# CMS Seeks Outcome-Based Fraud Contractors

CMS reports that its program-integrity efforts—using more than 300 analytics models, AI tools, and investigator review—generate an estimated $42 billion in annual savings by identifying suspected fraud and stopping payments. CMS is also seeking industry input through an RFI on restructuring its fraud-defense contracts, including a potential outcome-focused model that could move more investigative execution and case-building work to contractors; responses are due November 27, 2026, 17 days from the current date. Separately, Education’s Federal Student Aid office says its real-time FAFSA fraud-detection capability is on pace to prevent about $1.2 billion in fraud. These activities point to federal demand for analytics, identity verification, human review, and secure data sharing, but the signals identify no open solicitation or named technology provider beyond CMS’s RFI.

- The CMS RFI is the clearest near-term procurement action. Interested firms can submit industry recommendations by **November 27, 2026**; the contemplated outcome-focused model could affect how fraud investigations and case development are assigned and measured.
- Contractors with relevant analytics, AI-enabled monitoring, identity verification, and investigative case-management capabilities may find these requirements relevant across healthcare and student-aid programs. The signals do not identify a specific solicitation, award, or technology provider for the reported savings.
- CMS also reports a separate $109 million Comprehensive Error Rate Testing program support contract for measuring improper Medicare fee-for-service payment rates. Firms evaluating CMS opportunities should distinguish this existing support work from the RFI’s potential restructuring of fraud-defense contracts.

**Jurisdictions:** federal
**Industries:** Healthcare, Information Technology
**Topics:** Artificial Intelligence, Digital Infrastructure, Contracting Vehicles
**Published:** November 09, 2026

### Government Entities
- Centers for Medicare and Medicaid Services (CMS)
- U.S. Department of Education (Education Department)
- Federal Student Aid (FSA)

### Vendors
- Serco (awardee)
- Oracle (AI pilot participant)
- Socure ()

### Key Quotes
> With the real-time detection that we have on the FAFSA, we’re at pace right now that we’re going to track about $1.2 billion worth of fraud prevention in our space.
> — Richard Lucas, Acting Chief Operating Officer, Federal Student Aid

> Fraud is like running water. It is going to find the path of least resistance.
> — Jordan Burris, Head of Public Sector at Socure

### Sources
- [
        CMS, Education tout data-driven fraud prevention savings - Federal News Network](https://federalnewsnetwork.com/agency-oversight/2026/11/cms-education-tout-data-driven-fraud-prevention-savings) - Federal News Network
- [CMS and Student Aid Officials Detail Efforts to Stop Fraud Before Payment – MeriTalk](https://www.meritalk.com/articles/cms-and-student-aid-officials-detail-efforts-to-stop-fraud-before-payment) - MeriTalk
- [Messick: CMS Fraud Prevention Yields $42B Annual Savings](https://www.executivegov.com/articles/cms-messick-fraud-prevention-42b-annual-savings-ai) - ExecutiveGov