Presented by Carahsoft
Kim Brandt, Deputy Administrator and Chief Operating Officer at the Centers for Medicare & Medicaid Services, outlined how artificial intelligence is helping CMS improve fraud detection, streamline operations, and better serve more than 170 million beneficiaries. The agency is already seeing measurable results from AI-driven initiatives that strengthen program integrity and improve efficiency.
One of CMS's most significant accomplishments has been its use of AI to combat fraud, waste, and abuse. Machine learning and advanced analytics enable the agency to identify suspicious claims patterns in near real time, allowing investigators to detect issues that previously might have taken years to uncover.
Brandt reported that these efforts have prevented approximately $2.1 billion in improper payments in just over a year. By automating analysis and identifying anomalies more quickly, AI is helping CMS focus resources where they can have the greatest impact.
Workforce education remains a major priority. CMS leaders are investing heavily in AI literacy programs designed to ensure employees understand how to responsibly use emerging technologies. The goal is for every employee to develop a foundational understanding of AI and its potential applications.
Looking ahead, Brandt sees significant opportunities to improve beneficiary experiences through AI-enabled applications that integrate health information, claims data, and personal health metrics to support better care decisions and improve health outcomes.
Key Takeaways
• AI has helped CMS prevent approximately $2.1 billion in improper payments.
• Advanced analytics are improving acquisition decisions and operational efficiency.
• Workforce education and beneficiary trust remain essential to long-term success.