A new skilled nursing facility validation program could be the “tip of the iceberg” in verifying provider quality ...

Medicare erroneously paid an estimated $729 million to doctors and other health professionals under a multibillion-dollar federal initiative designed to shift the health-care system from paper ...

Health care companies say they're losing millions of dollars that are tied up in appeals because of increasing numbers of Medicare audits. But the rise in the often duplicative audits has failed ...

“The initiatives released today are essential to help strengthen and preserve the foundation of the program for the millions of Americans who depend on Medicaid’s safety net.

CMS recently announced it will move forward with a new initiative to reduce errors within Medicare Advantage plans, which is expected to save an estimated $370 million in overpayments for the ...

The plan calls for eight "new or enhanced" initiatives—including audits targeting certain state programs and certain known vulnerabilities—on top of 10 initiatives already underway, according ...

The Centers for Medicare & Medicaid Services launched several initiatives on Tuesday aimed at cutting down on fraud and waste in Medicaid. The programs, Administrator Seema Verma told reporters at ...

As you probably know, the RAC program allows audit contractors to challenge allegedly incorrect Medicare payments (and collect a 20 percent bounty for their trouble).

CMS will consolidate several Medicare quality reporting programs into a single contract worth up to $25 billion, the agency announced on May 15, 2018. The initiative is called the “Network of ...

Estimates suggest that Medicare Advantage plans may be overbilling by $17-43 billion annually, driving an expansion of aggressive audits. Leadership Accountability Across Departments ...

The Center for Health Insurance Reforms (CHIR) at the McCourt School of Public Policy launched a Medicare Policy Initiative, which will provide quick, short-term healthcare policy analysis for ...

Federal officials are planning a wide range of audits into billing and government spending on managed health care in the new fiscal year, ranging from private Medicare Advantage groups that treat ...