,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #ajfde  ,,9 ,,! ,,h\se ,,(         
,,repres5tatives  ,octob] #a1 #bjbf,mr4 
,bald]son 7= himself1 ,mr4 ,bilirakis1  
,mrs4 ,h>%b>g]1 ,mr4 ,joyce (           
,p5nsylvania1 & ,mr4 ,pflug]7 introduc$ 
! foll[+ bill2 :i* 0 ref]r$ to !        
,committee on ,en]gy & ,comm]ce  ,a     
,,bill  ,to am5d title ,,xix ( ! ,social
 ,security ,act to require ! ,secret>y (
 ,heal? & ,human ,s]vices to make       
uni=mly available to ,/ates c]ta9       
/&>diz$ data analytic te*nologies to    
id5tify & prev5t fraud1 wa/e1 & abuse "u
 ,m$icaid4  #a4 ,%ort title ,?is ,act   
may be cit$ z ! ,/r5g!n+ ,m$icaid       
,analytics to ,r$uce ,!ft ,act or !     
,,sm>t ,act4  #b4 ,requir+ !            
availability ( c]ta9 /&>diz$ data       
analytic te*nologies "u ,m$icaid        
,section #aijc ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;b7 is am5d$ by
 add+ at ! end ! foll[+ new subsection3 
7cc7  ,availability ( /&>diz$ data      
analytic te*nologies ,to id5tify fraud  

7#a7  ,9 g5]al  ,beg9n+ n lat] ?an #ahj 
days aft] ! date ( ! enactm5t ( ?is     
subsection1 ! ,secret>y %all make       
available to ea* ,/ate /&>diz$ data     
analytic te*nologies = purposes (       
id5tify+ & prev5t+ fraud1 wa/e1 & abuse 
"u ! ,/ate plan 7or waiv] ( su* plan7 ( 
su* ,/ate "u ?is title4 ,9 mak+ su*     
te*nologies available1 ! ,secret>y      
%all--  7,a7 ensure t su* te*nologies   
are int]op]able ) ! me*aniz$ claims     
process+ & in=mation retrieval sy/ems   
describ$ 9 subsection 7a77#c77;,a77i71  
includ+ ,m$icaid ,managem5t ,in=mation  
,sy/ems & ,/ate eligibility & enrollm5t 
sy/ems1 & any o!r sy/ems relevant to    
program integrity "u ?is title1 z       
det]m9$ by ! ,secret>y2  7,b7 ensure t  
ea* ,/ate has ! ability1 ?r\gh ! use (  
su* te*nologies1 to--  7i7 review ! risk
 indicators describ$ 9 subp>agraph      
7,c77i7 & receive al]ts reg>d+ fraud1   
wa/e1 & abuse vuln]abilities2  7ii7     
access datasets & analytic outputs =    
purposes ( id5tify+ pot5tially improp]  

bill+1 utilization1 or enrollm5t        
patt]ns2  7iii7 use any da%bo>d or o!r  
inve/igative tools made available by !  
,secret>y = ! purposes ( program        
integrity "u ?is title2  7iv7 receive   
any program integrity al]ts t apply     
across m ?an #a ,/ate or program2  7v7  
conduct ,/ate-specific analyses & g5]ate
 ,/ate-level reports2 &  7vi7 integrate 
analytic outputs f su* te*nologies into 
exi/+ ,/ate program integrity           
activities2 &  7,c7 use su* te*nologies 
to-- 7i7 e/abli% risk indicators t      
reflect ! ext5t to :i* provid]s1        
suppli]s1 & o!r entities p>ticipat+ 9 m 
?an #a ,/ate plan "u ?is title 7or waiv]
 ( su* plan71 or p>ticipat+ 9 multiple  
,f$]al heal? c>e programs1 may pres5t a 
risk = fraud1 wa/e1 or abuse1 bas$ on-- 
7,i7 bill+ data2  7,,ii7 utilization    
data2  7,,iii7 enrollm5t data2 &  7,,iv7
 any o!r relevant data relat$ to a      
,f$]al heal? c>e program 7z det]m9$ by !
 ,secret>y72 &  7ii7 provide ,/ates )   
actionable al]ts bas$ on su* risk       

indicators4  7#b7 ,te*nical assi/ance ,!
 ,secret>y %all provide te*nical        
assi/ance & tra9+ to ,/ates on h[ to use
 ! te*nologies made available "u        
p>agraph 7#a74  7#c7  ,report  ,n lat]  
?an #a ye> aft] ! date ( enactm5t ( ?is 
subsection1 & annually !reaft]1 !       
,secret>y %all submit to ,congress a    
report on ! te*nologies describ$ 9      
p>agraph 7#a74 ,ea* su* report %all     
include ! foll[+ in=mation3  7,a7 ,!    
numb] ( ,/ates ) access to ! te*nologies
 made available "u p>agraph 7#a71 & a   
description ( any b>ri]s to su* access4 
7,b7 ,! rate ( utilization ( su*        
te*nologies by ea* ,/ate1 & a           
description ( any b>ri]s to su*         
utilization4  7,c7 ,! numb] ( in/ances (
 possible fraud1 wa/e1 & abuse id5tifi$ 
?r\gh ! use ( su* te*nologies1 & an     
e/imate ( ! am\nt ( ov]paym5ts id5tifi$ 
& collect$ 9 connection ) su* in/ances4 
4