Artificial intelligence
Will Trump shake up regulatory efforts on health AI?
To be perfectly clear: I've got more questions than answers about what will happen.
Since Donald Trump's last presidency, there's been an explosion of interest in artificial intelligence. In health care it offers great potential to improve the diagnosis and treatment of disease, but there are also risks that algorithmic tools will not perform as intended, discriminate against disadvantaged individuals, or otherwise compromise care. For that reason, experts have urged caution and called for guardrails.
Organized under the Coalition for Health AI, or CHAI, health technology startups and huge names like CVS, Amazon, and Microsoft have taken an active role in ensuring that they help shape industry standards and government regulation of AI in health care. CHAI has already proposed a framework for so-called assurance labs that will certify health AI products.
Getting ahead of regulation made a lot of sense under President Biden, who took a number of early steps on AI policy, including a high-profile executive order directing agencies to be proactive about the technology.
Despite an incoming administration that's certain to favor lighter regulation, industry efforts to self-police will likely continue for a few reasons. First, AI is not going away and neither will the long-term desire to regulate it. And second, providers and tech companies will benefit from standards. Besides all the good health care reasons to ensure that AI models perform well, nobody wants liability if things go wrong.
"CHAI's main effort is a bottom-up self regulatory approach based on building these consensus guidelines" and partnering with the public sector, CHAI CEO Brian Anderson told us. The election doesn't change that mission,"it just changes who those representatives are in the public sector," he said. "It's no different if there's a Republican in the administration, or a Democrat in the administration."
Anderson, who said he worked on Operation Warp Speed under Trump, said he is familiar with the previous Trump administration's health care leaders, but hasn't yet spoken to anyone on the transition team.
Relatedly, it will be interesting to see what will happen to AI oversight at the Department of Health and Human Services. Micky Tripathi, the assistant secretary in charge of technology at the department, will likely be replaced by someone more aligned with the new administration. While in office, he oversaw a reorganization of the department's artificial intelligence efforts and a task force to develop rules for AI uses.
Will any nascent AI policy from the Biden years move forward under the new administration? Not if President-elect Trump picks up the way he ended his last term, when he proposed a rule to exempt from a regulatory review a wide swath of artificial intelligence products meant to help doctors detect serious medical conditions. That rule was later rescinded by the Biden administration.
If you have intel or want to chat about what's happening with health tech policy, reach out to me or my colleagues.
policy
Lame duck telehealth bill and looking ahead
Just before Election Day, regulators reminded everyone that Medicare enrollees will soon lose coverage for telehealth services. During the pandemic, lawmakers drastically expanded what care enrollees could receive over telehealth, and those flexibilities expire at the end of the year. In a news release about the finalized payment rules for 2025, the Centers for Medicare and Medicaid Services spelled out what it was doing to ameliorate the impacts of the expiring flexibilities. But without congressional action, they said, they do not have the authority to just keep paying for a full slate of currently available services, which were used by a quarter of eligible enrollees in 2023.
Bipartisan legislation making its way through the House of Representatives would extend the flexibilities for two years. Observers seem confident the bill will get done, but there's always risk involved in waiting to the last second in a lame duck session of Congress.
"In contrast to so many areas of health care policy, telehealth has been relatively immune to the election," health policy researcher Ateev Mehrotra told us. "There appears to be wide bipartisan support for telehealth. But we are at a precarious position right now with the looming deadline."
Looking ahead to the next few years, Mehrotra told us he's eying a number of telehealth issues. First, and maybe most importantly, will be whether lawmakers can find a way to pay for a permanent expansion of telehealth in Medicare. He's also curious whether there's any appetite for physician licensure reform so that people can get care from specialists out of state over telehealth.
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