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 ...

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

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

President Donald Trump’s administration has moved to shut down a long‑running Medicaid financing loophole that officials say allowed states to shift billions in costs onto federal taxpayers. 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 ...

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 ...