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

The Centers for Medicare & Medicaid Services (CMS) on Wednesday singled out personal care and home- and community-based services (HCBS) in announcing ...

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

The federal government must do a better job of folding aging services providers into healthcare solutions as it seeks to reduce administrative burdens, limit unnecessary hospitalizations and improve ...

CMS finalized a rule this week that ends what it called a healthcare‑related 'financing gimmick,' marking one of the most sweeping Medicaid program‑integrity actions in years. CMS said some states set ...

WASHINGTON, D.C. — The Trump administration’s Centers for Medicare & Medicaid Services this past Monday launched a rapid-fire slate of policy moves spanning drug price negotiations, Medicare Advantage ...

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 ...

Florida remains one of a small number of states that hasn’t seen a Medicaid program reauthorized. If an approval doesn’t come before the end of the month, it could throw ...