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

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 ...

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 ...

CMS Administrator Dr. Mehmet Oz said his agency paused the payment of $259 million of deferred Medicaid payments to Minnesota ...

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

The move is part of the “war on fraud” that Trump announced during his State of the Union address. It’s the latest action ...

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 ...

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 ...

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 ...