The Deficit Reduction Act of 2005 provided the resources to establish the Medicaid Integrity Program (MIP), the first national strategy in the 40-year history of the Medicaid program to promote the ...

Agentic AI can connect historical behavior, evolving utilization signals and payment integrity requirements into a single control framework that adapts over time.

Gainwell Technologies LLC, a leading innovator in healthcare technology and Medicaid modernization, will participate in the 2026 State Healthcare IT (HIT) Connect Summit Feb. 23-26 at the Hyatt ...

A third-party audit of the Minnesota Department of Human Services identified more than $1 billion in Medicaid funding that may be vulnerable to waste, fraud and abuse.

Nine people are facing charges for allegedly defrauding Ohio Medicaid through overbilling, services not rendered, and ...

A sweeping Republican bill aiming to reform Kentucky’s Medicaid program would impose copays on some patients, among other changes that advocates say would put up barriers to care. House Bill 2 was ...

Newsom’s political antics do nothing to resolve the deeper issue—namely, that Medicaid fraud costs taxpayers billions of dollars every year.

Since 1992, the 340B drug discount program has entitled certain federal grantee clinics and hospitals (called “covered entities”) to purchase outpatient drugs at substantial discounts. The discounted ...

We literally alerted them, and they did nothing until about two years later,” said Kelly Milan, the founder of the Colorado Transportation Alliance, about HCPF’s high rates used ...

The Minnesota Department of Human Services has launched a fact-checking website aimed at addressing what officials describe as misleading and false claims about Medicaid fraud in the state.

Minnesota officials say the site will "correct misleading information and outright false claims" about Medicaid fraud in the state.