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 ...

The Office of Inspector General (“OIG”) recently issued advisory opinion 25‑12 (“the Opinion”), which addresses a home care ...

CMS proposes a 0.09% Medicare Advantage payment increase for 2027 and plans to eliminate chart review payments, impacting insurers’ revenue.

The US Department of Health and Human Services Office of Inspector General (HHS OIG) issued a Special Advisory Bulletin (SAB) ...

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 ...

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

Providers who land on the SFF list must make immediate and significant improvements to avoid escalating enforcement.

PENNSYLVANIA (WTAJ) — A Pennsylvania Senator is looking to allow the Legislative Budget and Finance Committee (LBFC) to ...

The Commonwealth Foundation report shined a spotlight on Medicaid fraud in Pennsylvania earlier this week. Now, two days ...

Florida lab owner pleads guilty to a $52M Medicare fraud for unnecessary genetic testing, involving bribes and deceptive telemarketing, facing forfeiture and potential prison time.

Federal officials have a plan that could curb billions of dollars in overpayments to Medicare Advantage plans. But will they ...