Workload data used by CMS to oversee Zone Program Integrity Contractors has been inaccurate and inconsistent, and this has led to several ZPIC reporting errors and inconsistencies within information ...

The Trump administration and 119th Congress are preparing to reduce federal expenditures by targeting Medicare and Medicaid fraud, waste, and abuse. Medicare enrollment revocations, Medicaid ...

CMS, the Office of Inspector General and other governmental agencies have ramped up their stance on healthcare fraud and abuse, estimating that roughly $4.1 billion in taxpayer money was recovered in ...

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 ...

CMS has announced it is consolidating its efforts with new program-integrity contractors that will look at billing trends and patterns across Medicare. These contractors will focus on companies and ...

Medicaid is the joint federal-state health insurance program that provides medical coverage to almost five million low-income, elderly, disabled Floridians and children. Although the federal ...

The Government Accountability Office has issued a report recommending CMS more clearly communicate its goals for the Medicare Integrity Program and improve the reliability of data used to calculate ...

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 ...

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 ...

Minnesota DHS announces a freeze on enrolments for new providers in 13 Medicaid service categories prone to fraud, aiming to ...

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 ...