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CMS blocks $1.6 billion in sham Medicare lab payments, revokes providers

A photo of 3 female clinicians in white lab coats working in a lab, checking test tubes.
Photo: Horacio Villalobos/Corbis via Getty Images

The agency says machine-learning and AI analytics contributed to increased enforcement.

The Centers for Medicare & Medicaid Services (CMS) has announced that it has prevented more than $1.6 billion in potentially fraudulent Medicare laboratory payments through intensified program integrity efforts and the use of advanced fraud detection technologies.

The agency said the savings were achieved through a range of enforcement actions aimed

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