Medicare Transaction Fraud Prevention Act

[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 3996 Introduced in House (IH)] <DOC> 119th CONGRESS 1st Session H. R. 3996 To amend title XI of the Social Security Act to establish a pilot program for testing the use of a predictive risk-scoring algorithm to provide oversight of payments for durable medical equipment and clinical diagnostic laboratory tests under the Medicare program. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES June 12, 2025 Mr. Schweikert introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned _______________________________________________________________________ A BILL To amend title XI of the Social Security Act to establish a pilot program for testing the use of a predictive risk-scoring algorithm to provide oversight of payments for durable medical equipment and clinical diagnostic laboratory tests under the Medicare program. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Medicare Transaction Fraud Prevention Act''. SEC. 2. PILOT PROGRAM TESTING USE OF PREDICTIVE RISK-SCORING ALGORITHM TO PROVIDE OVERSIGHT OF PAYMENTS FOR DURABLE MEDICAL EQUIPMENT AND CLINICAL DIAGNOSTIC LABORATORY TESTS UNDER THE MEDICARE PROGRAM. Section 1128K of the Social Security Act (42 U.S.C. 1320a-7n) is amended-- (1) in the section heading by inserting ``; pilot program testing use of predictive risk-scoring algorithm to provide oversight of payments for durable medical equipment and clinical diagnostic laboratory tests under the medicare program'' after ``abuse''; and (2) by adding at the end the foll