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H.R. 7147

BillFederalHouseIn Committee
Medicare Transaction Fraud Prevention Act
About This Bill
Committee
Latest Action · December 17, 2024
Referred to the Subcommittee on Health.
Congress
118th (2023–2025)
Introduced
January 30, 2024
Cosponsors (0)
None
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Summary

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This bill creates a two-year pilot program starting January 1, 2025, to test whether artificial intelligence algorithms can help Medicare prevent fraud in payments for durable medical equipment and lab tests. The program will use a predictive risk-scoring system that rates transactions on a scale from 1 to 99 based on factors like unusual billing patterns, new provider relationships, and ownership changes. Only Medicare beneficiaries who have voluntarily opted into electronic notices will be included, and they can exit the program anytime. When the algorithm flags a high-risk transaction, Medicare staff will review it and contact the beneficiary by email or phone to confirm it's legitimate or correct any errors, while also sending enhanced Medicare statements every two weeks for three months. The bill requires the algorithm to be thoroughly tested, transparent about how beneficiary data is used, and based on the White House's AI Bill of Rights framework before implementation.

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