CMS is gathering information for and seeking industry feedback on a project that would consolidate the audit and investigation services for Medicare and Medicaid integrity functions, creating new ...

Weaponizing fraud and using it as a pretext to take funds away from states will destabilize their programs and ultimately ...

Medicaid-funded home care remains a flashpoint across the country, with the Trump administration raising the stakes for ...

Workload data used by CMS to oversee Zone Program Integrity Contractors has been inaccurate and inconsistent, and this has led to several ZPIC reporting errors and inconsistencies within information ...

The Trump administration launches fraud probe into New York's Medicaid program, citing alleged waste. Gov. Kathy Hochul has ...

As it continues to put a focus on addressing fraud, waste and abuse in healthcare, the CMS said it is also seeking feedback ...

The Trump administration and 119th Congress are preparing to reduce federal expenditures by targeting Medicare and Medicaid fraud, waste, and abuse. Medicare enrollment revocations, Medicaid ...

Agentic AI can connect historical behavior, evolving utilization signals and payment integrity requirements into a single ...

Jennifer Sheets, the new CEO of the National Alliance for Care at Home (the Alliance), is focusing “first and foremost” on ...

The Centers for Medicare & Medicaid Services (CMS) on Sept. 20, 2024, released the Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate ...

A constant refrain from the Trump administration about rooting out fraud, waste and abuse isn’t just about budget cuts. For nursing homes, it may signal increasing audit risk and a rise in burdensome ...

The U.S. Centers for Medicare and Medicaid Services alleges the Indianapolis-based health insurer has failed to properly submit required information to federal regulators since 2018.