Medicare would test a fraud-checking tool for some equipment and lab test claims. Patients would have to opt in, and people would review high-risk claims before any claim is stopped.
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Medicare Transaction Fraud Prevention Act is a Senate bill in committee. The latest recorded action: Read twice and referred to the Committee on Finance.
Latest action on S. 2066: Read twice and referred to the Committee on Finance.
Who this affects: This bill mainly affects Medicare patients who choose to join the pilot and already get Medicare Summary Notices online. It also affects suppliers of durable medical equipment, clinical labs, and health care providers tied to those claims. The Department of Health and Human Services would have to build, test, explain, and run the fraud-checking system.
Why this matters: Medicare could stop some suspect payments before money goes out, but some real claims could also slow down. The bill tests whether a computer risk score can help find fraud in two areas where fraud has been a concern. It also matters because it sets rules for using automated tools in Medicare. The bill requires testing, notice, and human review, but it still gives the Secretary broad choices about how the pilot works.
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