Lawmakers recently introduced a new law that directly impacts the ability to bill Medicare for certain healthcare services that make use of artificial intelligence (AI). If passed, the Health Tech Investment Act would change Medicare’s coverage of algorithm-based healthcare services.
Important provisions of the Health Tech Investment Act
As currently proposed, the Health Tech Investment Act aims to update title XVIII of the Social Security Act, allowing for the payment of algorithm-based healthcare services. Main provisions include:
- New technology ambulatory payment classification: The Act mandates that algorithm-based healthcare services be assigned to a new technology ambulatory payment classification. This classification is based on the cost of the service, including technology, clinical staff, and overhead costs.
- Adjustment and eligibility: The law also requires the Secretary of Health and Human Services to adjust the application process to help better ensure services that are distinct, adjunctive, or require additional resources meet eligibility requirements.
- Definition and scope: the proposal defines algorithm-based healthcare services as those delivered through FDA-cleared or approved devices using AI or machine learning to assist in clinical decision-making.
Although we do not know the fate of the proposal, support is building. If passed, the law would allow for further integration of AI services into Medicare.
Reminder to remain compliant with billing practices
Regardless of its fate, the introduction of this Act serves as a reminder for healthcare providers to review their billing practices to check for compliance with applicable federal and local regulations. In addition to regular internal audits to check for compliance and amend any potential issues before they escalate into a violation, it is important for healthcare leaders to familiarize themselves with the possibility of new technology ambulatory payment classification and other changes that could roll out in the future. By regularly reviewing updates hospital systems and private practices can better ensure they are prepared for any potential changes and can take advantage of these innovations to better serve their patients while increasing the efficiency of their practice.
Attorney John Rivas is responsible for this communication.