What is the official ID of this bill?
The official print number for this legislation is S 3630.
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.
Status:
Expired
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