{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:06:34Z","timestamp":1789589194498,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Centers for Medicare &amp; 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\u2010quality, evidence\u2010based stewardship of HGNS.<\/jats:p>","DOI":"10.1002\/ohn.70456","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:44:22Z","timestamp":1789587862000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Word to the WISeR: Why Otolaryngologists Must Lead to Preserve Access to Hypoglossal Nerve Stimulation"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8467-3269","authenticated-orcid":false,"given":"Phoebe Kuo","family":"Yu","sequence":"first","affiliation":[{"name":"Massachusetts Eye and Ear Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafa","family":"Khan","sequence":"additional","affiliation":[{"name":"Massachusetts Eye and Ear Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Rathi","sequence":"additional","affiliation":[{"name":"Ohio State University Medical Center Ohio State College of Medicine Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofer","family":"Jacobowitz","sequence":"additional","affiliation":[{"name":"ENT and Allergy Associates New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robson","family":"Capasso","sequence":"additional","affiliation":[{"name":"Stanford Medical Center Stanford Medicine Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"AAO\u2010HNS Sleep Disorders Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Centers for Medicare & Medicaid Services Center for Medicare and Medicaid Innovation.Wasteful and Inappropriate Service Reduction (WISeR) Model Provider and Supplier Operational Guide (Version 2.0). Centers for Medicare & Medicaid Services. November 6 2025:20\u201021.https:\/\/www.cms.gov\/files\/document\/wiser-provider-supplier-guide.pdf"},{"key":"e_1_2_5_3_1","unstructured":"Centers for Medicare & Medicaid Services. WISeR model: frequently asked questions. January 13 2026.https:\/\/www.cms.gov\/priorities\/innovation\/files\/document\/wiser-model-frequently-asked-questions"},{"key":"e_1_2_5_4_1","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1016\/j.arth.2024.03.013","article-title":"Prior authorization leads to administrative burden and delays in treatment in primary total joint arthroplasty patients","volume":"39","author":"Lizcano JD","year":"2024","journal-title":"J Arthroplasty"},{"issue":"2","key":"e_1_2_5_5_1","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.cgh.2023.06.021","article-title":"Prior authorizations delay therapy, impact decision\u2010making, and lead to adverse events in inflammatory bowel disease: 2022 provider survey","volume":"22","author":"Constant BD","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"2","key":"e_1_2_5_6_1","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1056\/NEJMoa1308659","article-title":"Upper\u2010airway stimulation for obstructive sleep apnea","volume":"370","author":"Strollo PJ","year":"2014","journal-title":"N Engl J Med"},{"issue":"9","key":"e_1_2_5_7_1","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.5664\/jcsm.6726","article-title":"Upper airway stimulation for treatment of obstructive sleep apnea: an evaluation and comparison of outcomes at two academic centers","volume":"13","author":"Huntley C","year":"2017","journal-title":"J Clin Sleep Med"},{"issue":"4","key":"e_1_2_5_8_1","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1007\/s11325-017-1519-0","article-title":"Effects of upper\u2010airway stimulation on sleep architecture in patients with obstructive sleep apnea","volume":"21","author":"Hofauer B","year":"2017","journal-title":"Sleep Breath"},{"issue":"4","key":"e_1_2_5_9_1","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1002\/lary.28057","article-title":"Upper airway stimulation therapy and sleep architecture in patients with obstructive sleep apnea","volume":"130","author":"Bohorquez D","year":"2020","journal-title":"Laryngoscope"},{"issue":"11","key":"e_1_2_5_10_1","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1001\/jamaoto.2019.2723","article-title":"Evaluation of hypoglossal nerve stimulation treatment in obstructive sleep apnea","volume":"145","author":"Kent DT","year":"2019","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"2","key":"e_1_2_5_11_1","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s11325-019-01923-2","article-title":"Hypoglossal nerve stimulation long\u2010term clinical outcomes: a systematic review and meta\u2010analysis","volume":"24","author":"Costantino A","year":"2020","journal-title":"Sleep Breath"},{"issue":"4","key":"e_1_2_5_12_1","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1177\/0194599817691491","article-title":"Upper airway stimulation for obstructive sleep apnea: patient\u2010reported outcomes after 48 months of follow\u2010up","volume":"156","author":"Gillespie MB","year":"2017","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"7","key":"e_1_2_5_13_1","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.5664\/jcsm.11620","article-title":"Adherence to unilateral hypoglossal nerve stimulation and changes in Epworth Sleepiness Scale scores","volume":"21","author":"Commesso EA","year":"2025","journal-title":"J Clin Sleep Med"},{"issue":"10","key":"e_1_2_5_14_1","doi-asserted-by":"crossref","first-page":"4627","DOI":"10.1007\/s00405-023-08062-1","article-title":"Patient\u2010reported outcomes with hypoglossal nerve stimulation for treatment of obstructive sleep apnea: a systematic review and meta\u2010analysis","volume":"280","author":"Braun M","year":"2023","journal-title":"Eur Arch Oto\u2010rhino\u2010laryngol"},{"issue":"11","key":"e_1_2_5_15_1","doi-asserted-by":"crossref","first-page":"2616","DOI":"10.1002\/lary.29755","article-title":"Impact of body mass index and discomfort on 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