News: Health care groups: Regulate AI, but not too much

Wednesday, May 15, 2024

Health care groups: Regulate AI, but not too much

May 15, 2024

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By Ben Leonard and Chelsea Cirruzzo

Presented by The American Hospital Association

Driving The Day

Ami Bera chairs a House Committee on Foreign Affairs Asia and Pacific subcommittee

Rep. Ami Bera (D-Calif.), a member of the House Task Force on Artificial Intelligence, is evaluating the need for regulations governing AI use in healthcare. | Drew Angerer/Getty Images

WHAT TOP TRADE GROUPS WANT ON AI — Many leading organizations across health care want the federal government to regulate artificial intelligence with a lighter touch.

As interest in AI grows exponentially, Rep. Ami Bera (D-Calif.) solicited input from health care leaders on AI policymaking. Bera serves on the House Task Force on Artificial Intelligence, newly formed by Speaker Mike Johnson and Minority Leader Hakeem Jeffries.

Pulse obtained responses from groups that represent doctors, medical device makers, technology developers, hospitals, health systems, insurers and others.

Their feedback sheds light on what some of the most influential advocacy groups in the industry want to see as they call for regulation. Here are highlights of their suggestions:

A ‘risk-based’ framework: Many groups, including the Consumer Technology Association and insurer lobby AHIP, said AI used in high-risk situations should undergo stricter federal scrutiny.

AHIP said regulations should differentiate between what it sees as high-risk AI (which can directly impact patient care) and low-risk AI (used to expedite claim processing, for example), warning that “overly restrictive” policy could hamper innovation. Some of the groups criticize the Biden administration’s new rules mandating transparency in software used by most hospitals and doctors’ offices because they don’t limit the regulation to high-risk technology.

“This is directly counter to … the risk-based approach to broader health regulation,” the Consumer Technology Association wrote to Bera.

Skepticism about transparency: Some groups said mandated transparency should be limited.

The American Health Information Management Association said that while guardrails must permit users to understand how AI comes to its conclusions, they shouldn't risk intellectual property. The Federation of American Hospitals called for similar transparency measures but said they shouldn't add “unnecessary burden.”

AHIP said that organizations developing AI internally shouldn't be required to divulge “proprietary information” about it.

“Revealing the inner workings of AI systems to the public or regulatory agencies should not be required, nor would it be beneficial,” the Healthcare Leadership Council, a group of health care CEOs, wrote.

Change payment systems: CMS hasn't yet released a “useful" framework for reimbursing for artificial intelligence, CTA wrote, saying many AI models are excluded.

Medical device trade group AdvaMed said that Medicare has the authority to pay for AI technology, but its regulatory framework isn’t specific enough to offer payment for it broadly.

The FDA factor: In line with other groups, the American Hospital Association said the FDA’s existing rules regulating software as a medical device are a “solid foundation” for what the government should do.

“Adapting these frameworks … could be a more … effective approach,” AHA wrote.

Liability: The American Medical Association called for tech companies to be held accountable for their data practices.

WELCOME TO WEDNESDAY PULSE. We heard there are only rats on the first floor of the Longworth House Office Building. We’re … skeptical. Reach us and send us your tips, news and scoops at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.

A message from The American Hospital Association:

America’s hospitals and health systems are ready for you, 24/7. This week, almost 1 out of every 100 individuals will visit the emergency room. And by the end of this year, more than 130 million people will have made this visit. You may not know when you’ll need us; but in America’s hospitals and health systems, we’re always ready — because emergencies don’t wait for business hours. Learn more during National Hospital Week May 12 – 18.

CAMPAIGN 2024

THE AWARENESS FACTOR — President Joe Biden’s messaging promoting his drug pricing provisions under the Inflation Reduction Act is reaching a growing segment of older Americans, but most still don’t know about his accomplishments, according to a new KFF poll.

Poll shows awareness of Biden's drug pricing accomplishments

Registered voters ages 65 and older are increasingly aware of the provisions, including those allowing Medicare to negotiate some drug prices for the first time. But a $35 monthly cap on insulin costs for Medicare patients is the only one most are aware of.

Just 48 percent of them said they know about the Medicare pricing negotiations, though that’s up from 36 percent in November. Two in 5 said they knew about an annual out-of-pocket prescription drug cap — up from about 1 in 4 in November. Just 15 percent said they knew about penalizing drug companies for hiking prices more than inflation.

The rising awareness can be interpreted as an encouraging sign for the Biden campaign that its messaging is breaking through, though the overall low awareness underscores the difficulty Biden has had in translating legislative achievements into campaign success.

The KFF poll also shows Biden has room for growth in the drug pricing arena if he can spread his message further. The insulin cap under the IRA enjoys support from close to 9 in 10 voters — both Democratic and Republican.

