After placing both parents in hospice, former CMS integrity leader Dara Corrigan offers a firsthand look at hospice fraud, ...

Medicaid program integrity efforts have been ramping up quickly, and last week we saw clear evidence of this trend when the ...

As discussed in our prior Alert, on May 13, 2026, the Centers for Medicare & Medicaid Services (CMS) announced two nationwide, six-month moratoria ...

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 ...

The buck stops here. We’ve got to clean up the system. With these words, Dr. Mehmet Oz, now at the helm of the Centers for Medicare and Medicaid Services (CMS), signaled a pivotal moment for Medicaid ...

CMS is gathering information for and seeking industry feedback on a project that would consolidate the audit and investigation services for Medicare and Medicaid integrity functions, creating new ...

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 ...

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 ...

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 ...

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 ...

The Trump administration unveiled a new program to speed up Medicare coverage for breakthrough devices, touting that the new pathway cuts red tape for medical device companies to gain reimbursement.