policy

How much Pfizer and Lilly paid telehealth companies

As pharma companies continue to build bridges with the telehealth companies that can get their drugs prescribed, a new report reveals that some drugmakers are paying hundreds of thousands, if not millions, for their telehealth contracts.

In the last nine months, four senators have peppered Pfizer, Eli Lilly, and five of their telehealth partners with questions about their contracts, hoping to suss out whether they are inappropriately influencing clinicians’ prescriptions. Their report published today reveals new details about those eyebrow-raising deals, along with some of the telehealth companies’ prescribing behaviors and industry payments outside the contracts.

Read more from Katie Palmer here

CMS doesn’t heed RPM warnings

As I discussed on Tuesday, Medicare regulators this week proposed to cover more remote patient monitoring. If the rules are finalized, doctors will now be able to bill in circumstances in which they collect less data and spend less time interacting with patients.

What Medicare did not do was propose any guardrails to prevent abuse despite a growing chorus of policy experts warning that Medicare may be paying for low-value services. Medicare started covering RPM in 2019, and paid over $300 million for RPM in 2022. There was a feeling on both sides of the debate that Medicare might institute new rules, but it did not.

• AI clinical decision support software has long been considered “software as a service” and lumped under a physician practice’s indirect costs. But this year, Medicare is asking for feedback on whether it should find other ways to pay for AI software, and where it can get data on how much time doctors spend evaluating AI outputs as well as the quality and efficacy of AI tech (page 319).
• As part of the quality incentives program called MIPS (which pays doctors extra if they improve their care), Medicare is proposing a new data collection field for reporting AI-attributable patient safety events and near-misses (page 990, with more details on page 1704). Experts I talked to thought this would have a small impact since this is an optional program. But this might be an improvement over the status quo — there aren’t many places to report AI-related adverse events besides FDA medical device adverse event reports, especially since the Agency for Healthcare Research and Quality’s “Artificial Intelligence in Healthcare Safety” program was shut down earlier this year as part of the dismantling of President Biden’s AI executive order.