Expressing the sense of the House of Representatives that the Centers for Medicare & Medicaid Services should halt the pilot program and should not jeopardize seniors' access to critical health care by utilizing artificial intelligence to determine Medicare coverage.
- Bill Number
- H.Res. 694
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-09-10: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2025-09-24T16:25:57Z
AI-Generated Summary
Purpose
This House Resolution (H. Res. 694) expresses the non-binding opinion of the U.S. House of Representatives that the Centers for Medicare & Medicaid Services (CMS) should stop a pilot program using artificial intelligence (AI) to decide Medicare coverage for certain services. The goal is to protect seniors' access to essential health care by avoiding AI-driven decisions that could limit coverage.
Key Provisions
- Sense of the House Statement: The resolution urges CMS not to use AI to evaluate whether patients' medical procedures or services qualify for Medicare coverage.
- Background Reference: It cites CMS's June 27, 2025, announcement of a pilot program contracting with for-profit companies to employ "enhanced technologies" like AI for coverage determinations.
- No Binding Actions: As a resolution, it does not mandate any changes; it only conveys congressional sentiment.
Significant Changes to Existing Law
- None. This is a simple resolution that does not amend laws, create new regulations, or alter Medicare policies. It serves as an advisory expression rather than enforceable legislation.
Potential Impacts
- On Government Agencies: May pressure CMS to pause or modify the pilot program, influencing how the agency implements technology in health care administration.
- On Citizens: Could help safeguard Medicare beneficiaries (primarily seniors) from potential denials of coverage due to AI decisions, preserving access to critical treatments without immediate disruptions.
- On International Relations: No direct impact, as this is a domestic health policy matter.
- Broader Effects: Might slow the adoption of AI in federal health programs, affecting efficiency gains or cost savings from such technologies.
Main Stakeholders Affected
- Medicare Beneficiaries: Especially older adults relying on Medicare for health coverage, who could face risks to service access.
- CMS and Federal Agencies: Directly addressed, with potential oversight from congressional committees like Ways and Means and Energy and Commerce.
- For-Profit Companies: Those contracted for the AI pilot program, whose business opportunities could be limited.
- Health Care Providers: Doctors and facilities submitting coverage claims, as AI decisions might affect reimbursements and patient care.
Notable Legal, Constitutional, or Political Implications
- Legal: Lacks binding authority, so it cannot legally compel CMS to act; however, it could support future lawsuits or regulatory challenges if the pilot proceeds.
- Constitutional: Aligns with Congress's oversight role over executive agencies like CMS but raises no direct constitutional issues, as it respects separation of powers.
- Political: Signals bipartisan or targeted congressional concern about AI's role in sensitive public services, potentially influencing debates on technology ethics, privacy, and equity in health care. It was introduced on September 10, 2025, and referred to relevant committees for review.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (3)
Rep. Pocan, Mark [D-WI-2], Rep. Frankel, Lois [D-FL-22], Rep. Kaptur, Marcy [D-OH-9]
Recent Actions
- 2025-09-10: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-09-10: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-09-10: Submitted in House
- 2025-09-10: Submitted in House
Bill Versions
- Expressing the sense of the House of Representatives that the Centers for Medicare & Medicaid Services should halt the pilot program and should not jeopardize seniors’ access to critical health care by utilizing artificial intelligence to determine Medicare coverage. — issued 2025-09-10 — PDF (2 pages)