Providers qualify for exemption by submitting at least 10 prior authorization requests during the assessment period, achieving a 90% affirmation rate, and maintaining good standing on Medicare exclusion lists. Exemptions last one year and are re-evaluated quarterly. The WISeR model itself launched January 1, 2026, as a six-year initiative designed to reduce wasteful care through rigorous oversight and financial penalties for inaccurate denials.
Washington providers should monitor for exemption notices from Virtix Health immediately. The July 6 effective date marks the first real-world test of whether the gold-carding approach can shift administrative burden away from high-performing providers while the broader WISeR model faces ongoing legislative and judicial challenges. Securing exemption status before the deadline requires meeting the 90% affirmation threshold and other compliance metrics.