{"id":376,"date":"2024-09-24T18:41:00","date_gmt":"2024-09-24T18:41:00","guid":{"rendered":"https:\/\/explak.com\/can-ai-reduce-health-care-fraud-ai-firm-in-texas-ags-crosshairs-and-more\/"},"modified":"2024-09-24T18:41:00","modified_gmt":"2024-09-24T18:41:00","slug":"can-ai-reduce-health-care-fraud-ai-firm-in-texas-ags-crosshairs-and-more","status":"publish","type":"post","link":"https:\/\/yasobe.com\/?p=376","title":{"rendered":"Can AI reduce health care fraud, AI firm in Texas AG&#8217;s crosshairs, and more"},"content":{"rendered":"<p><\/p>\n<div id=\"\">\n<p><em>You are reading the web edition of STAT&#8217;s Health Tech magazine, our guide to how technology is changing the life sciences. Sign up to receive it in your inbox every Tuesday and Thursday.<\/em><\/p>\n<h2>Texas AG decides to investigate AI health<\/h2>\n<p>In other legal matters, the Texas Attorney General has reached a settlement with a Dallas health AI company that the state accused of making false claims about the accuracy and safety of its products before sending them to Texas hospitals. . Company, called <span style=\"font-weight: bold;\">Pieces<\/span><span style=\"font-weight: normal;\">sells AI-powered technology it says provides an overview of patient conditions and treatment to nurses. The AG concluded that Pieces&#8217; metrics for accuracy, and its complaints about the relatively low rate of sightings, were themselves inaccurate. Read more. <\/span><\/p>\n<h2>Can AI reduce theft, waste and abuse?<\/h2>\n<p>Education about<span style=\"font-weight: bold;\"> NEJM Catalyst <\/span>suggests that <span style=\"font-weight: normal;\">using AI to screen medical claims for fraud, waste and abuse can reduce false claims. In a review led by several employees of a health analytics company <span style=\"font-weight: bold;\">Health at Scale<\/span> and a health technology platform <span style=\"font-weight: bold;\">Personalize Health <\/span>and go <span style=\"font-weight: bold;\">Massachusetts Institute of Technology <\/span>and goes <span style=\"font-weight: bold;\">University of Michigan<\/span>, <\/span><span style=\"font-weight: normal;\">The authors report that the AI \u200b\u200banalysis identified about $12 million in inappropriate claims before they were paid, about 1.2% of the total use of about 300,000 claims. The technology, marketed by Health at Scale, requested medical records for patients whose claims were flagged to ensure that &#8220;<\/span><span style=\"font-weight: normal;\">to coordinate medical services and measures related to the guidelines and standards of medical care.&#8221; Read more.<br \/><\/span><\/p>\n<div>\n<h2>Novartis is involved in AI drug development with Generate:Biomedicines<\/h2>\n<p><span style=\"font-weight: bold;\">Pioneering Flagship<\/span>&#8216;s <span style=\"font-weight: bold;\">Produce: Biomedicines<\/span><span style=\"font-weight: normal;\">which uses AI to develop new medicines, has revealed a partnership with <span style=\"font-weight: bold;\">Novartis <\/span><\/span><span style=\"font-weight: normal;\">comes with provisions for different disease areas, Brittany Trang reports. The deal comes with significant payments, giving the company about $1 billion in cash including royalties. Produce receives 65 million dollars from Novartis, including $ 15 million for some equity &#8211; undisclosed amount &#8211; in the company. Read more about the agreement here.