Category: AI Research

Beginning in January, UnitedHealthcare will no longer pay physicians to remotely monitor the data that patients collect at home about chronic conditions like hypertension. The updated medical policies for both Medicare and commercial health plans from the country’s largest insurer were posted in September and apply to most of the remote physiologic monitoring (RPM) of patient conditions using devices like blood pressure cuffs and scales. The policy states that RPM “is not reasonable and necessary due to insufficient evidence of efficacy” for a wide swath of conditions including high blood pressure, chronic obstructive pulmonary disease, depression, diabetes, and more. By exception, UnitedHealthcare said it will pay physicians to monitor heart failure as well as hypertensive disorders during pregnancy. UnitedHealthcare’s decision to scale back coverage of remote monitoring services will affect millions of its members and comes after the insurer faced intense criticism for allegedly denying to pay for medically necessary care for its Medicare Advantage beneficiaries. UnitedHealth Group, the insurer’s parent company, is also in the midst of a financial turnaround.Continue to STAT+ to read the full story…

Source: https://www.statnews.com/2025/11/07/united-healthcare-remote-patient-monitoring-medicare-advantage/?utm_campaign=rss

The Centers for Medicare and Medicaid Services has selected the six technology companies that will administer artificial intelligence-powered prior authorization programs for Medicare, STAT has learned.  The pilot, called the Wasteful and Inappropriate Services Reduction (WISeR) model, is a CMS effort to reduce waste and abuse within the taxpayer-funded health insurance program that spent more than $1 trillion in 2024. The new prior authorization program will launch in January and run until 2031 in New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington.  CMS’ decision to test the use of AI technology for prior authorizations comes at a time when large private insurers — including UnitedHealthcare and Humana — are facing class action lawsuits and congressional scrutiny over their use of AI for making decisions about care for Medicare Advantage beneficiaries. There is also congressional pushback against the WISeR program; on Friday, a congressional representative from Washington, one of the states where the program will be implemented, is planning to introduce a bill to prevent the Department of Health and Human Services from implementing WISeR.Continue to STAT+ to read the full story…

Source: https://www.statnews.com/2025/11/06/medicare-wiser-prior-authorization-pilot-tech-vendors/?utm_campaign=rss

You’re reading the web edition of STAT’s Health Tech newsletter, our guide to how technology is transforming the life sciences. Sign up to get it delivered in your inbox every Tuesday and Thursday. What to know about the FDA’s therapy bots meeting The Food and Drug Administration is considering whether and how to regulate therapy chatbots that are based on large language models. Today, the agency’s Digital Health Advisory Committee is meeting to consider the topic. In a new story, I explain what’s going on, including some fresh insider intel. The FDA wants to provide more clarity to developers of generative AI medical devices about what needs regulatory green light and how to get it. The agency is also also worried about LLM-based therapy bots that can provide unpredictable outputs. Regulators are aware about the growing concerns around general purpose bots like ChatGPT, which have been linked to delusions and allegedly to suicides.Continue to STAT+ to read the full story…

Source: https://www.statnews.com/2025/11/06/fda-ai-llm-therapy-chatbot-regulation-health-tech/?utm_campaign=rss

You’re reading the web edition of STAT’s AI Prognosis newsletter, our subscriber-exclusive guide to artificial intelligence in health care and medicine. Sign up to get it delivered in your inbox every Wednesday.  Later this week, I’m headed to the National Association of Science Writers’ conference near Chicago’s O’Hare airport. What are your best recommendations for restaurants (or ice cream) in the northwest suburbs? Restaurant recs, AI story tips, and questions: aiprognosis@statnews.com.Continue to STAT+ to read the full story…

Source: https://www.statnews.com/2025/11/05/testing-large-language-models-danielle-bitterman-ai-prognosis/?utm_campaign=rss

You’re reading the web edition of STAT’s AI Prognosis newsletter, our subscriber-exclusive guide to artificial intelligence in health care and medicine. Sign up to get it delivered in your inbox every Wednesday.  As you’ll see, AI Prognosis looks a little different today because I’ve been busy attending and traveling to/from the National Association of Science Writers’ conference in Chicago. Keep reading for some fun AI-related things I learned there. As always: Email tips, questions, story ideas to aiprognosis@statnews.com, or contact me on Signal at btrang.01 for sensitive story tips. How much water does AI really use? A conference session I attended this weekend addressed the climate and health effects of data centers. What caught my attention was an explanation of why Google says that its AI uses only 0.26 mL of water (or five drops) per prompt, whereas French AI company Mistral says its AI model uses 45 mL.  Shaolei Ren, an electrical and computer engineering professor at the University of California, Riverside, broke down electricity/water usage at data centers into three parts: Continue to STAT+ to read the full story…

