06/23/2026
They are using AI to find people now. And it is not just the person in the mugshot. It is everyone connected to them.
The placement agent. The social worker. The home health agency. The physician group. If your name touches their
billing, the AI pulls you in too.
It is a process called network analysis. One provider gets flagged, and the AI maps everyone connected. Who referred
patients. Who shared patients. Who billed alongside them. One thread gets pulled and the whole web lights up. CMS even
built a unit just for this. In its first year it flagged over 340 providers and stopped more than $1.4 billion before
it went out the door. This is not pay and chase anymore. It is detect and deploy.
And there is a moratorium right now. As of May 2026, CMS froze all new home health and hospice enrollments for six
months, and Texas is named a high fraud risk state with extra review on every claim.
Here is the part that should scare every owner. If they flag you, they go straight to your billing. They pull a
sample. If the error rate is high, they do not just bill you for those claims. They extrapolate it and go back six
years. That is the law. A small error on a sample becomes a number applied to six years of claims, plus triple damages
and a penalty on every single claim. A few mistakes can end a business.
This is exactly why owners NEED AI built for them. The same AI they use to find you, you should be using to protect
yourself. AI can make you money, save you money, and protect your business, all while doing the heavy lifting.
If you want AI customized for your business, reach out to me. I build on Claude, the same AI the government is using.
And if you want to check your billing before they do, run it through ClaimGuard. Find out if you are compliant on your
terms, not theirs.
Reach out if you want integrated in your business or want to learn how to make it work for you. 346.546.5654
👉 https://claimguard.poweredbyerika.com