<\/span><\/p>\n<\/div>\n<h2 style=\"font-size: 24px;\"><strong><span style=\"color: #000000;\">HHS watchdog examines remote patient monitoring <\/span><\/strong><\/h2>\n<p>Virtual care advocates and skeptics have long debated whether telehealth and remote care create new risks of fraud and abuse. Now, it&#8217;s new <span style=\"font-weight: bold;\">Department of Health and Human Services <\/span>The watchdog report suggests remote patient monitoring and fees for those services \u2014 think devices like digital blood pressure cuffs that doctors can use to monitor patients remotely \u2014 are ripe for of abuse, my colleague Katie Palmer reports.<\/p>\n<p>HHS&#8217; <span style=\"font-weight: bold;\">Office of the Inspector General<\/span><span style=\"font-weight: normal;\">The report calls for more attention to remote patient monitoring with devices such as connected scales and continuous glucose monitors, at least within <span style=\"font-weight: bold;\">Medicare. <\/span><span style=\"font-weight: normal;\">The report is also full of data on the use of RPM: The number of Medicare patients receiving remote patient monitoring services has increased from 55,000 to 570,000 between 2019 and 2022; <span style=\"font-weight: bold;\">Medicare benefits<\/span> patients increased 14 times during that period. Total Medicare spending on RPM services has increased to $311 million by 2022. <\/span><\/span><\/p>\n<p><span style=\"font-weight: normal;\"><span style=\"font-weight: normal;\">Where can the abuse be? Providers can even overuse these tools and services and drive up costs, the analysis suggests. <\/span><\/span><\/p>\n<p>&#8220;Provider recommendations are sometimes inconsistent with the true value to patients and society at large,&#8221; <span style=\"font-weight: bold;\">Harvard Business School <\/span>medical student <span style=\"font-weight: bold;\">Mitchell Tang<\/span>who studied RPM at Medicare, told Katie. <span style=\"font-weight: normal;\">Read more about the OIG&#8217;s findings.<\/span><\/p>\n<h2>New bill on telehealth prescription of stimulants<\/h2>\n<p>Also in terms of virtual care, some members of Congress are running to ensure that the ability of nurses to provide controlled devices via telehealth is not obsolete: My colleagues Lev Facher and Mario Aguilar report on especially the new bill written by longtime advocates Sen. <span style=\"font-weight: bold;\">Mark Warner <\/span>(D-Va.) and Rep. <span style=\"font-weight: bold;\">Doris Matsui<\/span>(D-Calif.) to extend the pandemic status until 2026. That bill is being written as <span style=\"font-weight: bold;\">Center for Drug Enforcement <\/span>puts together new rules that can reverse those conditions. &#8220;I am very concerned about the future of the changing landscape for health services regarding the teleprescription of controlled substances,&#8221; Warner said in a statement to STAT. Read more at Lev &#038; Mario.<\/p>\n<div>\n<h2>Past challenges of the FDA protection industry<\/h2>\n<p>My colleague Lizzy Lawrence has a unique report about <span style=\"font-weight: bold;\">Food and Drug Administration<\/span>choice to lead its medical device safety office: <span style=\"font-weight: bold;\">Ross Segan <\/span><span style=\"font-weight: normal;\">it was <\/span><span style=\"font-weight: normal;\">who was formerly the chief medical officer at <span style=\"font-weight: normal;\">endoscope company <span style=\"font-weight: bold;\">Olympus<\/span><span style=\"font-weight: normal;\">which it itself accepted <\/span><\/span><\/span>FDA warning letters stating that they do not address product defects (including, most disturbingly, caps that fell off patients&#8217; bodies.)