,,ii #aaith ,,congress #ast ,session ,s4 #acii ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,april #i1 #bjbe,mr4 ,rounds 7for himself1 ,mr4 ,heinrich1 and ,mrs4 ,blackburn7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xviii of the ,social ,security ,act to ensure appropriate payment of certain algorithm-based healthcare services under the ,medicare program4 #a4 ,short title ,this ,act may be cited as the ,health ,tech ,investment ,act4 #b4 ,ensuring appropriate payment of certain algorithm-based healthcare services under the ,medicare ,program 7a7 ,in general ,section #ahcc7t7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7t77 is amended-- 7#a7 in paragraph 7#b77;,e71 by inserting and new technology ambulatory payment classification of algorithm-based healthcare services under paragraph 7#af77;,h7 after 7#af77;,g72 and 7#b7 in paragraph 7#af71 by adding at the end the following new subparagraph3 7,h7 ,special rule for certain algorithm-based healthcare services 7i7 ,in general ,in the case of a covered ,,opd service furnished on or after ,january #a1 #bjbf1 that is an algorithm-based healthcare service 7as defined in clause 7ii77 that is assigned to a new technology ambulatory payment classification 7as described in the final rule entitled ,medicare ,program2 ,changes to the ,hospital ,outpatient ,prospective ,payment ,system for ,calendar ,year #bjjb published by the ,department of ,health and ,human ,services on ,november #cj1 #bjja 7#ff ,fed4 ,reg4 #eihig77 on or after the date of the enactment of this subparagraph or for which1 as of such date1 is currently and has been assigned to a new technology ambulatory payment classification for a period of less than #e years1 the ,secretary-- 7,i7 shall ensure that such service is assigned to a new technology ambulatory payment classification based on the cost of such service as submitted by the manufacturer of such service in a form and manner specified by the ,secretary1 including costs for the technology based on invoice prices1 subscription-based prices1 clinical staff1 overhead1 and other costs associated with providing the service2 7,,ii7 shall adjust the new technology ambulatory payment classification pursuant to subclause 7,i7 as necessary2 and 7,,iii7 may not remove such service from the new technology ambulatory payment classification as determined under subclauses 7,i7 and 7,,ii7 until the ,secretary determines that adequate claims data exists to reassign such service to another ambulatory payment classification 7which in no case may be before such service has received payment under the assigned new technology ambulatory payment classification for at least #e years74 7ii7 ,adjustment ,the ,secretary shall adjust the application process and criteria for the new technology ambulatory payment classification to ensure that1 in addition to currently eligible algorithm-based healthcare services1 algorithm-based healthcare services that otherwise meet the eligibility requirements for such classification and are distinct from but performed concurrently with1 adjunctive to1 or provided in any other modality or form as part of an underlying service and require additional resources1 meet-- 7,i7 the eligibility requirement that they are distinct new procedures with a beginning1 middle1 and end2 or 7,,ii7 any subsequent similar new technology ambulatory payment classification eligibility requirement4 7iii7 ,definition of algorithm-based healthcare service ,for purposes of this subparagraph1 the term algorithm-based healthcare service means a service delivered through a device cleared or approved by the ,food and ,drug ,administration that uses artificial intelligence1 machine learning1 or other similarly designed software to yield clinical outputs or generate clinical conclusions for use by a physician or practitioner in the screening1 detection1 diagnosis1 or treatment of an individual's condition or disease1 or any such other similar service as the ,secretary determines appropriate in consultation with appropriate organizations4 4 7b7 ,codifying ,,opps payment for software as a service ,effective for services provided on or after ,january #a1 #bjbc1 the ,secretary of ,health and ,human ,services shall apply the hospital outpatient prospective payment system payment for software as a service policy described in the final rule entitled1 ,medicare ,program3 ,hospital ,outpatient ,prospective ,payment and ,ambulatory ,surgical ,center ,payment ,systems and ,quality ,reporting ,programs2 ,organ ,acquisition2 ,rural ,emergency ,hospitals3 ,payment ,policies1 ,conditions of ,participation1 ,provider ,enrollment1 ,physician ,self-,referral2 ,new ,service ,category for ,hospital ,outpatient ,department ,prior ,authorization ,process2 ,overall ,hospital ,quality ,star ,rating2 ,,covid-#ai published by the ,department of ,health and ,human ,services on ,november #bc1 #bjbb 7#hg ,fed4 ,reg4 #gagdh74