The Trump administration says its war on fraud applies to the entire country. But only blue states have had their Medicaid ...

Advancing technology, evolving healthcare legislation, and the transition from fee-for-service to value-based care models is catalyzing a rapid transformation in American healthcare. Ensuring these ...

Unified Program Integrity Contractors (UPICs) operate within the universe of Medicare and Medicaid program integrity ...

Serco Awarded $109 Million CMS CERT Contract, Extending Support of Medicare Program Integrity The CMS CERT program is a vital ...

As the fog of the COVID-19 war continues to dissipate, it has become increasingly clear that hundreds of billions of dollars were needlessly added to the national debt due to the government’s ...

Medicaid, the federal and state program that provides health coverage to low-income and elderly adults, children, pregnant women and people with disabilities, is countercyclical by nature. During an ...

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 ...

“Program integrity” is the sort of technical term that sounds good. Who wouldn’t want to run Social Security with integrity? But unfortunately, in the Alice-in-Wonderland world of Washington-speak, ...

Late yesterday, August 28, 2013, the Centers for Medicare and Medicaid Services of the Department of Health and Human Services posted its Program Integrity: Exchange, SHOP, and Eligibility Appeals ...