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 take health care from people who can least afford it.

New York is about to get the Oz treatment. Medicaid czar Dr. Mehmet Oz is turning up the heat on Gov. Kathy Hochul, launching ...

As it continues to put a focus on addressing fraud, waste and abuse in healthcare, the CMS said it is also seeking feedback on additional fraud prevention strategies it could use in a future rule as ...

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 ...

The US Centers for Medicare & Medicaid Services (CMS) finalized important changes to the Medicare provider and supplier enrollment regulations, including adding marriage and family therapists (MFTs) ...

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

CMS must increase its oversight of Medicaid managed care programs by requiring states to audit payments to and by managed care organizations, according to a Government Accountability Office report. In ...

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

LAS VEGAS—Federal health officials are taking a more aggressive, data-driven approach to combating healthcare fraud, using analytics and cross-agency collaboration to stop suspicious payments before ...

Leading Republicans are looking toward the Government Accountability Office (GAO) to ensure CMS' new premium stabilization demonstration program is legal and in the best interest of seniors. In a ...