S.2066

Medicare Transaction Fraud Prevention Act establishes a pilot program to test predictive risk-scoring algorithms for Medicare payments.

The Medicare Transaction Fraud Prevention Act establishes a pilot program to test the use of predictive risk-scoring algorithms for overseeing payments for durable medical equipment and clinical diagnostic laboratory tests under Medicare. The pilot program will run for two years starting no later than January 1, 2026. The Secretary of Health and Human Services will adopt an algorithm to score transactions from 1 (least risky) to 99 (most risky). Beneficiaries can opt-in to participate, and the Secretary will notify them and providers about the algorithm's use.