Some other key findings from the poll:

— Independent voters overwhelmingly favor Biden over former President Donald Trump on the Affordable Care Act.

— Thirty-nine percent of independent voters trust Biden more to lower health care costs compared with 26 percent who trust Trump more.

A message from The American Hospital Association:

In Congress

CLOCK WINDING DOWN ON VA EHR? Congressional leaders unveiled legislation that would set a two-year deadline for Oracle Cerner and the Department of Veterans Affairs to hit certain metrics in their beleaguered digital health record system overhaul or end the contract.

Lawmakers have previously threatened to end the project — which is on pause — but this is the most significant effort thus far, with Senate Veterans’ Affairs Chair Jon Tester (D-Mont.) and ranking member Jerry Moran (R-Kan.) and House Veterans’ Affairs Chair Mike Bost (R-Ill.) backing it. The legislation is expected to be considered soon.

“Modernizing VA’s electronic health record is not optional,” Tester told POLITICO.

The system revamp has been tied to at least four veterans’ deaths, and its estimated cost has ballooned from $10 billion to more than $50 billion. Internal clinician messages obtained by POLITICO showed deep frustration last year with the software and providers struggling to access crucial data, including data related to prescription refills.

The details: If the package is approved, the VA would be required to end its contract two years after the bill goes into law unless quality measures improve and the facilities using the digital system have “recovered.” VA Secretary Denis McDonough said earlier this month that he hopes the agency can resume system rollouts by the end of the fiscal year in September.

What else is in it: The sweeping package would also mandate more transparency from the agency on veterans’ care options and institute a mental health grant program for family caregivers, among other things.

The VA and Oracle Cerner didn't respond to requests for comment.

W&M, E&C SET FOR TELEHEALTH BATTLE — The House Energy and Commerce Health Subcommittee will mark up legislation Thursday that would make permanent eased pandemic-era telehealth rules in Medicare.

The Telehealth Modernization Act goes beyond the legislation the House Ways and Means Committee unanimously advanced last week, which would extend those rules for two years. The differing proposals set up division within the Republican-led House for negotiation with the Democratic-held Senate. It’s worth noting that the bill can still be amended before the markup.

The bill from Reps. Buddy Carter (R-Ga.) and Lisa Blunt Rochester (D-Del.) also differs from the Ways and Means-passed bill because it has payment parity for federally qualified health centers and rural health clinics for in-person and virtual care.

Cost will be a key consideration for lawmakers in determining the length of a potential extension, as will how much to pay for in-person versus virtual care.

Congress appears poised to continue loosened telehealth rules, but the details — including how long the eased rules will last — are still up in the air.

A message from The American Hospital Association:

America’s hospitals and health systems are ready for you, 24/7. This week, almost 1 out of every 100 individuals will visit the emergency room. And by the end of this year, more than 130 million people will have made this visit. You may not know when you’ll need us; but in America’s hospitals and health systems, we’re always ready — because emergencies don’t wait for business hours. Learn more during National Hospital Week May 12 – 18.

Names in the News

Jim Rechtin will become the CEO of Humana on July 1, succeeding Bruce Broussard. Rechtin is currently chief operating officer and was previously CEO of Envision Healthcare.

Darío Gil of IBM Research and Victor McCrary of the University of the District of Columbia have become chair and vice chair, respectively, of the National Science Board.

THE GOLD STANDARD OF HEALTHCARE POLICY REPORTING & INTELLIGENCE: POLITICO has more than 500 journalists delivering unrivaled reporting and illuminating the policy and regulatory landscape for those who need to know what’s next. Throughout the election and the legislative and regulatory pushes that will follow, POLITICO Pro is indispensable to those who need to make informed decisions fast. The Pro platform dives deeper into critical and quickly evolving sectors and industries, like healthcare, equipping policymakers and those who shape legislation and regulation with essential news and intelligence from the world’s best politics and policy journalists.

Our newsroom is deeper, more experienced and better sourced than any other. Our healthcare reporting team—including Alice Miranda Ollstein, Megan Messerly and Robert King—is embedded with the market-moving legislative committees and agencies in Washington and across states, delivering unparalleled coverage of health policy and the healthcare industry. We bring subscribers inside the conversations that determine policy outcomes and the future of industries, providing insight that cannot be found anywhere else. Get the premier news and policy intelligence service, SUBSCRIBE TO POLITICO PRO TODAY.

WHAT WE'RE READING

Fierce Healthcare reports on CVS saying it could lose up to 10 percent of Medicare members next year.

The Star Tribune reports on Minnesota fining UnitedHealthcare over mental health parity violation allegations. The company didn’t admit or deny wrongdoing.

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