One Big Beautiful Bill Act 2025, Section 112204 ("Implementing artificial intelligence tools for purposes of reducing and recouping improper payments under Medicare")

• Authority: United States Congress
• Parent authority: Federal government
• Jurisdiction: United States
• Collections: U.S. federal laws
• Most recent activity: Proposed
• Most recent activity date: 2025-05-20

Risk subdomain coverage

Minimal coverage — Brief mention but no specific mitigations, recommendations or governance measures relating to the risk subdomain are described.

• AI system security vulnerabilities
• Lack of capability or robustness

All other risk subdomains had no coverage in this document.

Risk Coverage Summary

The document has minimal coverage of AI risk domains, with limited focus on AI system security (2.2) and lack of robustness (7.3). The document primarily addresses operational implementation of AI tools for fraud detection rather than comprehensive risk mitigation across multiple domains.

Sector coverage

Good coverage — Comprehensive governance measures or mitigations with clear procedures relating to the sector are explicitly described.

• Health Care & Social Assistance
• Public Administration (excl. National Security)

Minimal coverage — Brief mention but no specific mitigations, recommendations or governance measures relating to the sector are described.

• Professional & Technical Services

All other sectors had no coverage in this document.

Sectors Summary

This document primarily governs AI use in the Health Care and Social Assistance sector, specifically Medicare Parts A and B administration. It also has secondary coverage of Professional and Technical Services (AI vendors and data scientists) and Public Administration (CMS operations).

Legislative Status

Hard Law

Legislative Status Summary

This is a binding federal statute enacted by the United States Congress with mandatory implementation requirements, specific deadlines, enforcement mechanisms through the Secretary of Health and Human Services, and dedicated funding from federal trust funds.

Actors

Proposer

• Entity Types: AI_Governance_Actor
• Entities: United States Congress
• Summary: The document is Section 112204 of the 'One Big Beautiful Bill Act 2025', indicating it was proposed and enacted by the United States Congress as federal legislation amending the Social Security Act.

Target

• Entity Types: AI_Developer, AI_Deployer
• Entities: Vendors of artificial intelligence tools; Data scientists; Secretary of Health and Human Services (as deployer); Centers for Medicare & Medicaid Services
• Summary: The document targets AI vendors and data scientists who will be contracted to provide AI tools, and the Secretary of Health and Human Services/CMS who will deploy these tools for Medicare fraud detection. The regulation applies to those developing and deploying AI for improper payment detection.

Enforcer

• Entity Types: AI_Governance_Actor
• Entities: Secretary of Health and Human Services; Centers for Medicare & Medicaid Services; United States Congress (oversight)
• Summary: The Secretary of Health and Human Services has primary enforcement authority to implement the AI tools, contract with vendors, recoup payments, and report to Congress. Congress maintains oversight through mandatory annual reporting requirements.

Monitor

• Entity Types: AI_Governance_Actor
• Entities: United States Congress; Secretary of Health and Human Services
• Summary: Congress monitors implementation through mandatory annual reports starting January 1, 2029. The Secretary monitors the AI tools' performance in reducing improper payments and must report on opportunities for improvement and reasons for any failures to meet reduction targets.

AI Lifecycle Stages

Lifecycle stages covered by the documents, as defined in the OECD Framework for the Classification of AI Systems

• Plan and Design
• Deploy
• Operate and Monitor

AI Lifecycle Summary

The document primarily covers the Deploy and Operate and Monitor lifecycle stages, with mandatory implementation of AI tools by January 1, 2027, and ongoing monitoring through annual Congressional reporting starting in 2029. There is minimal coverage of the Plan and Design stage through contracting requirements, but no explicit coverage of data collection, model building, or verification stages.

Technical Scope

Terms relating to technical scope that are mentioned or implicitly referenced in the document

• Task-specific AI

Technical Scope Summary

The document explicitly mentions 'artificial intelligence tools' multiple times but does not define or specify particular types of AI models, systems, or technical characteristics. There is no mention of frontier AI, general purpose AI, foundation models, generative AI, predictive AI, compute thresholds, or open-weight models.