# CMS Seeks Input on Fraud Operations

On October 5, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a request for information on an outcome-focused contractor operating model for fraud detection and prevention across federal healthcare programs. The proposed model would strengthen CMS oversight while contractors support investigations, claims analysis, medical reviews, evidence development, enforcement support, interagency coordination, and surge staffing. This is market research, not a contract award opportunity, and the supplied signals give conflicting response deadlines: November 4, 2026, at 11 a.m. ET (25 days away) and November 27, 2026 (48 days away). Organizations should verify the deadline in the official RFI before submitting input.

- Healthcare contractors with program-integrity, claims analytics, AI, investigative, and medical-review capabilities can use the RFI to inform future requirements; the signals provide no contract value or award date.
- The proposed division of responsibilities places CMS in a stronger oversight role while contractors perform operational work, making governance, evidence handling, and measurable outcomes relevant areas for industry input.
- Because the reported deadlines conflict, prospective respondents should confirm the official response date and submission instructions in the CMS RFI.

**Jurisdictions:** federal
**Industries:** Healthcare, Information Technology
**Topics:** Artificial Intelligence
**Published:** October 09, 2026

### Government Entities
- Centers for Medicare & Medicaid Services (CMS)
- U.S. Department of Health and Human Services (HHS)
- Department of Health and Human Services Office of Inspector General (HHS OIG)
- Department of Justice (DOJ)
- Federal Bureau of Investigation (FBI)

### Sources
- [CMS pitches new contractor operating model for ‘detect and prevent’ fraud strategy - Nextgov/FCW](https://www.nextgov.com/digital-government/2026/10/cms-pitches-new-contractor-operating-model-detect-and-prevent-fraud-strategy/416481) - Nextgov/FCW
- [CMS Seeks Input on Fraud Defense Contracts](https://www.executivegov.com/articles/cms-fraud-defense-contracting-model-rfi) - ExecutiveGov