Federal prosecutors say Minnesota's Medicaid system is facing a fraud crisis so large it could eclipse 9 billion dollars, a figure that would rank among the most staggering public-assistance scandals ...

BOSTON, Dec. 15, 2025 /PRNewswire/ -- Basys.ai, an agentic AI-powered prior authorization and utilization management platform, has been selected by the Centers for Medicare & Medicaid Services (CMS) ...

Shireen Gandhi, temporary commissioner of the Minnesota Department of Human Services, speaks at a Dec. 12 news conference at the State Capitol as Gov. Tim Walz looks on. Credit: Matthew Blake for ...

Milliman, a global leader in actuarial and healthcare analytics, is proud to announce it has been selected as a finalist in the Centers for Medicare & Medicaid Services (CMS) “Crushing Fraud Chili ...

The CMS created ACCESS to address barriers to care stemming from Medicare’s fee-for-service payment model. Rather than pay for specific services, Medicare will make recurring payments to healthcare ...

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 ...

Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz on Friday warned Minnesota Gov. Tim Walz the state could lose federal Medicaid funding unless it restores "the integrity" of its ...

The Centers for Medicare and Medicaid Services (CMS) says the agency is "increasingly concerned with the performance and integrity of Minnesota’s Medicaid program." The letter signed by Dr. Mehmet Oz ...

Audit activity is expanding in the nursing home sector, with improper payments rising and nursing homes continuing to lead in documentation errors. As a result, the Centers for Medicare and Medicaid ...

CMS is reviving and expanding the national Competitive Bidding Program (CBP) through its 2026 home health final rule, a move that will directly affect access to continuous glucose monitors (CGMs) and ...