# CMS Expands Medicaid Fraud Detection

CMS plans to use new exclusion authority to quadruple provider suspensions over the next six months and is expanding AI and machine-learning pilots to identify Medicaid fraud before payment. The agency expects to publish results from its Indiana pilot with Oracle and is working with five additional states; CMS has also requested industry input on its fraud-defense contracting model. No solicitation schedule, contract value, or award is identified, but the activity points to potential needs in claims analytics, provider screening, data integration, and case management.

- CMS’s planned publication of the Indiana pilot results may give contractors a clearer view of the analytics methods the agency could scale nationally.
- Firms with Medicaid program-integrity, AI analytics, data-integration, or human-reviewed case-management capabilities can respond to CMS’s request for industry input; the signals specify no submission deadline or procurement schedule.
- The suspension target and expansion of pilots indicate increased emphasis on prepayment fraud detection and provider screening, but do not establish a funded contract or mandatory contractor requirement.

**Jurisdictions:** federal
**Industries:** Healthcare, Information Technology
**Topics:** Artificial Intelligence, Regulatory Compliance
**Published:** October 16, 2026

### Government Entities
- Centers for Medicare and Medicaid Services (CMS)
- Indiana Medicaid

### Vendors
- Oracle (AI pilot participant)

### Key Quotes
> My hope is that suspension number will quadruple over the course of the next six months.
> — Kimberly Brandt, CMS Deputy Administrator

### Sources
- [CMS hopes to quadruple provider suspensions over next six months, official says - Nextgov/FCW](https://www.nextgov.com/artificial-intelligence/2026/10/cms-hopes-quadruple-provider-suspensions-over-next-six-months-official-says/416640) - Nextgov/FCW
- [Brandt: CMS to Publish Results of Medicaid AI Fraud Pilot](https://www.executivegov.com/articles/cms-medicaid-ai-fraud-pilot-provider-exclusions-kim-brandt) - ExecutiveGov