Maintaining Innovation and Safe Technologies ActThis bill requires the Centers for Medicare & Medicaid Services (CMS) to issue guidance on payment requirements for certain remote monitoring devices (e.g., glucose monitors) under Medicare medical services. Specifically, the CMS must issue guidance on payment requirements for devices that use artificial intelligence components and that transmit information to health care providers.
Impact
The implications of HB193 are significant for both patients and healthcare providers. By laying out a framework for Medicare payments related to AI-driven healthcare methodologies, the bill seeks to facilitate the adoption of cutting-edge health technologies that can improve patient outcomes. This measure acknowledges the crucial role AI plays in modern healthcare and encourages innovation by ensuring that these technologies are integrated into the Medicare reimbursement landscape. Thus, it could lead to enhanced healthcare services provided to patients, while also supporting the development of new health technologies.
Summary
House Bill 193, titled the 'Maintaining Innovation and Safe Technologies Act,' mandates the Secretary of Health and Human Services (HHS) to issue guidance regarding Medicare payments for certain healthcare items that incorporate artificial intelligence. The bill aims to address the growing integration of AI technologies in the healthcare sector, particularly those utilized for remote patient monitoring, such as continuous glucose monitors, which are equipped with AI functionalities to optimize treatment and management of patient care. The guidance must be made available by January 1, 2027, to establish clarity on Medicare reimbursement for these innovative technologies.
Contention
Although the bill is primarily focused on encouraging the use of innovative technologies in healthcare, there may be points of contention surrounding how HHS determines the criteria for Medicare reimbursement. Critics could question whether the guidelines issued will be comprehensive enough to ensure equitable access to AI integration across various healthcare settings. Furthermore, the potential for disparities in how different institutions implement AI tools could lead to concerns about varying levels of access and effectiveness of care, fostering a debate on health equity and the preparedness of healthcare systems to adapt to these advancements.
Kids' Access to Primary Care Act of 2025This bill modifies payments for Medicaid primary care services. Specifically, the bill applies a Medicare payment rate floor to Medicaid primary care services that are provided after the date of enactment of the bill and extends the payment rate to additional types of practitioners (e.g., obstetricians).The Centers for Medicare & Medicaid Services must conduct a study on the number of children enrolled in Medicaid, the number of providers receiving payment for primary care services, and associated payment rates before and after the bill's implementation.
Expressing support for the Texas Health and Human Services Commission's application to the Cell and Gene Therapy Access Model through the Centers for Medicare and Medicaid Services and its Center for Medicare and Medicaid Innovation.
Expressing the sense of the House of Representatives that the Centers for Medicare & Medicaid Services should halt the pilot program and should not jeopardize seniors' access to critical health care by utilizing artificial intelligence to determine Medicare coverage.
Requires the executive office of health and human services to increase Medicaid payment rates for primary care services furnished by primary care providers to be commensurate with Medicare rates.
Access to Pediatric Technologies Act of 2025This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish, upon request, specific payment methodologies for qualifying pediatric technologies under the Medicare physician fee schedule. Qualifying pediatric technologies are medical devices that are (1) covered under Medicare, (2) approved by the Food and Drug Administration, (3) currently billed using a specified temporary billing code for emerging technologies, and (4) predominantly used or specifically designated for pediatric patients.The CMS must develop a payment methodology for a qualifying pediatric technology upon request from the manufacturer and based on available data, including pricing information and claims data. Manufacturers must include relevant information in their requests to enable the CMS to develop the corresponding methodologies.
Preventing Medicare Telefraud ActThis bill establishes conditions for payment of certain telehealth services, laboratory tests, and durable medical equipment under Medicare.Specifically, the bill conditions payment for certain high-cost laboratory tests and durable medical equipment that are ordered via telehealth on at least one in-person visit during the preceding six-month period. Additionally, practitioners must submit claims for separately billable telehealth services under the practitioner's unique national provider identification number.
Directs the department of health to request guidance from the Centers for Medicare and Medicaid Services to determine whether the state can claim federal financial participation for coverage of and payment for certain evidence-based mobile medical applications.