Comment on CMS-2026-2377-0002

CMS-1848-P This seems like a push from powerful, rich AI companies. If hospitals want to use AI as a tool, that is one thing, if they bill patients for it when they don't even bill for RN assessments, that is a whole other thing. That would likely lead to the unintended consequence of organizations using AI when it is not necessarily needed, as well as cleaning up a legal mess if the use or lack of use of AI is associated with negative outcomes for patients. If it is associated with negative outcomes, who gets the blame? Hospitals? AI companies? Individuals? Healthcare is a human field. Care is a human practice. AI can inform decision-making when the source is good OpenEvidence for example, but AI should not be given the power that comes with a billable service. I am a nurse practitioner. If I use AI to inform my visits, I use my own knowledge, my critical thinking, and source-check/fact-check before ever making a decision. This is hardly different than referencing a guideline I've saved in pdf form, or opening up a book of best practices to find an answer. I am doing the work. To include AI in billing will continue the pattern of non-for-profit hospitals acting more and more like for-profit entities. Furthermore, the hospitals and clinics with more money will likely invest more in their AI ventures, bill for it more, and become richer, thereby furthering inequity that is seen in already struggling areas of healthcare (rural clinics/hospitals, inner city clinics/hospitals, federally qualified health centers, NGOs, etc). Other issues to consider: data safety, consent from patients to charge for AI, cost to the healthcare system, cost to the patient, price of insurance, continued drop in healthy people paying for insurance coverage. Our healthcare system is already so broken. Please put the hammer down before you break it more. People and their work are our most valuable contributions to medicine.