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

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.

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

In post-acute care, Medicare is not an abstract federal program. It is Mrs. Thompson’s therapy after a hip fracture. It is Mr. Alvarez’s swallow ...

The decision is part of a crackdown on fraud to prevent payment of questionable claims while further investigation is completed, HHS says.

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 ...