# 119-hr-3996: Medicare Transaction Fraud Prevention Act

119-hr-3996, Medicare Transaction Fraud Prevention Act, is a 119th Congress bill sponsored by Rep. Schweikert, David [R-AZ-1] (R-AZ); status introduced; PRIA reads it as touching household money (as of 2026-04-21).

- Canonical: https://policyrisk.com/legislation/119-hr-3996
- As of: 2026-04-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-3996
- Congress: 119
- Title: Medicare Transaction Fraud Prevention Act
- Status: introduced
- Introduced: 2025-06-12
- Sponsor: Rep. Schweikert, David [R-AZ-1] (R-AZ)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-04-21

## Summary

**Uses predictive AI risk scores to screen Medicare payments for durable medical equipment and lab tests.** This bill would create a two-year pilot, starting by January 1, 2026, that applies a predictive risk-scoring algorithm to claims for durable medical equipment and clinical diagnostic laboratory tests for beneficiaries who opt in to electronic Medicare Summary Notices. The algorithm would score transactions from 1 to 99 and trigger human review, alerts, and possible payment suspension when a score exceeds a threshold set by the Secretary. - Beneficiaries: People who opt in to electronic Medicare Summary Notices get automatic alerts and a chance by email or phone to confirm or "cure" a flagged claim; notices repeat every two weeks for three months after the first alert. - Suppliers and labs: Durable medical equipment suppliers and clinical diagnostic laboratories must collaborate on the pilot and may see individual claims reviewed or temporarily suspended if flagged as high risk. - Administration and oversight: The Secretary must test and evaluate the algorithm, follow Executive Order 14179 guidance on AI, and require a human review step before suspending payments. - Fraud response and card authority: Alerts will include instructions on reporting suspected fraud and the Secretary may terminate or reissue Medicare cards to prevent abuse.

## Provisions PRIA read

- Opt-in Medicare fraud check pilot: mixed, medium. This bill would create a two-year pilot, starting no later than January 1, 2026. It would test computer risk scores (1–99) on Medicare claims for durable medical equipment and lab tests. You could join only if you opt in to electronic Medicare Summary Notices and to the pilot; you could leave anyti…

## Related bills

- 119-hr-7705: Tribal Tax and Investment Reform Act of 2026
- 119-hr-4895: Afghan Adjustment Act
- 119-hr-2025: Northeastern Arizona Indian Water Rights Settlement Act of 2025
- 119-hr-4206: CONNECT for Health Act of 2025
- 119-hr-3466: SMART Act
- 119-hr-7971: Taxpayer Experience Improvement Act

## Sources
- [119-hr-3996 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/3996)

## Related
- [119-hr-7705: Tribal Tax and Investment Reform Act of 2026](https://policyrisk.com/legislation/119-hr-7705)
- [119-hr-4895: Afghan Adjustment Act](https://policyrisk.com/legislation/119-hr-4895)
- [119-hr-2025: Northeastern Arizona Indian Water Rights Settlement Act of 2025](https://policyrisk.com/legislation/119-hr-2025)
- [119-hr-4206: CONNECT for Health Act of 2025](https://policyrisk.com/legislation/119-hr-4206)
- [119-hr-3466: SMART Act](https://policyrisk.com/legislation/119-hr-3466)
- [119-hr-7971: Taxpayer Experience Improvement Act](https://policyrisk.com/legislation/119-hr-7971)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-3996 (as of 2026-04-21).