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Bill proposes Medicare reimbursement for AI-enabled medical devices

April 13, 2025
in Health
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Bipartisan senators launched the Well being Tech Funding Act (S. 1399), which might set up a Medicare reimbursement pathway for FDA-cleared medical units that make the most of synthetic intelligence and machine studying.

The invoice, launched by Sens. Mike Rounds, R-S.D., and Martin Heinrich, D-N.M., seeks to amend title XVIII of the Social Safety Act to “guarantee acceptable fee of sure algorithm-based healthcare providers underneath the Medicare program.”

Via the invoice, the Secretary of Well being and Human Providers would assign eligible algorithm-based units to a brand new know-how ambulatory fee classification (APC), which will probably be decided primarily based on value information from the service producer.

Such information would come with bill costs, subscription-based charges, overhead prices, medical workers bills and different prices related to offering service.

The invoice says providers should stay within the new know-how APC for a minimum of 5 years and can’t be eliminated till information is on the market to reassign them appropriately.

The laws additionally states that, if accepted, the HHS Secretary will regulate the applying course of and the factors for brand spanking new know-how APCs to permit AI-enabled providers with an outlined starting, center and finish.

The providers should even be “distinct from however carried out concurrently with, adjunctive to, or supplied in another modality or kind as a part of an underlying service and require further useful resource.”

THE LARGER TREND

One other proposed laws, H.R.238, targeted on using AI in healthcare, was launched earlier this yr within the U.S. Home of Representatives. It might enable AI and machine studying know-how to prescribe medicine accepted by the FDA autonomously.

The invoice seeks to amend the Federal Meals, Drug, and Beauty Act (FFDCA) to “make clear that synthetic intelligence and machine studying applied sciences can qualify as a practitioner eligible, to prescribe medicine if approved by the State concerned and accepted, cleared or approved by the Meals and Drug Administration and for different functions.”

If accepted, part 503(b) of FFDCA can be amended to acknowledge AI as a “practitioner licensed by regulation to manage such medicine.”



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Tags: AIenabledbilldevicesMedicalMedicareProposesReimbursement
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