Colin J. Zick

AI can be used by these private commercial payers in a litany of ways to identify, the word I'll use is opportunities for them to push back alleged overpayment and then try to recoup funds from providers.

We have been, my colleague here, Boston mentor, Colin Zick, who I work very closely with on fraud and abuse and reimbursement issues, have seen, I couldn't even tell you how many examples over the past one or two years of instances of private payers, like I said, identifying uncrossed Ts and non-dotted Is and using that for not only to identify the initial overpayment, but as healthcare providers know, then taking that overpayment and extrapolating it to a huge number across a certain audit period.

So that I would say is really the key issue from a fraud and abuse standpoint with respect to AI for healthcare providers in terms of reimbursement.

It's the risk that if you are not so buttoned up in the claims that you're submitting, it's now a whole lot easier for your payers to pick them apart and come back and try to take away the money they've already paid you.

In terms of where is this all going, if I knew exactly where the AI boom would end up in five to 10 years, I'd probably be in pretty good shape financially in five to 10 years.

But it's somewhat of a gray area at the moment.

Colin Zick, who I mentioned a moment ago, partner here at Foley Hoag.

He and I have delivered two in the past two months presentations to healthcare providers.

The legal problem is that many states' wiretap and eavesdropping laws turn on whether a private conversation was intercepted or its contents acquired, not just whether an audio file was saved.

Colin Zick, a privacy lawyer, has pointed out in Massachusetts, the law defines an intercepting device to include equipment capable of transmitting, receiving, amplifying, or recording a communication.

In his view, a device that listens continuously and produces written summary could fall under that language even without saving audio.

And the risk may land on the wearer.

Right.

Attorneys Colin Zick and Daniel Pi explained that state laws often turn on whether a communication was intercepted or its meaning acquired, not just audio recording.

Now, Pi does add the caveat that the practical risk of prosecution is low, but the responsibility shifts to the wearer because they deliberately opt in.

Michael Stokes summed it up well.