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Aug 19, 2024 View in browser   By Ben Leonard and Chelsea Cirruzzo With Toni Odejimi  Driving the Day In 2017, then-Sen. Kamala Harris joined Sen. Bernie Sanders at an event to introduce the Medicare for All Act of 2017. | Alex Wong/Getty Images ALL FOR ONE AND ONE FOR ALL — Democratic presidential nominee Kamala Harris, after backing Medicare for All for years, is dropping the policy from her agenda, POLITICO’s Daniel Payne reports. Progressive health advocates and policy wonks are OK with that. Despite Harris being one of their best chances in recent memory to get a nominee for the White House to make a single-payer pitch, progressives said they understand the need to keep Republican candidate Donald Trump from winning, which they said would be an existential threat not just to the health system but also American democracy. They said they trust Harris to decide the policy agenda needed to do that. “When you juxtapose the possibility of disappointment with the possibility of a loss of democracy, I think that I would choose a health policy that doesn’t exactly fit my desires every time,” said Gillian Mason, interim executive director at Healthcare-NOW, an advocacy group that supports a single-payer system. Even so, many progressives believe Harris needs to push a bold vision for the American health care system to energize voters. And several Democratically aligned policy experts — both centrist and progressive — said Harris needs to use this moment to differentiate herself from the current administration. Mason said sticking to centrist Democratic health policy “would be a mistake” that could cost Harris key voters. But several others in the party disagree, saying the Biden administration has proven its approach works and that Harris should pledge to “finish the job.” “We don’t need new ideas,” said Leslie Dach, founder and chair of Protect Our Care, an advocacy group working to reduce costs and increase access to care. “She really should continue this administration’s work and not worry too much about creating her own things.” What’s Harris’ plan? Details of Harris’ health agenda are still unclear, but people on her campaign suggested she would be more interested in following the path of the current administration than blazing a new one. On Friday, she released a suite of proposals similar to what President Joe Biden has called for, including expanding monthly insulin and annual out-of-pocket drug spending caps and expediting Medicare drug price negotiations. Why it matters: Harris' health policy decisions could define her focus should she win the White House — and set the tone for Democrats nationwide. WELCOME TO MONDAY PULSE. If you’re in Chicago for the DNC, try the Malört. It’s incredible. Send your tips, scoops and feedback to bleonard@politico.com and ccirruzzo@politico.com and follow along @_BenLeonard_ and @ChelseaCirruzzo. Artificial Intelligence Hospital systems and health technology researchers are collaborating to develop industry standards for advanced AI in health care. | Kirill Kudryatsev/AFP/Getty Images ROOTING OUT B[AI]S — Hospitals and university health technology experts have allied to remove one of the biggest impediments to the adoption of advanced artificial intelligence tools in health care: bias. How so? The initiative, called VALID AI, began last year when two AI digital health specialists at the University of California, Davis, Dennis Chornenky and Ashish Atreja, convinced health care systems and research facilities to join their effort to establish industry standards for advanced AI, Toni reports. They hope to develop tools that collect more information about patients’ “social vital signs” — characteristics like socioeconomic status or access to care linked to health outcomes. One potential tool they’ve proposed is an AI toolkit of diverse data that would better capture the role of social determinants of health. Armed with the toolkit, empowered providers could work more deliberately to improve health care outcomes by linking patients to community resources. VALID AI has more than 50 members, including New York-Presbyterian, Ochsner Health in Louisiana and Boston Children’s Hospital. Why it matters: Because artificial intelligence is based on data gathered by people, it reflects human prejudices against people of color, women and low-income patients. VALID AI believes it can reverse the problem by working with organizations that could train algorithms to detect bias and help patients. If the researchers succeed, they hope it will speed responsible adoption of AI tools to improve care, reduce disparities in access and diagnosis and make providers more efficient. “AI can analyze and synthesize vast amounts of health data incomprehensibly faster than a human or a bunch of humans could do to identify disparities in access and outcomes,” said Craig Kwiatkowski, chief information officer at one of the group’s founding members, Cedars-Sinai Medical Center in Los Angeles. HEALTH DATA RULE OF THE INFORMATION HIGHWAY CHANGE — Nonprofit data-sharing framework Carequality is