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Health policy review highlights prior authorization for hypoglossal nerve stimulation under Medicare, indicating a need for clinician-led stewardship to maintain access.
The Centers for Medicare & Medicaid Services' Wasteful and Inappropriate Service Reduction (WISeR) model introduced prior authorization review for hypoglossal nerve stimulation (HGNS) and took effect on January 1, 2026, in six states. HGNS was the only otolaryngology procedure included in the model, reflecting the rapid growth in utilization and potential payor concern about continued access to the procedure. This policy shift presents an opportunity for otolaryngologists to define and demonstrate high‐quality, evidence‐based stewardship of HGNS.
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Yu et al. (2026) studied this question.
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