Las Vegas – The Centers for Medicare & Medicaid Services (CMS) is exploring the use of artificial intelligence (AI) to help Medicare beneficiaries navigate the complexities of their healthcare, a move officials announced at the HIMSS conference on Thursday, March 13, 2026. This initiative comes as the agency simultaneously leverages AI to combat fraud within the Medicare system, signaling a broader strategy to integrate the technology across multiple facets of the program. The push for AI-powered tools reflects a growing recognition of the need to modernize healthcare and address rising costs, but also acknowledges the significant hurdle of building trust among a population that remains largely skeptical of the technology.
CMS Administrator Dr. Mehmet Oz emphasized the disparity between technological advancements in healthcare and other sectors of the U.S. Economy. He argued that although other industries have seen deflationary effects from technology adoption, healthcare costs continue to climb. “The fundamental problem right now is that other sectors of the U.S. Economy have advanced and been deflationary with their use of technology,” Dr. Oz stated during a panel discussion. “Healthcare has remained inflationary.” The agency’s vision involves deploying “AI agents” – autonomous AI systems – to assist beneficiaries in finding appropriate doctors and selecting Medicare Advantage plans, with a goal of having these tools available before the end of the current administration. This ambitious plan, however, is tempered by the reality that only 31% of Medicare enrollees aged 65 and older currently express trust in AI for accessing medical records and receiving personalized health advice, according to a 2025 survey by the Kaiser Family Foundation (KFF). KFF survey on AI trust
Addressing Beneficiary Skepticism and Building Trust
Dr. Oz pinpointed a key challenge: demonstrating the tangible benefits of AI to Medicare beneficiaries. “No one has gotten to them with the use case of why it’ll transform their life for the better,” he explained. He suggested that current AI applications often appear geared towards institutional needs, such as hospital efficiency, rather than directly addressing the concerns and needs of individual patients. Overcoming this perception will be crucial for successful adoption. The CMS is attempting to address this through its Health Tech Ecosystem, launched last year, which aims to foster partnerships with the private sector to expand access to conversational AI tools. This ecosystem seeks to ease data exchange and increase the availability of digital health solutions, including AI-powered chatbots designed to help patients navigate their care and discuss their health concerns.
Several companies are already responding to this call. OpenAI launched its health-focused AI tool in January 2026, and Microsoft announced Copilot Health this week, both designed to provide health-related information and assistance. OpenAI’s ChatGPT Health launch Microsoft’s Copilot Health announcement However, the potential for misuse and the dissemination of inaccurate information remain significant concerns. Recent research published in *Nature* found that OpenAI’s consumer health chatbot frequently “under-triaged” cases, failing to recognize the severity of certain conditions and potentially delaying necessary emergency care. Nature research on OpenAI chatbot triaging
AI and Fraud Detection: A Current Success Story
While the rollout of AI-powered tools for patient navigation is still in its early stages, the CMS is already successfully utilizing AI to combat fraud within the Medicare program. Kimberly Brandt, COO and deputy administrator at the agency, explained that they are employing algorithms trained on data from previous enforcement actions against fraudulent providers. This allows the CMS to identify potentially problematic new providers during the enrollment process. “We wanted to use AI to really help us be able to find out where the problems are,” Brandt said. This proactive approach is part of a broader effort by the current administration to prioritize fraud prevention, demonstrated by the recent halting of $259 million in Medicaid funds to Minnesota due to unsupported claims and a six-month moratorium on Medicare enrollment for certain durable medical equipment suppliers. CMS halts Medicaid funds to Minnesota CMS targets DME suppliers in fraud crackdown
The CMS Health Tech Ecosystem and Interoperability
The broader context for these AI initiatives is the CMS’ Health Tech Ecosystem, an initiative launched in 2025 to improve data exchange and promote the adoption of digital health tools. Amy Gleason, acting administrator of the U.S. Digital Service and senior advisor to the CMS, highlighted the goal of expanding access to conversational AI within this framework. The ecosystem aims to connect patients with the right information and resources, streamlining the healthcare experience. This initiative builds upon ongoing efforts to enhance interoperability, allowing for seamless data sharing between healthcare providers and systems. HIMSS, a global advisor and thought leader serving the health information and technology communities, has also set recommendations for a path to Medicare digital quality measure reporting, advocating for FHIR-enabled digital quality measures as the standard for all CMS programs. HIMSS recommendations for digital quality measures
However, the implementation of these technologies is not without its challenges. Experts caution that AI chatbots can sometimes provide inaccurate or misleading information, a phenomenon known as “hallucinations.” Gleason acknowledged this risk but argued that even human doctors are prone to errors. “The same will happen with AI, and they’re the dumbest today that they’ll ever be,” she said, emphasizing the need for ongoing learning and improvement. She believes that embracing AI and educating patients about its potential benefits is essential for realizing its transformative power in healthcare.
Key Takeaways
- The CMS is actively exploring the use of AI to improve Medicare beneficiary navigation and combat fraud.
- Beneficiary trust remains a significant hurdle to AI adoption in healthcare.
- The CMS Health Tech Ecosystem aims to foster innovation and data exchange through partnerships with the private sector.
- AI-powered fraud detection is already yielding positive results for the Medicare program.
- Ongoing research and careful implementation are crucial to mitigate the risks associated with AI chatbots.
The CMS is expected to provide further updates on the development and rollout of AI-powered tools for Medicare beneficiaries in the coming months. The agency will likely focus on addressing concerns about data privacy, security, and algorithmic bias as it moves forward. The success of this initiative will depend on building trust with beneficiaries and ensuring that AI is used responsibly and ethically to improve the quality and accessibility of healthcare. Readers are encouraged to share their thoughts and experiences with AI in healthcare in the comments below.
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