Medicare Fraud Prevention: New Pilot Program for Risk Scoring
This act establishes a two-year pilot program within Medicare to detect fraud related to durable medical equipment and laboratory tests. It uses predictive risk-scoring algorithms to protect taxpayer money and ensure benefits reach the right people. Participation is voluntary for beneficiaries who opt-in to electronic notifications.
Key points
Introduction of an algorithm to assess transaction risk in Medicare to detect potential fraud more quickly.
The pilot program focuses on payments for durable medical equipment and laboratory tests, potentially reducing waste of public funds.
Medicare beneficiaries who opt-in to electronic notifications can voluntarily participate and can opt-out at any time.
If a high-risk transaction is detected, the beneficiary will be notified and given the opportunity to confirm or correct the data, enhancing their account security.
Expired
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