Texas Attorney General Settles Health AI Probe
The Texas Attorney General has recently reached a settlement with a Dallas-based health AI company called Pieces. The company was accused of misleading claims regarding the accuracy and safety of its generative AI technology, which is designed to provide summaries of patients’ conditions and treatment plans to clinicians. After an investigation, the AG found that Pieces’ metrics for accuracy and its claims of a low hallucination rate were inaccurate. This settlement highlights the importance of transparency and accountability in the health tech industry, especially when it comes to AI applications in healthcare.
Can AI Combat Health Care Fraud?
A study published in NEJM Catalyst suggests that utilizing AI to screen medical claims for fraud, waste, and abuse could significantly reduce erroneous charges. The analysis, conducted by employees of health analytics company Health at Scale, personalized health tech platform Personify Health, and researchers from MIT and the University of Michigan, revealed that AI screening flagged nearly $12 million in inappropriate claims before they were paid. This amounted to approximately 1.2% of total spending across almost 300,000 claims. The technology employed by Health at Scale not only identified potential fraud but also emphasized the importance of aligning medical services with established guidelines and standards of care to ensure patient safety and quality of care.
Novartis Partners with AI Firm for Drug Development
Generate:Biomedicines, a company utilizing AI to develop new medicines, has entered into a partnership with Novartis to identify targets for various disease areas. This collaboration includes milestone payments totaling up to $1 billion, in addition to royalties. Generate received an upfront payment of $65 million from Novartis, which also included an equity stake in the company. This partnership showcases the growing trend of pharmaceutical companies leveraging AI technologies to enhance drug discovery and development processes.
HHS Investigates Remote Patient Monitoring
The Health and Human Services Department’s Office of the Inspector General recently released a report highlighting potential risks of fraud and abuse in remote patient monitoring (RPM) services. The report focused on the increasing utilization of devices such as digital blood pressure cuffs and continuous glucose monitors for remote patient care. Medicare spending on RPM services surpassed $311 million in 2022, indicating a significant shift towards virtual care. However, concerns were raised about potential misuse of these tools, leading to overutilization and increased costs. The report calls for enhanced oversight to ensure the appropriate use of RPM services and devices, especially within Medicare.
Legislation on Telehealth Prescription of Controlled Substances
As the expiration of pandemic-era flexibilities for telehealth services approaches, members of Congress are working on a new bill to extend the prescription of controlled substances via telehealth through 2026. This bill, crafted by Sen. Mark Warner and Rep. Doris Matsui, aims to address concerns about the potential limitations on telehealth prescribing practices. The Drug Enforcement Agency is also considering new rules that could impact the flexibility of prescribing controlled substances via telehealth. The proposed legislation seeks to ensure continued access to essential healthcare services while maintaining regulatory oversight.
FDA Appoints New Device Safety Head with Industry Background
The FDA recently appointed Ross Segan to lead its medical device safety office, replacing William Maisel. Segan previously served as the chief medical officer at endoscope company Olympus, which faced FDA warning letters regarding product defects and patient safety concerns. The appointment of Segan raises questions about the FDA’s approach to regulating medical devices and ensuring patient safety. The agency must balance industry experience with a commitment to upholding regulatory standards to protect public health.
Particle Health Challenges Epic Systems in Lawsuit
Particle Health, a health data startup, has filed a federal lawsuit against Epic Systems, alleging monopolistic practices in the electronic health record (EHR) software market. The lawsuit accuses Epic of using its dominance to undermine competition and restrict access to health data. Epic refutes the allegations, citing concerns about patient data privacy and security. This legal battle sheds light on the complex dynamics of the health tech industry and the challenges faced by smaller companies in navigating a market dominated by established players like Epic Systems.
In Conclusion
The evolving landscape of health technology and AI applications in healthcare presents both opportunities and challenges. While AI holds immense potential to improve patient care, enhance efficiency, and combat fraud, its implementation must be accompanied by robust oversight and accountability measures. Collaborations between AI firms and pharmaceutical companies, regulatory developments in telehealth, and legal disputes within the industry underscore the importance of transparency, ethical practices, and patient safety in the rapidly advancing field of health tech. As stakeholders navigate the complexities of this ever-changing landscape, maintaining a focus on innovation, patient-centric care, and regulatory compliance will be crucial in shaping the future of healthcare delivery.
