CMS releases guide on prior authorization submissions, determinations under WISeR model  

The Centers for Medicare & Medicaid Services has released an operational guide for Medicare-enrolled providers and suppliers on the Wasteful and Inappropriate Service Reduction model. It provides an overview of the prior authorization submissions and determinations procedures and details the pre-payment medical review processes for services delivered in states where the WISeR model is being implemented: New Jersey, Ohio, Oklahoma, Texas, Arizona and Washington.