Medicare Transaction Fraud Prevention Act
The source supplies the latest action, but no lifecycle stage.
Latest action (12 Jun 2025): Read twice and referred to the Committee on Finance.
What this bill does
S. 2066, the Medicare Transaction Fraud Prevention Act, would amend the Social Security Act to require the Secretary of Health and Human Services to establish a two-year pilot program, beginning no later than January 1, 2026, testing a predictive risk-scoring algorithm to flag potentially fraudulent Medicare claims for durable medical equipment and clinical diagnostic laboratory tests. The algorithm would score claims from 1 (least risky) to 99 (most risky) using factors such as lack of a prior beneficiary-provider relationship, unusual billing volume, changes in electronic fund transfer information, or ownership changes at a supplier or provider. High-risk claims could be reviewed and potentially suspended, but only after human review, with beneficiaries given a chance to confirm or correct the transaction and information on reporting suspected fraud.
Participation is limited to Medicare beneficiaries who voluntarily opt in to receive electronic Medicare Summary Notices and join the pilot, and they may withdraw at any time. Durable medical equipment suppliers, lab test providers, and HHS's Office of Inspector General would also be involved, since HHS must consult industry representatives and coordinate on notification and oversight procedures. The bill also gives the Secretary authority to terminate or reissue Medicare cards to prevent fraud.
The bill was introduced June 12, 2025, by Senator Tim Sheehy with several cosponsors and referred to the Senate Committee on Finance. It has not yet received committee action, a floor vote, or been enacted.
Plain-English summary generated by Bill100 AI from the official record. Always verify against the source below.
Timeline
12 Jun 2025
Read twice and referred to the Committee on Finance.
Common questions
- What does S. 2066 do?
- S. 2066, the Medicare Transaction Fraud Prevention Act, would amend the Social Security Act to require the Secretary of Health and Human Services to establish a two-year pilot program, beginning no later than January 1, 2026, testing a predictive risk-scoring algorithm to flag potentially fraudulent Medicare claims for durable medical equipment and clinical diagnostic laboratory tests. The algorithm would score claims from 1 (least risky) to 99 (most risky) using factors such as lack of a prior beneficiary-provider relationship, unusual billing volume, changes in electronic fund transfer information, or ownership changes at a supplier or provider. High-risk claims could be reviewed and potentially suspended, but only after human review, with beneficiaries given a chance to confirm or correct the transaction and information on reporting suspected fraud. Participation is limited to Medicare beneficiaries who voluntarily opt in to receive electronic Medicare Summary Notices and join the pilot, and they may withdraw at any time. Durable medical equipment suppliers, lab test providers, and HHS's Office of Inspector General would also be involved, since HHS must consult industry representatives and coordinate on notification and oversight procedures. The bill also gives the Secretary authority to terminate or reissue Medicare cards to prevent fraud. The bill was introduced June 12, 2025, by Senator Tim Sheehy with several cosponsors and referred to the Senate Committee on Finance. It has not yet received committee action, a floor vote, or been enacted.
- Has S. 2066 become law?
- The source does not supply a confirmed lifecycle stage for S. 2066. Check the latest action and official source below.
- Who sponsored S. 2066?
- S. 2066 was sponsored by Sen. Sheehy, Tim [R-MT] (R-MT), with 3 cosponsors.
- What's the latest action on S. 2066?
- Read twice and referred to the Committee on Finance. (12 Jun 2025).
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