H.R. 5546: To provide for the establishment of a fraud, waste, and abuse detection and mitigation program for the Medicare Program under title XVIII of the Social Security Act.
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H.R. 5546: To provide for the establishment of a fraud, waste, and abuse detection and mitigation program for the Medicare Program under title XVIII of the Social Security Act.
111th Congress · introduced 2010-06-16 · Health · Latest: Referred to House Ways and Means
federal
Follow this bill, step by step
- Where it came from: introduced 2010-06-16 · official record
- Who proposed it: Rep. Roskam, Peter J. [R-IL-6] · what a sponsor is
- What happened next: no floor votes in our records yet. Why?
- Where it stands now: Referred to House Ways and Means Not final yet: this can still change. We check for updates every day.
- If it becomes law and spends money: follow the money to money laws, then agencies and contracts and grants.
Official title
To provide for the establishment of a fraud, waste, and abuse detection and mitigation program for the Medicare Program under title XVIII of the Social Security Act.
Plain summary
Directs the Secretary of Health and Human Services (HHS) to develop and implement a fraud, waste, and abuse comprehensive prepayment review Prevention System for reviewing claims for reimbursement under title XVIII (Medicare) of the Social Security Act. Requires the Secretary to carry out the system acting through the Center for Program Integrity of the Centers for Medicare and Medicaid Services (CMS). Requires the Prevention System to cover all types of providers and suppliers under the Medicare program, but allows it to be limited to a subset of claim segments. Requires the Prevention System to: (1) be a high volume, rapid, near real-time information technology solution which includes data pooling and scoring capabilities to quickly and accurately capture and evaluate data; (2) identify high-risk Medicare claims by scoring all such claims in near real-time before payment is made; (3) involve a statistically sound, empirically derived predictive modeling technology; and (4) utilize a fraud management system that presents score, reason codes, and treatment actions for high-risk scored transactions, and a feedback loop to gain access to outcome information on adjudicated Medicare claims. Prohibits the Secretary from making a payment on a claim selected for review until it has been reviewed under the System.
Congressional Research Service summary (Introduced in House), quoted unchanged (nonpartisan). Read the source.
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What does this mean? (plain words)
Official text
To provide for the establishment of a fraud, waste, and abuse detection and mitigation program for the Medicare Program under title XVIII of the Social Security Act.
Source: Congressional Research Service summary (Introduced in House)
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How did my representative vote? · This bill's floor votes
Officials and money
Sponsor: Rep. Roskam, Peter J. [R-IL-6] · 0 cosponsors
Cost estimate: No cost estimate published yet.
No linked floor roll calls in our collected records yet. This does not mean the bill has never had a vote. Check the official bill history.
Words on this page, explained (1)
- Securities
- Financial investments that can be bought and sold, such as stocks and bonds.
Plain meanings written from linked sources. All words.
Sources
- Congressional Research Service summary (Introduced in House)
- Congress.gov
- Data: GovInfo BILLSTATUS bulk data (Library of Congress), BILLSTATUS-111hr5546.xml <https://www.govinfo.gov/bulkdata/BILLSTATUS/111/hr>
Record fed-us-cong111-hr5546 · catalog fed-us-congress-bills-cong111 · updated 2026-11-15 by psicol fed-bills-cong111