CMS is cracking down on Medicare fraud and has identified several cases involving hospices in California. The move protects ...
The feds have AI reviewing whether claims through traditional Medicare are 'medically necessary' — upending longstanding ...
In this article, we outline actionable strategies for strengthening one of the most essential administrative data ...
The future of Maryland’s health and our state budget can benefit greatly by removing MCOs. With 1.5 million Marylanders ...
Minnesota’s Department of Human Services (DHS) released a new report Friday that was provided by an outside consultant, which examined Medicaid system billing over four years and raised concerns with ...
Getting your Trinity Audio player ready... As Colorado policymakers grapple with the state’s increasing Medicaid costs, an Arvada legislator has an idea for how to fill some of the gap. Her bill would ...
Fee-for-service payments in 2027 for physicians who treat Medicare patients should be increased by 1.25% for those participating in advanced alternative payment models and 0.75% for other physicians, ...
The Medicare Payment Advisory Commission estimated Medicare Advantage payments will be 14% greater than fee-for-service Medicare in 2026, according to a March 12 report from the congressional agency.
The WISeR Model Comes to Original Medicare: What Providers and Suppliers in Model States Should Know
The Wasteful and Inappropriate Service Reduction (WISeR) Model began on January 1, 2026, with model participants and Medicare Administrative Contractors accepting prior authorization requests ...
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