Friday, December 5, 2025

CMS RFI: Using Advanced Technology in Program Integrity

Solicitation Number: RFI-CPI-AdvTech-2019

“CMS designed this RFI to obtain input on how the agency can better use emerging technologies such as AI to ensure proper claims payment, reduce provider burden, and overall, conduct program integrity activities in a more efficient manner. For the purpose of this RFI, AI means the ability of a computer program or machine to think and learn. ML is a type of AI that provides systems the ability to automatically learn and improve from data sets without being explicitly programmed. Our reference to AI, includes all such technologies and frameworks. CMS will use the feedback to better align its initiatives with rapidly advancing technology and create possible solutions for sharing medical records during audits.”

This RFI is organized as follows:

  1. AI Medical Record Review Tools in Medicare FFS
  2. Documentation Requirement Repositories
  3. Advanced Technologies for CMS to use in Medicare Advantage and for CMS Contract-Level Risk Adjustment Data Validation (RADV) Audits
  4. Provider Enrollment
  5. Data Analytics and Data Systems

Read more here.

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Jackie Gilbert
Jackie Gilbert
Jackie Gilbert is a Content Analyst for FedHealthIT and Author of 'Anything but COVID-19' on the Daily Take Newsletter for G2Xchange Health and FedCiv.

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