Lawmakers expressed concern about the implications of artificial intelligence for the healthcare system—and made clear that they aren't sure what to do about them—during a congressional hearing Wednesday.
A House Energy and Commerce Committee subcommittee heard testimony from business, healthcare and academic experts at the session, which focused on issues such as safety, insurance coverage, legal matters, privacy and racial and ethic biases. The hearing occurred amid growing calls for federal regulation from organizations such as the American Medical Association and controversy about how insurers such as Cigna and UnitedHealth Group use AI.
Read more: Are insurers using tech to automate claims denials?
Subcommittee members indicated that emerging AI technology and its healthcare applications demand scrutiny, but were not prepared to outline what Congress should do.
“In terms of AI, what they're talking about, where it goes—I'm just scratching the surface,” Health Subcommittee Chair Brett Guthrie (R-Ky.) told reporters after the hearing.
Health Subcommittee ranking member Anna Eshoo (D-Calif.) acknowledged to one witness that she had more to learn. “There were different parts of your testimony where I really didn't understand what you were talking about,” she said.
Following the hearing, Rep. Robin Kelly (D-Ill.) said swift action is unlikely. “We can always pass legislation,” she said. “But I think we we need to really educate ourselves as much as we can before we jump in and make any decisions. We need to be careful."
Despite this uncertainty, subcommittee members seemed to coalesce around the notion of making policy to protect patient privacy.
“This committee has worked on a national data privacy standard,” Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Wash.) said. “That's the first step that Congress should take as we think through the guardrails that are needed in regard to artificial intelligence.”
Health insurance AI
Republicans and Democrats alike expressed alarm over allegations that health insurance companies have tasked AI and other automated systems to review prior authorization requests and medical claims. Cigna and UnitedHealth Group are both fending off lawsuits based on charges they are using these technologies inappropriately.
“When healthcare companies driven by efficiency implement AI suggestions without subjecting them to critical scrutiny, I worry that patient safety could be put at risk,” Energy and Commerce Committee ranking member Frank Pallone (N.J.) said. “There’s a lot of work to be done here.”
No lawmaker specified what sort of work, but Guthrie and Rep. Dr. Larry Bucshon (R-Ind.) said Congress should investigate these insurance industry practices. "We need to have a big effort if there is a systematic way of insurance companies just not approving without medical reasons,” Guthrie said.
“Let the insurance providers defend themselves, and talk about what’s actually happening,” said Buchson, a cardiothoracic surgeon. “I was a provider for many years, and I’ve had a long-standing concern about claims being denied inappropriately and limiting care.”
UnitedHealth Group and Cigna have denied the allegations in the lawsuits.
At the hearing, witnesses and lawmakers also explored topics such as federal preemption of state AI regulations, patients' legal rights and how to hold companies accountable when AI fails.
The Senate has been holding closed-door learning sessions on AI, but scant information and no legislation have emerged from those meetings.
Calls for regulation
President Joe Biden issued an executive order on AI last month, but agencies such as the Food and Drug Administration and the Health and Human Services Department Office of the National Coordinator for Health Information Technology are in the early stages of turning that directive into policy.
On Tuesday, the AMA published a new official policy regarding augmented intelligence, a form of AI that requires human involvement. The medical society also is lobbying Congress to take action about AI in health insurance and patient data security and privacy, AMA President Dr. Jesse Ehrenfeld said. “We do think government has a big role to play,” he said.
Healthcare providers frustrated with health insurance companies are not alone in advocating AI regulation. Some digital health companies also have called for government oversight.
