive Officer

> There are a lot of things about WISeR that are not working.
> — Kimberly Brandt, CMS Deputy Administrator

> Decision[s] about changes to the model would be based on such experiences and findings.
> — Chris Klomp, then-nominee for HHS Deputy Secretary

### Sources
- [Medicare’s AI-assisted coverage review pilot hit early snags, documents show - Nextgov/FCW](https://www.nextgov.com/artificial-intelligence/2026/11/medicares-ai-assisted-coverage-review-pilot-hit-early-snags-documents-show/416978) - Nextgov/FCW