Medicare Transaction Fraud Prevention Act

Senate Bill

S. 2066

119th Congress

Medicare Transaction Fraud Prevention Act

In Committee

Introduced:Jun 12, 2025

Primary Sponsor

Sheldon Whitehouse

D - RI

Cosponsors

1

Quick Stats

Policy Area

International Affairs

Summary

This bill creates a two-year pilot program to test computer algorithms that predict fraud risk in Medicare payments for medical equipment and lab tests. The system would score transactions from 1 to 99 based on risk level, and high-risk transactions would be reviewed and potentially suspended until the Medicare beneficiary confirms the purchase was legitimate.

Latest Action

Read twice and referred to the Committee on Foreign Relations.

Introduced6/12/2025

StatusRead twice and referred to the Committee on Finance.

ChamberSenate

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Vote Prediction

Medicare Transaction Fraud Prevention Act

This bill creates a two-year pilot program to test computer algorithms that predict fraud risk in Medicare payments for medical equipment and lab tests. The system would score transactions from 1 to 99 based on risk level, and high-risk transactions would be r

Community Breakdown

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This bill creates a two-year pilot program to test computer algorithms that predict fraud risk in Medicare payments for medical equipment and lab tests. The system would score transactions from 1 to 99 based on risk level, and high-risk transactions would be reviewed and potentially suspended until the Medicare beneficiary confirms the purchase was legitimate.

Bill Number: 2066
Introduced: 6/12/2025
Status: Read twice and referred to the Committee on Finance.
Policy Area: International Affairs

Data from Congress.gov

AI-generated summary

Fact Sheet

Title: Medicare Transaction Fraud Prevention Act
Bill Number: 2066
Sponsor: No sponsor
Status: Read twice and referred to the Committee on Finance.
Introduced: 6/12/2025
Summary: This bill creates a two-year pilot program to test computer algorithms that predict fraud risk in Medicare payments for medical equipment and lab tests. The system would score transactions from 1 to 99 based on risk level, and high-risk transactions would be reviewed and potentially suspended until

Data from Congress.gov

AI Summary

Plain-English explanation of this bill

This bill creates a two-year pilot program to test computer algorithms that predict fraud risk in Medicare payments for medical equipment and lab tests. The system would score transactions from 1 to 99 based on risk level, and high-risk transactions would be reviewed and potentially suspended until the Medicare beneficiary confirms the purchase was legitimate.

Last updated: 2/20/2026

Key Points

Main provisions of the bill

The pilot program would run for two years starting no later than January 1, 2026, and only applies to Medicare beneficiaries who voluntarily opt in.
A computer algorithm would assign risk scores to transactions based on factors like unusual billing patterns, lack of prior relationship between patient and supplier, and changes in supplier ownership.
Transactions flagged as high-risk would be reviewed and could be suspended until the beneficiary confirms by email or phone that the purchase was legitimate.
The Secretary of Health and Human Services must test and evaluate the algorithm before using it and establish methods to notify beneficiaries and suppliers about how it works.
The program focuses specifically on durable medical equipment (like wheelchairs or oxygen tanks) and clinical laboratory tests covered by Medicare.

How This Impacts Americans

Potential effects on citizens and communities

This bill primarily affects Medicare beneficiaries who choose to participate in the program and suppliers of medical equipment and lab testing services. Participating beneficiaries may experience payment delays on legitimate purchases if flagged as high-risk, but would have the opportunity to quickly confirm valid transactions. Suppliers could face payment suspensions on transactions the algorithm identifies as potentially fraudulent, which may affect their cash flow but could help reduce fraudulent billing in the Medicare system.

Policy Areas

Primary Policy Area

International Affairs

Scope & Jurisdiction

Jurisdiction Level

federal

Congressional Session

119th Congress

Citation Reference

2066, 119th Congress (2025). "Medicare Transaction Fraud Prevention Act". Source: Voter's Right Platform. https://votersright.org/bills/118-s-2066

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