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.

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 ...

WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services (CMS) announced a new oversight initiative aimed at ensuring that enrollees in Medicaid and the Children’s Health Insurance Program ...

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 ...

Groundbreaking AI solution recognized as best-in-class for combating Medicare fraud Milliman, Inc. is proud to announce that it has been selected as the winner of the Centers for Medicare & Medicaid ...

Despite the late Justice Louis Brandeis's famous praise of the American political system for helping courageous states serve as "laboratories of democracy," the Centers for Medicare & Medicaid ...

Since 1992, the 340B drug discount program has entitled certain federal grantee clinics and hospitals (called “covered entities”) to purchase outpatient drugs at substantial discounts. The discounted ...