Members of Congress propose faster Medicare payment pathway for imaging AI
Bipartisan members of Congress on Thursday proposed establishing a new Medicare payment pathway for artificial intelligence, drawing praise from the imaging industry.
Sens. Mike Rounds, R-S.D., and Martin Heinrich, D-N.M., note that AI is quickly becoming the standard of care. The U.S. Food and Drug Administration has cleared nearly 1,000 AI-enabled devices, but Medicare lacks a standard, consistent method for covering these products.
They’re proposing the Health Tech Investment Act to fix this problem and get seniors faster access to AI.
“There is currently no clear Medicare payment system for these devices, meaning that it can take years to be approved and paid out by Medicare accurately,” Rounds, who is co-chair of the Senate Artificial Intelligence Caucus with Heinrich, said in a statement April 10. “This legislation would create that system, improving diagnoses and encouraging the adoption of AI devices in clinical settings.”
The Health Tech Investment Act will assign all FDA-approved AI devices to a New Technology Ambulatory Payment Classification. This would fall under the Hospital Outpatient Prospective Payment System (OPPS) for a minimum of five years so that adequate data could be acquired prior to assigning a permanent payment code.
The bill on Thursday drew praise from AdvaMed—an imaging industry lobbying group representing 50 radiology vendors including Annalise.ai, Onc.AI, Siemens Healthineers, Canon and Philips. Leaders hailed the “landmark” legislation, noting AI’s increasing role in radiology. Members of the specialty already are using the technology to analyze medical images, detect illnesses and make more informed diagnoses, but they often are not getting paid for this work.
“Sen. Rounds and Sen. Heinrich have shown their deep knowledge of how AI is used in healthcare, and we greatly appreciate their leadership,” Peter J. Arduini, president and CEO of GE HealthCare and chair of AdvaMed’s Board of Directors, said in a statement. “We look forward to working with members of Congress to pass this important legislation and help bring these latest technologies to patients,” he added later.
Senate Bill 1399 also is supported by the National Health Council, a patient advocacy group, which also echoed concerns that the current landscape is preventing patients’ access to new devices. Other supporters include the Alliance for Aging Research, Brem Foundation to Defeat Breast Cancer, Focused Ultrasound Foundation, National Psoriasis Foundation, Patients Rising, and Right Scan Right Time.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.