<\/p>\n<\/div>\n<p>&#8220;Olympus&#8217; continued failure to meet FDA requirements demonstrates a complete disregard for patient safety,&#8221; <span style=\"font-weight: bold;\">Jeffrey Shuren<\/span>head of the FDA&#8217;s medical device agency, he said at the time. Segan takes over <span style=\"font-weight: bold;\">William Maisel<\/span><span style=\"font-weight: normal;\">who came down as <\/span>director of assessment and quality at <span style=\"font-weight: bold;\">Center for Radiological Resources and Health<\/span> in February after 14 years at the FDA. Read more about Lizzy.<\/p>\n<h2>Particle Health is suing Epic over privacy practices<\/h2>\n<p>The medical records giant <span style=\"font-weight: bold;\">Epic Systems&#8217;<\/span> market dominance has long been an open secret within the world of health technology. But now a small health news publication is taking the unusual step of suing Epic, accusing it of private practices and using its power to undermine the competition.<\/p>\n<p>In a federal lawsuit filed this week in the Southern District of New York, <span style=\"font-weight: bold;\">Part Health<\/span><span style=\"font-weight: normal;\">    called Epic a <\/span>&#8220;Behemoth&#8221; and &#8220;monopolist in the EHR software market,&#8221; Casey Ross reports. Epic, for its part, called the allegations &#8220;baseless&#8221; and accused Particle of disclosing patient information on the health information exchange, which led to a dispute between Particle and Epic earlier this year. Read more about Casey&#8217;s suit, and submit your comments and stories.<\/p>\n<h2>What we read<\/h2>\n<ul>\n<li>Amazon cuts ties with fertility company, STAT<\/li>\n<li>Q&#038;A with Bristol Myers Squibb&#8217;s chief digital and technology officer, Endpoints<\/li>\n<li>Ginkgo Bioworks is betting on an AI protein model to turn around a struggling company, STAT <\/li>\n<\/ul>\n<\/div>\n<p><script>\n\t\t\t\twindow.statGlobal = window.statGlobal || { };\n\t\t\t\twindow.statGlobal.analytics = window.statGlobal.analytics || { };<\/p>\n<p>\t\t\t\twindow.statGlobal.analytics.fbq = function( eventName, parameters ) {\n\t\t\t\t\tjQuery.ajax( {\n\t\t\t\t\t\turl: '\/wp-json\/stat-analytics\/v1\/facebook-pixel',\n\t\t\t\t\t\ttype: 'POST',\n\t\t\t\t\t\tdata: {\n\t\t\t\t\t\t\tevent_name: !eventName ? null : eventName,\n\t\t\t\t\t\t\tparameters: !parameters ? {} : parameters,\n\t\t\t\t\t\t\tsource_url: window.location.href\n\t\t\t\t\t\t},\n\t\t\t\t\t\tsuccess: function( data, textStatus, jqXHR ) {\n\t\t\t\t\t\t\t\/\/console.log( data );\n\t\t\t\t\t\t},\n\t\t\t\t\t\terror: function ( jqXHR, textStatus, errorThrown ) {\n\t\t\t\t\t\t\t\/\/console.log( jqXHR );\n\t\t\t\t\t\t}\n\t\t\t\t\t} );\n\t\t\t\t};<\/p>\n<p>\t\t\t\tjQuery( window ).on( 'load', function() {\n\t\t\t\t\tif ( !window.bgmpGdpr || window.bgmpGdpr.isOptedOut() ) {\n\t\t\t\t\t\treturn;\n\t\t\t\t\t}<\/p>\n<p>\t\t\t\t\t!function(f,b,e,v,n,t,s){if(f.fbq)return;n=f.fbq=function(){n.callMethod?\n\t\t\t\t\tn.callMethod.apply(n,arguments):n.queue.push(arguments)};if(!f._fbq)f._fbq=n;\n\t\t\t\t\tn.push=n;n.loaded=!0;n.version='2.0';n.queue=[];t=b.createElement(e);t.async=!0;\n\t\t\t\t\tt.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window,\n\t\t\t\t\tdocument,'script','https:\/\/connect.facebook.net\/en_US\/fbevents.js');<\/p>\n<p>\t\t\t\t\tfbq( 'init', '436331036555416' );\n\t\t\t\t\tfbq( 'track', 'PageView' );<\/p>\n<p>\t\t\t\t\tdocument.addEventListener( 'stat-hubspot-signup-subscribed', () => {\n\t\t\t\t\t\t\/\/ Successful HubSpot newsletter signup AJAX form submission.\n\t\t\t\t\t\twindow.statGlobal.analytics.fbq( 'Lead' );\n\t\t\t\t\t} );\n\t\t\t\t\t\t\t} );\n\t\t\t<\/script>  <br \/>#reduce #health #care #fraud #firm #Texas #AGs #crosshairs<\/p>\n","protected":false},"excerpt":{"rendered":"<p>You are reading the web edition of STAT&#8217;s Health Tech magazine, our guide to how technology is changing the life 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