| action-alert-act-now-to-prevent-physician-shortages | Action Alert! Act Now to Prevent Physician Shortages | Latest_News | Shared_Content/News/advocacy-report/2026/April 3/action-alert-act-now-to-prevent-physician-shortages | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/april/getty-images-8RHFeR8fbOI-unsplash-for-web.jpg" class="pull-right" alt="Concerns with Medicare and Medicaid " /></div>
<h5>Apr. 3, 2026</h5>
<h2>Action Alert! Act Now to Prevent Physician Shortages</h2>
<p><em>Urge Congress to support H.R. 7961</em>
</p>
<p>
The bipartisan <a href="https://www.congress.gov/bill/119th-congress/house-bill/7961">H-1Bs for the Physicians and Healthcare Workforce Act (H.R. 7961)</a> would exempt physicians from the new $100,000 H-1B visa filing fee—helping ensure hospitals and physician practices can continue recruiting the international medical graduates who make up one in four U.S. physicians and serve many underserved communities. Without this fix, rising costs will worsen physician shortages, increase wait times for appointments, and limit access to care.
</p>
<p>
Take action: <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%2fCampaigns%2f130422%2fRespond">Urge your member of Congress to co-sponsor H.R. 7961 and protect patient access to care</a>.
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<p>
The WSMA has reached out directly to members of Washington's congressional delegation to request their support for this critical legislation.
</p>
</div> | 4/2/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| wsma-raises-concerns-with-cms-on-wiser-model-implementation | WSMA Raises Concerns with CMS on WISeR Model Implementation | Latest_News | Shared_Content/News/advocacy-report/2026/April 3/wsma-raises-concerns-with-cms-on-wiser-model-implementation | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/april/Medicare-iStock-1047505000-645x425px.jpg" class="pull-right" alt="Concerns with Medicare and Medicaid " /></div>
<h5>Apr. 3, 2026</h5>
<h2>WSMA Raises Concerns with CMS on WISeR Model Implementation</h2>
<p><em>Share your experiences under the new Medicare prior authorization pilot</em>
</p>
<p>
The WSMA recently sent a follow-up <a href="https://takeaction.wsma.org/wp-content/uploads/2026/03/wsma-follow-up-letter-to-cmmi-03262026.pdf">letter to the Centers for Medicare and Medicaid Services' Center for Medicare and Medicaid Innovation</a> regarding physician and patient experiences under the Wasteful and Inappropriate Service Reduction Model.
</p>
<p>
In the letter, the WSMA shares real-world examples from Washington physicians highlighting delays in care, administrative challenges, and ongoing issues with prior authorization and claims processing. These include extended authorization timelines, difficulty accessing the vendor portal, and unresolved discrepancies that have left some practices unable to receive payment despite valid approvals.
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<p>
The letter emphasizes that while we support efforts to improve program integrity, current implementation challenges are causing concerning disruptions in patient care and clinical workflows. We will continue to engage with CMS and advocate for improvements.
</p>
<h5>Follow WSMA guidance for Medicare prior authorizations</h5>
<p>
The WISeR model took effect Jan. 15 and subjects new prior authorization and prepayment review requirements to certain traditional Medicare services. Not sure if your practice is affected? <a href="https://www.wsma.org/wsma/resources/practice-management/prior-authorization-navigator/wsma/resources/practice-management/prior-authorization-navigator.aspx?hkey=97bc759f-c0fe-45fe-aa78-55d6b3ea017f">WSMA's resource</a> outlines impacted services and provides step-by-step guidance on documentation, prior authorization, and claims submission to help your practice navigate these new requirements.
</p>
<h5>Are you subject to WISeR? Share your experience</h5>
<p>
We strongly encourage impacted practices to share their experiences with WISeR with us—including administrative challenges, access issues, and impacts on patient care (positive or negative). The WSMA is uniquely positioned to serve as a conduit between Washington physicians, members of Congress, Virtix, Noridian, CMS, and the media. Your experience under WISeR is critical to informing ongoing congressional oversight and future CMS decision-making. Please contact WSMA Director of Policy Jeb Shepard at <a href="mailto:jeb@wsma.org">jeb@wsma.org</a> to share your feedback.
</p>
</div> | 4/2/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| wsmas-latest-prior-authorization-reform-bill-signed-into-law | WSMA's Latest Prior Authorization Reform Bill Signed Into Law | Latest_News | Shared_Content/News/advocacy-report/2026/April 3/wsmas-latest-prior-authorization-reform-bill-signed-into-law | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/april/SB-5395-bill-signing-photo-cropped.jpg" class="pull-right" alt="WSMA 2026 priority legislation updates" /></div>
<h5>Apr. 3, 2026</h5>
<h2>WSMA's Latest Prior Authorization Reform Bill Signed Into Law</h2>
<p><em>Legislation sets parameters on AI use and determination timelines</em>
</p>
<p>
Last week, WSMA priority legislation <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=5395&amp;Year=2025&amp;Initiative=false">Senate Bill 5395</a> was signed into law by Gov. Bob Ferguson. The bill, developed in partnership by the WSMA, the Washington State Hospital Association, and Proliance Surgeons, is the third prior authorization reform bill the WSMA has helped advance through the legislative process since 2020, working to address a top priority issue for our state's physician community and patients.
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<p>
Aligning with recent WSMA House of Delegates policy, SB 5395 prohibits insurance carriers from solely using artificial intelligence to deny prior authorizations, ensuring that a licensed health care practitioner makes such determinations. The bill also clarifies a prohibition in state law around retroactive denials of prior authorizations and requires insurance carriers to post policy updates on a single site.
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<p>
SB 5395 builds on legislation from 2023 that requires integration of prior authorization processes into electronic health records to help streamline and expedite determinations. That law goes into effect Jan. 1, 2027, dovetailing with a similar federal law that was put in place subsequent to WSMA's legislation. The federal law applies to prior authorizations for physical health care services, while the state law goes further and also applies to prescription drug authorizations.
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<p>
In 2020, the WSMA and WSHA successfully advocated for a bill requiring tracking of insurance carriers' utilization of prior authorization, directing <a href="https://app.leg.wa.gov/ReportsToTheLegislature/Home/GetPDF?fileName=FINAL%202025%20Prior%20Authorization%20Report_43836481-1f6e-428a-9a65-00de64d2e8b2.pdf">annual reports</a> from the Office of the Insurance Commissioner. As expected, the reports have found the vast majority of prior authorizations are approved, underscoring frustration that the process primarily serves to drive up costs for practices and cause delays for patients accessing care.
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<p>
While we're proud of our work to help reform prior authorization processes and our state's standing as a leader on this issue, we know there's more to be done. We’ll continue to work at the state and federal levels to advance WSMA policies on prior authorization and mitigate its administrative and financial burdens.
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</div> | 4/2/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |