About six months ago, I wrote an article titled "Turning Traditional Medicare Into Medicare (Dis)Advantage...From Within." In it, you learned that the Center for Medicare Services (CMS) was going to move decisions regarding your Traditional Medicare service and treatment over to private firms. This risibly named WISeR model (Wasteful and Inappropriate Service Reduction) is billed as a pilot project that would take place in six states, Washington being one of them. As of the first of January, those of us here in Washington are now are being overseen by a company that knows how to exctract money from Medicare, that is, your money.  

Washingtonians' Traditional Medicare will by and large be taken over by Virtix Health located somewhere in Pheonix, Arizona. "What is known about Virtix Health is that it offers risk adjustment coding services, such as chart reviews, to MA [Medicare Advantage] plans. These chart reviews are used by MA insurers to add medical codes to an enrollee’s chart, making them appear sicker than they are in order to receive a higher payment from the government." [Source: The Retiree Advocate January 2026 - you will want to read this article in its entirety!] Additional information about the company can be found at the Vitrix site on Linkedin here. Once there, you will be entertained by such argle-bargle as:

"Virtix Health is your connection to exceptional performance—helping health plans and provider organizations support value-based care and risk adjustment programs through complete, compliant clinical documentation. We specialize in clinical data acquisition, risk adjustment coding, and HEDIS/quality abstraction—delivered by certified in-house experts and technology that reduce administrative burden. We support retrospective, prospective, and concurrent workflows for payers and providers in Medicare Advantage, ACOs, Commercial/ACA, and Medicaid managed care, and offer payment integrity and documentation validation for health plans, ensuring accurate, compliant clinical records for claims and services across the healthcare ecosystem."

The folks who wrote the gibberish above are now in charge of pre-approvals of the following treatments and services under Traditional Medicare in Washington; their goal is to delay/deny services to make money at your expense. Vitrix and its Artificial Intelligence and machine learning will have the say, above and beyond that of your physician, for these conditions, many of which involve pain management: 

Electrical Nerve Stimulators (NCD 160.7)

Sacral Nerve Stimulation for Urinary Incontinence (NCD 230.18)

Phrenic Nerve Stimulator (NCD 160.19)

Deep Brain Stimulation for Essential Tremor and Parkinson's Disease (NCD 160.24)

Vagus Nerve Stimulation (NCD 160.18)

Induced Lesions of Nerve Tracts (NCD 160.1)

Epidural Steroid Injections for Pain Management excluding facet joint injections (L39015, L33906, L39036, L39240, L39242, L36920, L38994, L39054)

Percutaneous Vertebral Augmentation (PVA) for Vertebral Compression Fracture (VCF) (L33569, L34106, L34228, L38201, L34976, L35130, L38737, L38213)

Cervical Fusion (L39741, L39799, L39770, L39758, L39762, L39793, L39773, L39788)

Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee (NCD 150.9)

Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (L38276, L38307, L38398, L38387, L38310, L38312, L38385, L38528)

Incontinence Control Devices (NCD 230.10)

Diagnosis and Treatment of Impotence (NCD 230.4)

Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis (NCD 150.13)

Skin and Tissue Substitutes (LCDs below)—only applicable to MAC jurisdictions and states that have an active LCD in place

You, too, can writhe in pain for days or weeks or more while these schmucks decide your fate. With CMS, cruelty knows no bounds for they are the WISeR.

In conjuntion with my article, I suggest you read the articles below under RELATED WEBSITE LINKS.

Indeed provides employee ratings of Vertix and the ratings are not good.  

Get ready for an exciting ride. 

P.S. You may want to show this article to your physician(s).