The Centers for Medicare & Medicaid Services (CMS) has issued its Advance Notice and related rulemaking for the Medicare Advantage (MA) and Part ...

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 ...

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 Centers for Medicare & Medicaid Services (CMS) has set a net average increase of 2.48% for Medicare Advantage plans in calendar year 2027, representing more than $13 billion in additional ...

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 Centers for Medicare & Medicaid Services is implementing the Substance Access Beneficiary Engagement Incentive, a new ...

Organizations across the health care continuum, including the home-based care industry, have responded to the Centers for Medicare and Medicaid (CMS)’ ...

A constant refrain from the Trump administration about rooting out fraud, waste and abuse isn’t just about budget cuts. For nursing homes, it may signal increasing audit risk and a rise in burdensome ...

The Centers for Medicare and Medicaid Services (CMS) on Thursday issued its Skilled Nursing Facility Prospective Payment ...

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 ...