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Medicare Fraud Prevention: Pilot Program Using AI Risk-Scoring for Payments.

This bill establishes a two-year Medicare pilot program utilizing a predictive risk-scoring algorithm to monitor payments for durable medical equipment and lab tests. The goal is to quickly identify and prevent fraudulent transactions, protecting both public funds and beneficiaries. Participation is voluntary for those receiving electronic Medicare notices.
Key points
A new system will score Medicare transactions (1 to 99) in real-time to flag potential fraud related to medical equipment and lab services.
If a transaction is flagged as high-risk, the beneficiary will be contacted (email/phone) to confirm the service or correct data before the payment is suspended.
Any suspension of a payment or account must be confirmed by a human reviewer, ensuring the algorithm does not make final decisions alone.
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Additional Information
Print number: 118_S_3630
Sponsor: Sen. Braun, Mike [R-IN]
Process start date: 2024-01-18
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Summarized by: gemini-flash-latest
Source data: api.congress.gov
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OFFICIAL LEGAL TITLE

Medicare Transaction Fraud Prevention Act

FREQUENTLY ASKED QUESTIONS

What is the official ID of this bill?

The official print number for this legislation is 118_S_3630.

Which chamber initiated this legislation?

This legislation was initiated in the Senate.

When did the legislative process begin?

The process officially started on 2024-01-18.

What are the main provisions?

Key points include:

  • A new system will score Medicare transactions (1 to 99) in real-time to flag potential fraud related to medical equipment and lab services.
  • If a transaction is flagged as high-risk, the beneficiary will be contacted (email/phone) to confirm the service or correct data before the payment is suspended.
  • Any suspension of a payment or account must be confirmed by a human reviewer, ensuring the algorithm does not make final decisions alone.
What is the specific legal status?

The current status is Expired.

Where can I read the full text of this legislation?

The full official text is available at: View full text

Who is the primary sponsor?

The primary sponsor is Sen. Braun, Mike [R-IN].

What is the latest detailed status?

The latest detailed status is: Introduced in Senate

Is this summary verified?

Yes. This content was analyzed by AI and verified by the Lustra Judge System on 2025-12-26.

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