One Big Beautiful Bill Act 2025, Section 112204 ("Implementing artificial intelligence tools for purposes of reducing and recouping improper payments under Medicare")

Proposed 2025-05-20 | Official source

Summary

Implements AI tools by 2027 to reduce and identify improper payments in Medicare Parts A and B. Contracts with AI vendors. Recoups identified payments. Reports annually to Congress starting 2029. Allocates $25 million from federal trust funds for implementation.

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This document has not been enacted or otherwise finalized and is subject to change. This summary is based on a copy of the document collected 2025-06-25 - refer to the official source for the most current version.

Key facts

🏛️ This document has been proposed by the United States Congress, but is not yet enacted. For authoritative text and metadata, visit the official source.

📜 This document's name is One Big Beautiful Bill Act 2025, Section 112204 ("Implementing artificial intelligence tools for purposes of reducing and recouping improper payments under Medicare"). It is part of One Big Beautiful Bill Act 2025.

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This document has not been enacted or otherwise finalized and is subject to change. This summary is based on a copy of the document collected 2025-06-25 - refer to the official source for the most current version.

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Full text

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(a) In General.--Part E of title XVIII of the Social Security Act (42 U.S.C. 1395x et seq.), as amended by the preceding provisions of this Act, is amended by adding at the end the following new section: ``SEC. 1899D. IMPLEMENTING ARTIFICIAL INTELLIGENCE TOOLS FOR PURPOSES OF REDUCING AND RECOUPING IMPROPER PAYMENTS. ``(a) In General.--Not later than January 1, 2027, the Secretary shall implement such artificial intelligence tools determined appropriate by the Secretary for purposes of-- ``(1) reducing improper payments made under parts A and B; and ``(2) identifying any such improper payments so made. ``(b) Contracts.--The Secretary shall seek to contract with a vendor of artificial intelligence tools and with data scientists for purposes of implementing the artificial intelligence tools required under subsection (a). ``(c) Recoupment.--The Secretary shall, to the extent practicable, recoup payments identified using the artificial intelligence tools implemented under subsection (a). ``(d) Report.--Not later than January 1, 2029, and not less frequently than annually thereafter, the Secretary shall report to Congress on the implementation of artificial intelligence tools under subsection (a) and the recoupment of improper payments under subsection (c). Such report shall include-- ``(1) a description of any opportunities for further reducing rates of improper payments described in subsection (a)(1) or further increasing rates of recoupment of such payments; ``(2) the total dollar amount of improper payments recouped in the most recent year for which data is available; and ``(3) in the case that the Secretary fails to reduce the rate of improper payments by 50 percent in such most recent year as compared to the year prior to such most recent year, a description of the reasons for such failure.''.

(b) Implementation Funding.-- (1) Federal hospital insurance trust fund.--The Secretary of Health and Human Services shall provide for the transfer from the Federal Hospital Insurance Trust Fund established under section 1817 of the Social Security Act (42 U.S.C. 1395i) to the Centers for Medicare & Medicaid Services Program Management Account of $12,500,000 for fiscal year 2025 for purposes of carrying out the amendment made by this section, to remain available until expended. (2) Federal supplementary medical insurance trust fund.-- The Secretary of Health and Human Services shall provide for the transfer, from the Federal Supplementary Medical Insurance Trust Fund established under section 1841 of the Social Security Act (42 U.S.C. 1395t) to the Centers for Medicare & Medicaid Services Program Management Account of $12,500,000 for fiscal year 2025 for purposes of carrying out the amendment made by this section, to remain available until expended.