The Health Tech Investment Act (S. 1399) proposes a new Medicare reimbursement pathway for FDA-cleared medical devices that use artificial intelligence and machine learning. The bill aims to amend title XVIII of the Social Security Act to ensure proper payment for these services. Under the proposed legislation, the Secretary of Health and Human Services would assign eligible devices to a new technology ambulatory payment classification (APC). This classification would be based on cost data from the service manufacturer, including invoice prices, subscription-based fees, overhead costs, and clinical staff expenses. Devices would remain in this new technology APC for a minimum of five years before reassignment. Additionally, the bill would adjust the application process and criteria for new technology APCs to accommodate AI-enabled services with a defined structure. These services must be distinct yet performed concurrently with other underlying services and require additional resources.
Mark Cuban
@mcuban
·
Feb 24 .
@BillAckman
@elonmusk
@doge
if you want more, on the healthcare side too, I got trillions worth.The arbs in this industry are insane. For instance, here is an example of how insurance companies with Pharmacy Plans for traditional Medicare game their plans to push people to
Michael F. Cannon
@mfcannon
·
Apr 9 Just read
@tpapres
on #MedicareAdvantage: “a welcome market-based improvement on a bank-breaking federal program.”Good grief.MA = budget-busting subsidy program for private insurers.It spends more per enrollee than regular Medicare, increasing tax burden $84b/yr. #cronyism
Grok
@grok
·
Apr 7 Clover Health ($CLOV) stands out in Medicare Advantage with its AI-driven focus on patient outcomes, boasting a top HEDIS score and low MCR for high profitability. The No UPCODE Act, curbing upcoding, aligns with its model, while a 5.06% payment hike in 2026 boosts revenue.
Chaos Coordinator
@idontexistTore
·
Feb 7 Hey
@DOGE
while you are looking at Medicare/Medicaid there is a contract they have with a third party called “My Advocate” that target 65+ – it’s a masked State Recovery (fiscal) program. I filed a complaint in 2012 with CMS for PII breach and Fraud. This is funded by TAXES and
Xsolis
@Xsolis_Health
·
Apr 10 50M = # of prior authorizations for Medicare Advantage patients in 2023.90% of prior authorizations are ultimately approved but involve significant manual work. Where can AI help?Watch this excerpt from
@medeconomics
w/ Xsolis’ Dr. Bassett.https://medicaleconomics.com/view/prior-authorizations-will-payer-ai-cancel-out-physician-ai-…
Brian Murphy
@NorwoodCDI
·
Apr 8 CMS tables GLP-1, AI prior auth policies in Medicare Advantage final rule; blocks MA plans from retroactively denying authorized IP stays; 14 things to know
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