updating its rules after a data-sharing dispute rattled the health technology sector. The group announced the changes after electronic health records giant Epic claimed that Integritort, which offers analysis of medical records for legal cases, improperly accessed its patient data through Carequality. The controversy underscores what legal and industry experts said is a lack of clarity in governance and oversight that threatens industry efforts to securely facilitate data flow. The backstory: Epic said Integritort incorrectly retrieved the patient data through Carequality using health IT firm Particle Health. According to Epic, Integritort retrieved the data by falsely claiming it was for treatment purposes, which made it easier to gain access without a doctor’s authorization, in violation of Carequality’s rules. Integritort denies the allegations, saying it followed federal regulations and Carequality guidelines when it obtained the data for treatment purposes. The parties are undergoing a formal dispute process. The changes: Carequality clarified Friday what “treatment” means, aligning its definition with the federal-backed data-sharing initiative known as TEFCA, short for Trusted Exchange Framework and Common Agreement. The move comes after POLITICO previously reported that it reviewed documentation showing that Integritort’s claim that it needed the data for treatment purposes made it easier to pull patients’ data without a doctor’s authorization. Epic applauded the change, saying it will allow organizations to vet other organizations requesting records like in TEFCA. Particle CEO Jason Prestinario told Pulse that the group is “happy to see additional clarity.” “If we want to achieve the vision of the 21st Century Cures Act , we need consistent standards that compel all actors in the system to operate in a best-faith effort and with open communication,” Prestinario said. Artificial Intelligence PELOSI REBUFFS AI BILL — Former House Speaker Nancy Pelosi slammed a bid to regulate large-scale artificial intelligence models in California, saying it’s “well-intentioned but ill-informed,” POLITICO’s Lara Korte reports. The legislation from state Sen. Scott Wiener, a fellow San Francisco Democrat, would mandate AI developers to undergo safety testing before deployment to avert AI from causing catastrophic harm, such as aiding in the creation of a biological weapon. Wiener pushed back against Pelosi on Saturday, saying, “I reject the false claim that in order to innovate, we must leave safety solely in the hands of technology companies and venture capitalists.” AROUND THE AGENCIES REVERSING COURSE — Medicare contractors responsible for administrating claims are pulling back on a coverage policy proposed last year that would have restricted access to noninvasive blood tests intended to monitor for signs of organ rejection in people who had a transplant. “Due to the importance of identifying … rejection early and to ensure the public has additional opportunities to comment on the policy, the [contractors] intend to issue a new [local coverage determination] in the coming months,” CMS said Friday. The change came amid concerns about overuse. The reversal comes after groups like the Health Equity in Transplantation Coalition and members of Congress, including Reps. Anna Eshoo (D-Calif.) and Michael Burgess (R-Texas), had pushed back against the proposal, saying it could undermine transplant patients’ health and increase health disparities. “Black and Brown organ transplant patients regained access to a blood test that helps determine their health outcomes,” said the Rev. Al Sharpton, senior adviser to HEiTC, in a release. Names in the News Alya Sulaiman is now chief compliance and privacy officer and senior vice president of regulatory affairs at Datavant. She was previously partner at McDermott Will & Emery. Dana Perrino is now chief member services officer at the American Health Information Management Association. She was previously vice president of membership at the organization. Jeff Micklos of the Health Care Transformation Task Force has been named the next CEO of the National Association of ACOs. Alicia Yass is now Democratic chief counsel for the House Select Subcommittee on the Coronavirus Pandemic. She was previously a senior counsel with the subcommittee. Joseph Romero is now a senior investigative counsel for the House Select Subcommittee on the Coronavirus Pandemic. He was previously a counsel with the subcommittee. WHAT WE'RE READING POLITICO’s Matt Friedman reports on pharmaceutical industry ally Sen. Bob Menendez (D-N.J.) ending an independent run days before he’s slated to resign. STAT reports on Lykos Therapeutics’ founder Rick Doblin tearing into the FDA for its decision not to approve MDMA for post-traumatic stress disorder.   Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Lauren Gardner @Gardner_LM Sophie Gardner @sophie_gardnerj Kelly Hooper @kelhoops Robert King @rking_19 Ben Leonard @_BenLeonard_ David Lim @davidalim Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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