With Megan R. Wilson

AI IN PRACTICE — Conversation about artificial intelligence can often seem abstract and futuristic as Congress and policymakers examine potential regulation, but the technology has already been put to use in unseen and unregulated ways in health care.

By giving medical advice, AI can effectively be used to act as a co-pilot for doctors in several areas, our Daniel Payne and Ruth Reader write as part of a larger POLITICO article on how AI is affecting Americans.

Here are some top ways AI is being put into practice in health care:

Medical imaging: AI has been used substantially in radiology. The technology helps clinicians decipher medical images like X-rays — and some systems work on par with humans, according to recent studies. The algorithms also measure and improve radiologists’ performance.

Cancer: Some providers use AI to help determine a cancer’s progression. UCLA Medical Center oncologist Wayne Brisbane uses it for his patients who have prostate cancer.

“Prostate cancer is a tricky disease,” he said, explaining that the tumors grow in multiple locations and extend in ways that might not get picked up on imaging. AI makes surgical planning a lot easier, he added.

Notes: AI systems help doctors make better sense of their notes. Many health tech companies target “low-risk, high-reward projects” that can summarize information and act more like a secretary than a co-pilot.

Billing and coverage decisions: AI deals with paperwork that leads to the $4 trillion in medical bills Americans receive each year. Firms are toying with technology that can change how bills are generated and processed.

Plenty of money is at stake because AI can scrutinize bills more quickly than humans, leading to potential labor and time savings.

Technology advocates say it means patients will face shorter processing times on claims, making care more accessible. But skeptics worry AI could reduce transparency and accountability in decisionmaking across providers and insurers alike. And major insurers face lawsuits accusing them of using technology to systematically deny care.

Meanwhile, the FDA has taken an experimental approach to regulating AI in medical devices, mostly issuing strategic plans and policy guidance. The biggest challenge is that AI evolves over time, and companies don’t want to re-apply for FDA clearance to market their technology.

HHS has also taken a crack at regulation, with a rule finalized in December that would require more transparency in AI in clinical settings.

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WE’RE HEARING THERE ARE LOTS OF HEARINGS — Get ready for a busy week in health care hearings on the Hill, although not much legislation is expected to move.

Here’s a rundown of what to watch:

Artificial intelligence: The Senate Finance Committee will meet Thursday for a hearing on AI’s “promise and pitfalls” in health care. Witnesses include professors and representatives from tech groups and companies. It comes after the House Energy and Commerce Committee held a similar hearing in November and as Congress’ interest in the technology is rising.

Pharma execs: Major pharmaceutical executives are set to testify Thursday before Sen. Bernie Sanders’ (I-Vt.) Health, Education, Labor and Pensions Committee to discuss drug prices. The CEOs of Johnson & Johnson and Merck relented in their resistance to testify after Sanders threatened a subpoena vote. The CEO of Bristol Myers Squibb had said he’d testify if another executive appeared.

FDA oversight: The House Energy and Commerce Committee is slated to meet Tuesday for a hearing on “shortcomings” in the agency’s foreign drug inspection program. Republican committee staffers write that the U.S. relies too much on foreign manufacturers that frequently violate FDA safety rules.

Drug shortages: The House Ways and Means Committee will meet Tuesday to tackle drug shortages. The hearing comes after the Senate Finance and House Energy and Commerce committees have eyed action on the issue.

PBMs: The House Oversight Committee marks marking up legislation Tuesday to rein in pharmacy benefit managers. It comes amid a broader bipartisan push to take on PBMs, which negotiate drug discounts with drugmakers and design prescription drug benefits for health plans.

QALY BILL HITS HOUSE RULES — A bill that would ban the use of a metric that some see as discriminatory is slated for consideration by the House Rules Committee today.

The legislation from Rep. Cathy McMorris Rodgers (R-Wash.), chair of the House Energy and Commerce Committee, would ban the use of quality-adjusted life years, or QALYs, in federal programs. The metric assesses a drug’s impact on health outcomes and quality of life. Proponents of such a ban argue that the statistic discriminates against people with disabilities by discounting how much treatments can help them.

The hearing is a procedural hurdle before a vote scheduled on the bill on the House floor later this week. The legislation advanced out of committee in March, but no Democrats voted for it.

Rep. Frank Pallone (D-N.J.), E&C’s ranking member, has expressed concern that the legislation would interfere with Medicare drug pricing negotiations by barring other cost-effectiveness measures. But some Democrats, like Anna Eshoo (D-Calif.), ranking member of the E&C health subcommittee, have previously signaled possible support for the bill and said a deal was in sight.

BORDER DEAL TACKLES FENTANYL — Senators unveiled an anticipated $118 billion border deal Sunday that has many provisions aimed at stopping fentanyl trafficking.

The deal includes legislation that allows sanctions on fentanyl cartels and beefs up law enforcement spending, including for the Drug Enforcement Administration.

It’s unclear whether the legislation has the votes to pass the Senate ahead of a procedural vote planned for Wednesday. But House Speaker Mike Johnson said Sunday the bill would be “dead on arrival” if it passes the Senate.

PENALTIES FOR TB OUTBREAKS? Rep. Debbie Dingell (D-Mich.), Sen. Gary Peters (D-Mich.) and other Michigan Democrats are rolling out legislation aiming to prevent future tuberculosis outbreaks from cell and tissue donations.

The bill would call on HHS to undergo research and education campaigns and allow the federal government to enact civil penalties for providers who cause an outbreak of a disease like TB.

The effort comes after 36 people last year underwent surgeries with tuberculosis-contaminated bone grafts before public health officials could intervene. Five patients contracted TB, and two of them died.

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CENTENE BETS ON BIDEN — Top Centene executives, including CEO Sarah London and President Kenneth Fasola, have collectively given more to President Joe Biden’s 2024 campaign than any other executives at a health care company, Megan reports.

The donations from nine Centene execs to the Biden Victory Fund — a joint fundraising committee he shares with the Democratic National Committee and state Democratic party committees — total more than $41,000, according to newly released year-end reports filed to the Federal Election Commission. The checks are all dated the first few days in October.

Centene, a publicly traded insurance company, offers a slew of government-subsidized plans including options for Medicare, Medicaid, TRICARE and the Affordable Care Act marketplace.

The company did not respond to a request for comment.

London, named CEO in 2022, gave $7,900 to the Biden Victory Fund — which sent the maximum amount allowed to Biden’s campaign —and $1,300 to the DNC. Fasola contributed $5,000.

Chief Financial Officer Andrew Asher; Chris Koster, secretary and general counsel; David Thomas, CEO of Markets & Medicaid; Chief Health Officer Alice Chen; and Chief People Officer Tanya McNally each gave $5,000.

Shannon Susko, chief communications officer, contributed $3,000, and Jaclyn Pettinari, senior vice president of Enterprise Transformation, gave $2,000.

Vernessa Pollard is now a partner and co-chair of DLA Piper’s FDA Practice. She previously has been a partner and FDA practice leader at McDermott Will & Emery.

Dr. Marketa Wills has been named the next CEO and medical director of the American Psychiatric Association. She’s currently chief medical officer of Johns Hopkins Health Plans and will assume the role in June.

Dr. P.K. Morrow has been named head of oncology at Takeda. She was previously chief medical officer at CRISPR Therapeutics.

The top five takeaways from POLITICO Pro’s briefing on state health issues to watch this year.

STAT reports on researchers and consumer advocates pushing the FDA to move more expeditiously to ensure pulse oximeters are accurate for all patients.

The Wall Street Journal reports on U.S. manufacturers of masks and gloves struggling to compete with foreign suppliers.