The Centers for Medicare and Medicaid Services has moved to make anti-fraud enforcement a centerpiece of the Trump administration’s health care agenda, unveiling a new initiative called CRUSH and asking the public for input on how to detect suspicious billing faster, including through analytics and AI. The agency says the effort is designed to stop improper payments before they go out the door and to strengthen oversight across Medicare, Medicaid, CHIP and the Health Insurance Marketplace.
What CMS proposed
In late February, CMS issued a request for information on a possible future rule under its Comprehensive Regulations to Uncover Suspicious Healthcare initiative, or CRUSH, with comments due March 30, 2026. The agency said it wants ideas from states, providers, payers, technology companies, patient advocates and beneficiaries on how to better prevent, detect and respond to fraud, waste and abuse. CMS framed the effort as part of a broader shift away from a “pay and chase” model toward a “detect and deploy” approach that uses real-time tools to flag suspicious activity earlier.
“For decades, Medicare fraud has drained billions from American taxpayers—that ends now,” Health and Human Services Secretary Robert F. Kennedy, Jr., said, noting that CMS is replacing the traditional “pay and chase” model with a modernized “detect and deploy” strategy powered by advanced artificial intelligence tools.
Sec. Kennedy, Vice President J.D. Vance, and Administrator of the Centers for Medicare & Medicaid Services (CMS), Dr. Mehmet Oz, announced the actions during a White House event, describing them as a decisive shift toward real-time fraud detection and accountability.
AI and real-time detection
A central part of the proposal is the use of advanced analytics and artificial intelligence to identify fraud as it is happening rather than after the fact. The agency said it is looking for feedback on both existing authorities and possible new regulatory approaches that could improve program integrity and payment accuracy. That emphasis reflects the administration’s wider push to use data-driven enforcement to clamp down on wasteful spending.
Broader crackdown
The CRUSH request for information arrived alongside other enforcement steps, including a six-month moratorium on new Medicare enrollment for certain durable medical equipment, prosthetics, orthotics and supplies suppliers. CMS also said it deferred $259.5 million in federal Medicaid funding for Minnesota while it reviews questionable claims and program integrity problems. The agency said the combined actions are meant to protect taxpayer dollars, reduce improper payments and lower costs for beneficiaries.
What happens next
The RFI is not itself a final rule, but it gives CMS a roadmap for a future proposed regulation and possibly other policy changes. CMS said the public comments will help shape how aggressively it can pursue fraud prevention across federal health programs. The agency has signaled that the eventual CRUSH rule could be broad, touching multiple parts of the health care system rather than a single payment category.
As part of the crackdown, the federal agency deferred $259.5 million in Medicaid matching funds to Minnesota after citing serious concerns about questionable or unsupported claims. The move came after an earlier January notice that flagged deficiencies in the state’s program integrity oversight and ordered corrective action.
