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Senators Introduce Bipartisan Bill to Use AI in Combating Medicare Fraud

Medicare fraud is estimated to cost taxpayers roughly $60 billion annually.

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Written by: CDO Magazine Bureau

Updated 7:30 PM UTC, Mon June 23, 2025

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A bipartisan group of senators introduced a new legislation aimed at curbing fraud, waste, and abuse in the Medicare system by leveraging artificial intelligence tools.

The legislation, called the Medicare Transaction Fraud Prevention Act, proposes a pilot program to test an AI-powered risk-scoring algorithm that flags irregular Medicare fee-for-service transactions involving lab tests and medical equipment. 

High-risk claims would be sent to the Inspector General’s office for prioritized review. Participation in the pilot would be voluntary, requiring beneficiary consent. Medicare fraud is estimated to cost taxpayers roughly $60 billion annually.

The legislation is sponsored by Sens. Eric Schmitt (R-Mo.), Maggie Hassan (D-N.H.), and Tim Sheehy (R-Mont.).

“Artificial intelligence has set our nation at the precipice of the next great American revolution, and harnessing AI’s power to identify potential waste, fraud, and abuse will help strengthen the Medicare system for those who depend on it and ensure our taxpayer dollars are being well spent. I’m glad to lead this bipartisan bill to utilize cutting edge technology to help America’s seniors and protect Medicare benefits,” Senator Schmitt said in a statement.

“New technologies allow for innovative ways to root out waste, fraud, and abuse and safeguard taxpayer dollars. This bipartisan bill takes a common-sense approach to protecting seniors and Medicare as a whole by identifying waste, fraud, and abuse in the system while also providing appropriate privacy protections, human review, and protection of the benefits that seniors have paid into and deserve,” Senator Hassan added.

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