Source: https://www.statnews.com/2025/11/12/water-usage-zuckerberg-biohub-microsoft-superintelligence-ai-prognosis/?utm_campaign=rss

The Trump administration appears poised to extend a temporary, Covid-era rule allowing health providers to prescribe certain controlled substances, like ADHD medications and treatments for opioid addiction, via telemedicine.  Under the current rules, providers can initiate prescriptions for drugs like Ritalin or Adderall for ADHD, or buprenorphine for opioid use disorder, without first examining the patient in-person.  The extension would mark the fourth time that the federal government has re-upped the flexibilities, enacted by the Drug Enforcement Administration during March 2020 as the Covid-19 pandemic accelerated, without reaching a permanent decision on how telemedicine prescribing of controlled substances will be regulated.Continue to STAT+ to read the full story…

Source: https://www.statnews.com/2025/11/11/covid-era-rules-for-addiction-medication-ritalin-are-extended-again/?utm_campaign=rss

You’re reading the web edition of STAT’s Health Tech newsletter, our guide to how technology is transforming the life sciences. Sign up to get it delivered in your inbox every Tuesday and Thursday. Congress’ failure to pass a spending bill at the end of September led to the expiration of Covid-era policies that expanded the telehealth services covered by Medicare. An early analysis from investigators at Brown University School of Public Health suggests an immediate impact. The portion of traditional Medicare visits conducted over telehealth dropped by 24% in the first 17 days of October compared to the preceding three months. In Medicare Advantage, it dropped by 13%. Many providers continued offering services as there was — and remains — an expectation they will be retroactively paid.  Overall, telehealth has become a key part of the care for older Americans and other people on Medicare: In 2024, 6.7 million traditional Medicare enrollees, 25% of those eligible, used a telehealth service.Continue to STAT+ to read the full story…

Source: https://www.statnews.com/2025/11/11/federal-government-shutdown-impact-telehealth-usage-health-tech/?utm_campaign=rss

When patients visit Matthew Budoff for a CT angiogram of their heart, the preventive cardiologist may tell them about a new test. It’s not covered by insurance, he explains, but for an extra $850, an artificial intelligence algorithm can quantify and characterize the volume of plaque in their coronary arteries. How much of that plaque is calcified and stable? How much is the more dangerous soft plaque that could rupture and cause a heart attack or stroke?  Budoff is one of a relatively small number of cardiologists and radiologists who offer AI plaque analysis of those coronary CT studies. But next year, the technology is likely to see a significant boost as private insurance companies start to cover the algorithms from AI vendors Heartflow, Cleerly, Elucid, and Caristo, and Medicare sets a national payment rate of just over $1,000.  The technology is coming of age as debate grows over the cost of devices powered by artificial intelligence and machine learning. AI device companies say that their algorithms’ price is justified by the downstream savings when the test results lead to better care and help avoid unnecessary, expensive procedures. But as insurance starts to cover more algorithms, some medical groups and physicians worry AI’s costs could balloon out of proportion with its benefits.Continue to STAT+ to read the full story…

Source: https://www.statnews.com/2025/11/11/medicare-coverage-ai-heart-scans-heartflow-cleerly-elucid/?utm_campaign=rss

You’re reading the web edition of STAT’s Health Tech newsletter, our guide to how technology is transforming the life sciences. Sign up to get it delivered in your inbox every Tuesday and Thursday. A new Pfizer job posting for a digital medicine & PDURS strategy lead offers a glimpse of where the pharma giant may be going with some of its digital health work. The new role would be charged with heading up a PDURS Center of Excellence at Pfizer and “will guide cross-functional teams to design, validate, and launch drug-digital solutions that meet regulatory requirements.” What is PDURS you may reasonably ask? In 2023, the Food and Drug Administration issued draft guidance on Prescription Drug Use-Related Software, which is of particular interest because it offers the agency’s thinking on what drugmakers are supposed to do when they have software, like an app, that when used with a drug offers “meaningful improvement in a clinical outcome” as compared to use of the drug alone. With evidence of this benefit, it could be added to a drug’s label, and that opens the door to new marketing and reimbursement opportunities.Continue to STAT+ to read the full story…

Source: https://www.statnews.com/2025/11/13/pfizer-signals-brewing-digital-health-work-health-tech/?utm_campaign=rss