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

The Centers for Medicare & Medicaid Services (CMS) has announced a nationwide, six-month Medicare enrollment moratoria for new hospices and ...

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

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 ...

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 ...

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 ...

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 ...

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 ...

Jeneen Iwugo, Acting Director for the Center for Program Integrity at CMS, discusses the potential of agentic automation to streamline decision-making processes, particularly in handling claims and ...

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 ...