policy
AI taskforce identifies payments as key issue
A House of Representatives task force on artificial intelligence this week released a nearly-300 page report including a number of recommendations and policy proposals for health care. The bipartisan task force was led by Reps. Jay Obernolte (R-Calif.) and Ted Lieu (D-Calif.).
My colleague Brittany Trang wrote a very good guide to what's in the report, which includes discussions of AI regulation, the potential to improve patient care and drug development, and a thoughtful discussion of the potential harms to patients.
I was interested to see lawmakers raise concerns about how AI in health care is paid for. The report notes that the Centers for Medicare and Medicaid Services currently reimburses based on physician time, acuity of care, and practice expense, and that "current payment mechanisms cannot adequately reimburse these tools."
This is something I want to follow next year! If you have thoughts on AI reimbursement, I'd love to hear them.
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policy
Hidden health tech in the big health package
A major chunk of health care legislation, including a two-year extension for the Medicare telehealth expansion adopted during the pandemic, is in jeopardy after President-elect Donald Trump came out against the broader funding package Wednesday afternoon. Trump's comments followed similar criticism from tech billionaire Elon Musk who said on X that any lawmaker who supported the "outrageous spending bill" should be voted out of office. Lawmakers are scrambling to avoid a government shutdown at the end of the week, and it's unclear what will happen to the health care legislation.
Industry groups are on red alert. The American Telemedicine Association was calling reporters Wednesday drumming up concerns that the whole thing would fall apart — even before Trump made his remarks. Meanwhile, the Hospital at Home Users Group has all week been advertising a "just in case" webinar today to discuss what happens if congress doesn't extend a pandemic-era waiver program that allowed approved hospitals to deliver impatient care in people's homes. The package lawmakers agreed to grant a five-year extension of the waiver.
Regular Health Tech readers are by now well-versed in the issues surrounding the expiring telehealth flexibilities that the proposed legislation would address. Here's other parts of the package that we haven't discussed yet:
- The package includes a provision that allows virtual providers to be suppliers of Medicare Diabetes Prevention Programs, which offer a year-long course that promotes dietary changes, physical activity, and other behaviors to help people lose weight. Providers are paid both for sessions attended and weight loss outcomes. The provision also removes a once in a lifetime cap on this service. Digital health giants Teladoc and Omada Health have been at the front lines of advocating for this change, which Omada CEO Sean Duffy told me could be helpful in gaining traction with Medicare Advantage plans.
- There's also an unusual provision requiring a report on wearable devices. Within 18 months, the government accountability office must produce a report on "(1) the potential for such devices to accurately prescribe treatments; (2) an examination of the benefits and challenges of artificial intelligence to augment such capabilities; and (3) policy options to enhance the benefits and mitigate potential challenges of developing or using such devices." I sent a few messages trying to figure out what exactly the deal is, but the language has been attached to telehealth legislation since at least May.
medical devices
What's getting in the way of brain-computer interfaces?
Brain-computer interfaces offer enormous potential to improve the lives of people with disabilities, and a new report from the Government Accountability Office spells out some of the challenges developers must overcome.
In particular, the report calls out privacy concerns around how neural data is used, the risk that someone might lose support for an implanted device, and questions around Medicare coverage for the devices.
In their guide to the report, STAT's Timmy Broderick notes that the report comes at a pivotal moment for the industry, with several prominent companies running trials in humans and fresh funding pouring in.
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