On February 25, 2026, the Centers for Medicare & Medicaid Services (“CMS”) announced several program integrity actions impacting Medicaid funding and Medicare supplier enrollment, along with a request ...

New York is about to get the Oz treatment. Medicaid czar Dr. Mehmet Oz is turning up the heat on Gov. Kathy Hochul, launching ...

The history of HCBS demonstrates that its growth is not, in fact, evidence of massive undetected fraud, but rather is based on decades of federal policy response to major demographic change, guided by ...

The Trump administration launches fraud probe into New York's Medicaid program, citing alleged waste. Gov. Kathy Hochul has ...

On February 26, 2026, the Trump Administration announced “new steps to crack down on fraud in Medicare and Medicaid to protect patients and ...

Kim Brandt, CMS’s chief operating officer and deputy administrator, said AI tools are helping the agency stop money from going out the door to fraudsters.

Amber Nigam is CEO and cofounder of basys.ai, a Harvard-based company streamlining prior authorization for health plans with agentic AI. Fraud, waste and abuse (FWA) has historically been addressed at ...

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 ...

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 ...