Healthcare (Telehealth)

HR 7064, the AI in Health Care Efficiency and Study Act, requires the U.S. Department of Health and Human Services (HHS) to study how artificial intelligence can streamline administrative tasks in healthcare while protecting patient privacy. The study will examine AI applications for scheduling, claims processing, electronic health records, and cybersecurity threats like ransomware, involving healthcare providers, health plans, AI developers, and privacy experts. HHS must report findings and recommendations to Congress within 6 months of completing the study, focusing on reducing provider workload, improving data security, and ensuring compliance with health privacy laws. This bill does not create new regulations but directs a federal study to inform future policy on AI in healthcare administration.

This bill requires Medicare to cover "prescription digital therapeutics" (software-based treatments for medical conditions, like apps for diabetes management or mental health) starting January 1, 2026. It mandates Medicare to establish payment rules for manufacturers - considering actual costs and usage - and create specific billing codes for these tools. Manufacturers must annually report pricing, distribution volume, and user data to Medicare, with penalties for noncompliance. The bill directly affects Medicare beneficiaries, digital therapeutic developers, and healthcare providers who prescribe these digital health tools.

This bill amends IRS rules to require health insurance plans to cover telehealth services without applying deductibles, preventing plans from being disqualified as high-deductible health plans (HDHPs) solely because they waive deductibles for telehealth. It directly affects health insurance plans and employers offering HDHPs by changing how telehealth services are treated under IRS regulations. Key provisions include creating a specific exemption for telehealth services in the Internal Revenue Code and clarifying that such coverage does not disqualify plans from HDHP status. The changes take effect for plan years starting after December 31, 2024.