In late October, the Biden Administration unveiled an executive order aimed at prioritizing the responsible use of artificial intelligence (AI), focusing on safety, security, privacy, equity, and innovation across various sectors. Under the authority of the Defense Production Act, the executive order mandates that AI developers disclose safety test outcomes and relevant data to the government. Simultaneously, the National Institute of Standards and Technology will be tasked with establishing criteria to guarantee the safety and security of AI tools before they are made available to the public. Additionally, the Department of Commerce will be responsible for releasing directives aimed at marking and distinguishing AI-generated content through labeling and watermarking. This multifaceted order covers a wide array of additional concerns related to privacy, civil rights, consumer safeguards, scientific research, and labor rights.
Within the healthcare realm, the order aims to ensure the safe and effective use of AI in healthcare, targeting the development of affordable and life-saving drugs. To that end, the Department of Health and Human Services (HHS) is directed to establish a strategy for regulating the use of AI and AI-enabled tools in drug development processes. HHS is also directed to prioritize grantmaking that favors responsible AI development, as well as collaborate with the Secretary of Defense and Veterans Affairs to create a strategic plan on the responsible deployment of AI and AI-enabled technologies. The intersection of AI with telehealth is currently most evident in how AI can impact medical diagnosis, treatment, and patient care that happens to be delivered through a telehealth modality.
LEARN MORE – AMERICAN TELEMEDICINE ASSOCIATION (ATA) ARTIFICIAL INTELLIGENCE PRINCIPLES
On November 1, 2023, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2024 Home Health Prospective Payment System (HH PPS) Rate Update final rule, which updates Medicare payment policies and rates for Home Health Agencies (HHAs). This rule includes routine updates to the Medicare Home Health PPS payment rates for CY 2024 in accordance with existing statutory and regulatory requirements. As described further below, CMS estimates that Medicare payments to HHAs in CY 2024 will increase in the aggregate by 0.8 percent, or $140 million, compared to CY 2023.
On October 27, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates payment rates and policies under the end-stage renal disease (ESRD) prospective payment system (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2024. This rule also updates the acute kidney injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities for calendar year (CY) 2024. In addition, the rule updates requirements for the ESRD Quality Incentive Program (QIP).
On October 30, 2023, President Biden issued a landmark Executive Order to ensure that America leads the way in seizing the promise and managing the risks of artificial intelligence (AI). The Executive Order establishes new standards for AI safety and security, protects Americans’ privacy, advances equity and civil rights, stands up for consumers and workers, promotes innovation and competition, advances American leadership around the world, and more.
Beginning Jan. 1, 2024, the presence of prior pharmacy claims for insulin alone will no longer qualify Blue Cross Blue Shield of Michigan commercial and Blue Care Network commercial members for coverage of the medications in the table listed below. We’ll require a prior authorization to confirm that the medications listed below are being used for Type 2 diabetes for members who don’t have a supporting prescription or medical record with a diabetes diagnosis.
The full-coverage requirements are listed in the table below.
| Brand-name medication | FDA-approved indication | Coverage requirements starting Jan. 1 | |
| Bydureon® Byetta® Mounjaro® Ozempic® |
Rybelsus® Trulicity® Victoza® |
Type 2 diabetes | Coverage without prior authorization will require diagnosis of Type 2 diabetes verified by one of the following:
If either coverage criteria outlined above isn’t fulfilled, you must submit a prior authorization to confirm that your patient has a diagnosis of Type 2 diabetes for coverage. |
**Effective Jan. 1, 2024, previous trial of only insulin will no longer qualify members for coverage without prior authorization if they don’t have a medical diagnosis of Type 2 diabetes.
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