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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