A Word to the WISeR: Why Otolaryngologists Must Lead to Preserve Access to Hypoglossal Nerve Stimulation.

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.