The convergence of quantum technology and artificial intelligence in precision medicine is set to revolutionize healthcare by enabling highly personalized treatments and advancing drug design, medical imaging, and real-time health monitoring. Second-generation quantum technologies, which integrate quantum and classical computing, offer significant advantages in computing, sensing, and networking, with applications ranging from drug discovery to secure patient data sharing. However, these advancements come with regulatory challenges, as existing frameworks may not adequately address the unique risks associated with quantum devices, necessitating the development of new evaluation protocols, risk management frameworks, and clinical trial guidelines. Policymakers are encouraged to promote quantum literacy, anticipate societal impacts, and implement adaptive regulations to balance innovation with public safety. Ultimately, global collaboration and harmonized standards are essential to harnessing the potential of quantum technology in healthcare responsibly.
Fraud & Abuse
Dr. Basem Hamid, a 52-year-old neurologist from Pearland, Texas, has agreed to pay $948,359.85 to settle allegations of submitting false Medicare claims. The claims involved billing for the surgical implantation of neurostimulator electrodes between August 27, 2019, and October 3, 2022. However, it is alleged that neither Dr. Hamid nor his staff performed these surgeries. Instead, patients received electro-acupuncture devices that were non-invasive and applied in his clinic, not in a surgical setting. Many patients reported that the devices, which were taped behind the ear, often fell off within a few days.
The U.S. Department of Justice (DOJ) has historically focused on combating fraud against federally funded healthcare programs like Medicare, Medicaid, and TRICARE by encouraging whistleblowers to file lawsuits under the False Claims Act. Recently, the DOJ launched the Corporate Whistleblower Awards Pilot Program, a three-year initiative aimed at incentivizing reports of corporate crime, including private healthcare fraud, with potential monetary rewards for whistleblowers. This program expands the DOJ’s focus to include fraud involving private insurers and healthcare benefit programs outside the scope of the False Claims Act. The DOJ’s updated Evaluation of Corporate Compliance Program guidance emphasizes the importance of confidential reporting structures to protect whistleblowers and urges healthcare providers to enhance compliance programs to address both public and private healthcare fraud. These developments signal an increased scrutiny of corporate healthcare practices and the need for robust compliance systems.
In February 2024, a group including the Johnson & Johnson Group Health Plan sued Johnson & Johnson over alleged fiduciary breaches related to the management of its specialty-drug prescription benefit program under ERISA. The plaintiffs claimed that Johnson & Johnson failed to negotiate effectively with its pharmacy benefit manager (PBM) and to oversee third-party conflicts of interest, resulting in excessive drug payments and higher costs for plan members. This lawsuit highlights increasing scrutiny on PBM practices and suggests a broader fiduciary responsibility for plan sponsors and administrators. As a response, plans are advised to establish competitive PBM procurement processes, maintain continuous oversight of PBM contracts, and routinely review these contracts to ensure compliance and adaptability to regulatory changes. The case underscores the importance of fulfilling fiduciary duties to protect plan members’ interests.
