Retirees on Medicare Advantage are missing out on crucial coverage, and their health could suffer because of it.

Though the arrangement does not fit squarely within a regulatory safe harbor, and therefore technically would generate (if ...

Medicare lab spending totaled $8.4 billion in 2024, up 5 percent year over year, with $3.6 billion of that spent on genetic testing, an increase of 20 percent over 2023.

While providers aren’t required to follow OIG recommendations, a compliance program based on their guidance can spare facilities future headaches, since ...

On January 16, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published Advisory Opinion 26-01, approving ...

Network adequacy remains a significant challenge for behavioral healthcare in Medicare Advantage (MA) and Medicaid managed care, according to a new report. Analysts at the Department of Health and ...

The Department of Health and Human Services Office of Inspector General yesterday released a bulletin addressing how direct-to-consumer drug programs can sell prescription drugs to patients with ...

Medicare Advantage organizations may be improperly using health risk assessments to increase risk-adjusted reimbursement, according to a report HHS’ Office of Inspector General issued in September.

Five federal audits on behalf of Medicare found $12 million in erroneous claims filed by dialysis centers in West Virginia and Delaware, two hospitals in the Altoona Regional Health System in ...

The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services recently issued an unfavorable Advisory Opinion (No.

A recent report published by the Office of the Inspector General showed the Medicaid program pays significantly less than Medicare for drugs. The OIG compared the prices paid (including rebates) for ...

A federal watchdog said Tuesday it has begun auditing nursing homes’ use of the Patient Driven Payment Model to drive skilled nursing reimbursement, and the first targeted facility is blasting the ...