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

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 ...

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

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

Dozens of influential divisions within the Trump administration‘s Centers for Medicare & Medicaid Services are headed by holdovers from the Obama and Biden administrations, a Washington Examiner ...

The Trump administration is temporarily halting some federal Medicaid funding to Minnesota, Vice President JD Vance said ...

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

Diana Shaw of Wiley Rein LLP examines a recent HHS Office of Inspector General advisory on direct-to-consumer prescription ...

CMS blocks durable medical equipment enrollments nationwide with a six-month moratorium to curb suspected fraudulent billing in Medicare programs.

Vice President JD Vance and CMS Administrator Mehmet Oz, MD, announced a series of actions affecting Medicare and Medicaid, including a $259.5 million deferral of federal Medicaid funding in Minnesota ...