---
kind: "section"
citation: "42 U.S.C. § 1320a–7n"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1320a–7n"
heading: "Disclosure of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and abuse"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1320a-7n"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XI — General Provisions, Peer Review, and Administrative Simplification"
  - "Part A — General Provisions"
---

# §1320a–7n. Disclosure of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and abuse

- (a) **Reference to predictive modeling technologies requirements—** For provisions relating to the use of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and [abuse](/usc/42/1397j.md?p=1) with respect to the Medicare program under subchapter XVIII, the Medicaid program under subchapter XIX, and the Children’s Health Insurance Program under subchapter XXI, see [section 1320a–7m of this title](/usc/42/1320a–7m.md).
- (b) **Limiting disclosure of predictive modeling technologies—** In implementing such provisions under such [section 1320a–7m](/usc/42/1320a–7m.md) with respect to covered algorithms (as defined in [subsection (c)](#c)), the following shall apply:
  - (1) **Nonapplication of FOIA—** The covered algorithms used or developed for purposes of such [section 1320a–7m](/usc/42/1320a–7m.md) ([including](/usc/42/1301.md?p=b) by the [Secretary](/usc/42/1301.md?p=a-6) or a [State](/usc/42/619.md?p=5) (or an entity operating under a contract with a [State](/usc/42/619.md?p=5))) shall be exempt from disclosure under [section 552(b)(3) of title 5](/usc/5/552.md?p=b-3).
  - (2) **Limitation with respect to use and disclosure of information by State agencies—**
    - (A) **In general—** A [State agency](/usc/42/629a.md?p=a-3) may not use or disclose covered algorithms used or developed for purposes of such [section 1320a–7m](/usc/42/1320a–7m.md) except for purposes of administering the [State](/usc/42/619.md?p=5) plan (or a waiver of the plan) under the Medicaid program under subchapter XIX or the [State child health plan](/usc/42/1397jj.md?p=c-7) (or a waiver of the plan) under the Children’s Health Insurance Program under subchapter XXI, [including](/usc/42/1301.md?p=b) by enabling an entity operating under a contract with a [State](/usc/42/619.md?p=5) to assist the [State](/usc/42/619.md?p=5) to identify or prevent waste, fraud, and [abuse](/usc/42/1397j.md?p=1) with respect to such programs.
    - (B) **Information security—** A [State agency](/usc/42/629a.md?p=a-3) shall have in effect data security and control policies that the [Secretary](/usc/42/1301.md?p=a-6) finds adequate to ensure the security of covered algorithms used or developed for purposes of such [section 1320a–7m](/usc/42/1320a–7m.md) and to ensure that access to such information is restricted to authorized [persons](/usc/42/1301.md?p=a-3) for purposes of authorized uses and disclosures described in [subparagraph (A)](#b-2-A).
    - (C) **Procedural requirements—** [State agencies](/usc/42/629a.md?p=a-3) to which information is disclosed pursuant to such [section 1320a–7m](/usc/42/1320a–7m.md) shall adhere to uniform procedures established by the [Secretary](/usc/42/1301.md?p=a-6).
- (c) **Covered algorithm defined—** In this section, the term “covered algorithm”—
  - (1) means a predictive modeling or other analytics technology, as used for purposes of [section 1320a–7m(a) of this title](/usc/42/1320a–7m.md?p=a) to identify and prevent waste, fraud, and [abuse](/usc/42/1397j.md?p=1) with respect to the Medicare program under subchapter XVIII, the Medicaid program under subchapter XIX, and the Children’s Health Insurance Program under subchapter XXI; and
  - (2) [includes](/usc/42/1301.md?p=b) the mathematical expressions utilized in the application of such technology and the means by which such technology is developed.

## Source credit

(Aug. 14, 1935, ch. 531, title XI, § 1128K, as added Pub. L. 114–198, title VII, § 706(a), July 22, 2016, 130 Stat. 753.)