The Centers for Medicare & Medicaid Services (CMS) has announced a nationwide, six-month Medicare enrollment moratoria for new hospices and ...
On April 23, 2026, Dr. Mehmet Oz, in his capacity as Administrator of the Centers for Medicare & Medicaid Services ("CMS"), ...
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 ...
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New York Medicaid fraud enforcement draws scrutiny as federal audit nears
New York Medicaid Fraud Enforcement Draws Scrutiny as Federal Audit Nears ...
The buck stops here. We’ve got to clean up the system. With these words, Dr. Mehmet Oz, now at the helm of the Centers for Medicare and Medicaid Services (CMS), signaled a pivotal moment for Medicaid ...
CMS has announced it is consolidating its efforts with new program-integrity contractors that will look at billing trends and patterns across Medicare. These contractors will focus on companies and ...
Amber Nigam is CEO and cofounder of basys.ai, a Harvard-based company streamlining prior authorization for health plans with agentic AI. Fraud, waste and abuse (FWA) has historically been addressed at ...
The Government Accountability Office has issued a report recommending CMS more clearly communicate its goals for the Medicare Integrity Program and improve the reliability of data used to calculate ...
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 ...
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 ...
As Congress continues to debate next steps on the Affordable Care Act's (ACA's) enhanced subsidies, insurers are urging legislators to consider an extension with additional program integrity measures ...
CMS agency is recruiting engineers, cybersecurity specialists and data scientists while expanding its use of AI tools to identify fraudulent payments.
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