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 ...

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 and Medicaid Services announced Tuesday that it will expand the Medicare Prior Authorization Model for Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) ...

* * * Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program Notice for Proposed Rulemaking (CMS-2434-P) The Centers for Medicare & ...

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 ...

Milliman, Inc. is proud to announce that it has been selected as the winner of the Centers for Medicare & Medicaid Services ...

RESTON, Va.--(BUSINESS WIRE)--NCI, Inc. (NASDAQ:NCIT), a leading provider of information technology (IT) and professional services and solutions to U.S. Federal Government agencies, announced today ...

Federal regulators should audit all Medicare Advantage (MA) plans yearly to boost oversight of the program, which has come under criticism from Congress for overpayments, a key advocacy group said.

The Centers for Medicare and Medicaid Services today released the final rule to change the methodology for the U.S. Department of Health and Human Services' risk adjustment data validation (HHS-RADV) ...

Serving as the primary liaison for the $50 billion Rural Health Transformation Program, the ORHT is now responsible for ...