Last week, PCMA submitted comments to the U.S. Department of Health and Human Services on a proposed interoperability rule that would make significant changes to the Office of the National Health Coordinator (ONC) for Health IT Certification Program by reducing regulatory requirements and encouraging a transition toward more API-based interoperability. We also submitted a response to a Request for Information regarding the use of artificial intelligence (AI) in health care settings.  

PBMs have longstanding experience using advanced analytics and decision-support tools to improve medication safety, support appropriate utilization, and reduce prescription drug costs for patients and employers. PBMs have consistently called for improvements to the government’s interoperability capabilities. 

The comments on interoperability express support for efforts to modernize health IT infrastructure and promote data exchange, while emphasizing the importance of maintaining interoperability capabilities during the transition. The administration’s effort to deregulate data exchange throughout the health care system is a significant step forward toward greater interoperability. 

In addition, PCMA’s comments on the administration’s information request on AI encourage policymakers to support responsible AI innovation while maintaining strong privacy and security protections and ensuring that AI tools can be effectively integrated into existing clinical workflows. AI has shown much promise, but we in the health care system owe it to patients to adopt tools that improve patient care, rather than merely streamline its administration. We also emphasize the importance of interoperability and standardized data exchange to support the safe and effective deployment of AI-enabled tools across the health care system.  

Engagement on interoperability and AI policy will remain an important priority for PBMs as federal agencies continue developing policies that impact how patients, providers, and employers exchange and use health information.