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Artificial Intelligence at CMS

At CMS, Artificial Intelligence (AI) has the power to reshape the way we use data to make decisions. In fact, because CMS is such a data-rich agency, there is no better place to implement AI technology. To do so responsibly, we must educate our workforce, share knowledge with our partners, follow ethical standards, and experiment with new methodologies.

That is why we have created this website. It offers a starting point for stakeholders interested in any aspect of AI at CMS.

Leveraging the power of AI to serve America's healthcare needs

With nearly 150 million Americans enrolled in Medicare, Medicaid, and the Child Health Insurance Program, CMS possessesone of the most robust data portfolios in the federal government. We house patient and provider claims, beneficiary enrollments, and medical records, along with internal data such as budget documents and contract records.

Artificial Intelligence (AI) will play a key role in leveraging all of this data to fulfill its mission of advancinghealth equity, expanding coverage, and improving health outcomes for the American public. As defined by the Department of Health and Human Services, “AI enables computer systems to perform tasks normally requiring human intelligence.”

AI can analyze data, automate labor-intensive processes, find operational efficiencies, provide business insights, interact with customers, make predictions, identify disparities, and reveal new ways of solving problems. In short, AI is an emerging technology that will positively impact both CMS and the public we serve. The impacts include cost savings and better health outcomes.

CMS AI Resources

Those who wish to engage in AI-related activities, as either a CMS employee, partner, or vendor, should be aware of federal policies regarding the application of AI. Following are links to foundational governance documents on AI and other related resources:

  • Executive Order 13859: Maintaining American Leadership in Artificial Intelligence

    This 2019 Executive Order sets forth a federal strategy for promoting advancements in AI technology and innovation while protecting American technology, economic and national security, civil liberties, privacy, and American values and enhancing international and industry collaboration with foreign partners and allies.

  • National Artificial Intelligence Act of 2020

    The National AI Initiative Act of 2020 (DIVISION E, SEC. 5001) became law on January 1, 2021, providing for a coordinated program across the entire Federal government to accelerate AI research and application for the Nation’s economic prosperity and national security. The mission of the National AI Initiative is to ensure continued U.S.leadership in AI research and development, lead the world in the development and use of trustworthy AI in the public and private sectors, and prepare the present and future U.S. workforce for the integration of AI systems across all sectors of the economy and society.

  • The National Artificial Intelligence Initiative

    This website contains news and information about the five pillars of the national AI strategy as outlined in the National AI Initiative Act of 2020. Those pillars are: innovation, advancing trustworthy AI, education and training, infrastructure, applications, and international cooperation.

  • CMS AI Playbook

    Does leveraging AI seem as overwhelming as it does promising? Don’t worry. The AI Playbook is your how-to manual with detailed guidance on key design principles, best practices, and step-by-step instructions for building mission-critical, trustworthy AI solutions. It is designed to be readable even for those unfamiliar with the more technical concepts of AI. While leadership and managers alike can learn from the high-level principles in the playbook and apply them to their technology strategy, the Playbook’s full explanation of enterprise-level AI at CMS is especially useful for those with technical talent looking to get in on the ground floor.

    The Playbook also covers Responsible AI, a governance framework that defines the principles and practices an organization follows to address the societal, ethical, and legal impacts of AI. As AI processes mature and are deployed at greater scale, it will also be necessary to regularly measure the integrity of those processes via automation, sometimes called Machine Learning Operations (MLOps), also addressed in the Playbook.

  • HHS Trustworthy AI Playbook

    The goal of Trustworthy AI is to maximize the benefits while minimizing the risks of novel AI-enabled technologies. The Playbook covers six overarching principles of Responsible AI, based on Executive Order 13960, “Promoting the Use of Trustworthy Artificial Intelligence in the Federal Government," and OMB Memorandum M-21-06,“Guidance for Regulation of Artificial Intelligence Applications.” According to the Playbook, AI should be:

    • fair and impartial
    • transparent and explainable
    • responsible and accountable
    • robust and reliable
    • private
    • safe and secure

    Additionally, the Playbook lists concrete steps we can take to encode these principles while designing AI solutions.