The ideas and innovators shaping health care
| | | | |  | | By Ruth Reader, Daniel Payne, Erin Schumaker and Carmen Paun | | | | | 
Newsom wants doctors to make the final call, not AI. | Rich Pedroncelli/AP | California doctors must sign off on any medical care recommended — or denied — by artificial intelligence under new state legislation. Democratic Gov. Gavin Newson signed the health care-related AI bill even as he vetoed a consumer-focused measure that would have required AI systems be tested before public release and include a “kill switch.” Why it matters: Doctors have won a round in their fight to ensure AI continues to support them — not replace them. The California Medical Association, a doctors’ advocacy group, backed the bill. The CMA’s parent organization, the American Medical Association, has campaigned to rename artificial intelligence as augmented intelligence as a way to reinforce doctors’ primary role. But the bill’s enactment also means that legal liability for patient care will remain with doctors when they use AI — a position held by the Federation of State Medical Boards. The law also includes insurance claims decisions. The California-based Clarkson Law Firm sued Cigna in July on behalf of patients who believe the insurer used AI to deny coverage in violation of state law. It's more evidence that states are taking the lead in regulating AI in health care in the absence of consensus in Washington. That could lead to a patchwork of inconsistent rules nationwide. Colorado passed a law in 2021 preventing insurance companies from using AI that results in unfair discrimination. But federal rules have been slow to come. The Food and Drug Administration has issued guidance on applications for AI-enabled devices. And the Department of Health and Human Services has set AI transparency rules for the health IT systems it certifies. What’s next? In January, HHS plans to release an AI strategy, laying out its framework for regulating the technology.
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Flam, Norway | Shawn Zeller/POLITICO | | This is where we explore the ideas and innovators shaping health care. Doctors Without Borders is testing an AI app in South Sudan that can identify if a venomous snake bit a person to ensure expensive antivenoms are only used when necessary, the Guardian reports. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com, or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.
| | |  Medical bills burden many Americans. | Jacquelyn Martin/AP | Collection firms hired to pursue medical debts are on the Consumer Financial Protection Bureau’s radar — and not for a good reason. This week, the CFPB issued guidance warning debt collectors that it’s illegal to try to collect an already-paid debt or add upcharges beyond the original debt. The agency says it’s received complaints that medical bills are frequently confusing or wrong and Americans often don’t know their rights to contest the charges. Why it matters: Americans owe $220 billion in medical debt, according to a recent analysis by two think tanks, the Kaiser Family Foundation and the Peterson Center on Healthcare. Debtors are disproportionately low income, working class, middle-aged, Black or veterans and live in the Southeast or Midwest. Health systems are often aggressive in tracking down unpaid medical debt. More than two-thirds take legal action against patients, according to a 2022 report from Kaiser Health News.
| | |  Bertagnolli shares lawmakers' desire to revive an NIH advisory board. | AP | The National Institutes of Health has re-established its scientific management review board, a group Congress created in a 2006 law to review the agency's structure and research portfolio and make recommendations to the NIH director. Why it matters: Congressional Republicans have pressured the agency to do so for months. Cathy McMorris Rodgers (R-Wash.), chair of the House panel with responsibility for health policy, and Bill Cassidy (R-La.), the top Republican on the comparable Senate committee, have made reviving the board a centerprise of their proposals to increase oversight of the agency. Many Republicans felt the agency wasn’t transparent enough during the Covid-19 pandemic, specifically about the origins of the disease. State of play: The board hasn’t met or issued any reports in nearly a decade. According to its charter, it’s supposed to advise and make recommendations to the NIH director about reorganizing, adding, removing or transferring NIH offices, centers, divisions or institutes and to review the NIH research portfolio's progress and effectiveness. The newly appointed board members haven’t met yet. They comprise members the HHS secretary selected, including NIH’s institute and center directors, as well as members who aren't U.S. government employees. Members have staggered tenures that run through the next two to five years. NIH Director Monica Bertagnolli shares the lawmakers’ desire to get the board up and running again, the agency said in a statement. | | | | Follow us on Twitter | | | | Follow us | | | | |
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