OIG issued a new report finding that in 2022 some Medicaid managed care plans self-reported making no or very few potential provider fraud, waste, and abuse referrals. OIG reported that 33 plans, ten ...
CMS has rolled out the “Crushing Fraud Chili Cook‑Off Competition,” a market-based research challenge seeking explainable AI and machine learning to detect Medicare fraud, waste and abuse. The ...
LUTZ, Fla., Nov. 19, 2025 /PRNewswire/ -- MyCare Medical, a participant in the CMS Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, expressed strong ...
ACOs are focusing on identifying and addressing anomalous billing, such as for catheters and skin substitutes, to prevent fraud and protect shared savings. Collaboration with payers, regulators, and ...
Protect Medicaid signs light up at protect Medicaid lights up the U.S. Capitol amid a budget showdown on May 7, 2025 in Washington, DC. (Photo by Leigh Vogel/Getty Images) We find ourselves in an ...
CMS will share its data analytics tools and best practices for preventing medical claims fraud, waste and abuse with the U.S. Department of Veterans Affairs, the agencies announced Jan. 23. Under the ...
My Administration has been relentlessly committed to rooting out waste, fraud, and abuse in Government programs to preserve and protect them for those who rely most on them. The Medicaid program was ...
BOSTON, Dec. 15, 2025 /PRNewswire/ -- Basys.ai, an agentic AI-powered prior authorization and utilization management platform, has been selected by the Centers for Medicare & Medicaid Services (CMS) ...
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