In fiscal 2023, the most recent year for which detailed financial information is available, Medicaid’s net cost was $894.2 ...

Here are five physician fraud cases Becker’s has reported on since June 17: 1. Columbus, Ohio-based Robert Florea, MD, was sentenced to 24 months in prison for a $1.5 million Medicaid fraud scheme. Dr ...

The U.S. Centers for Medicare & Medicaid Services (CMS) released its CY 2026 home health final payment rule on Monday. The rule projects a 6.4% ...

The Centers for Medicare & Medicaid Services (CMS) rolled out an Innovation Center model Friday to test new prior ...

CMS has unveiled the Wasteful and Inappropriate Service Reduction model, a new Innovation Center initiative aimed at reducing unnecessary services in traditional Medicare and streamlining the prior ...

The Centers for Medicare & Medicaid Services is warning healthcare providers and suppliers about a new fraud scheme involving fake faxed requests for medical records. According to a June 26 alert ...

Some spine procedures that are traditionally fee-for-service Medicare cases will have prior authorizations added, according to CMS’ new Wasteful and Inappropriate Service Reduction model. CMS is ...

The Centers for Medicare & Medicaid Services today announced it has identified a fraud scheme targeting Medicare providers ...

The Centers for Medicare & Medicaid Services announced a new Innovation Center model aimed at helping ensure people with Original Medicare receive care.

The Centers for Medicare & Medicaid Services June 27 announced the rollout of a 6-year technology-enabled prior authorization ...

When you turn 65 and enroll in Medicare, your eligibility for Medicaid may change—even if your income stays the same. This is due to how Medicaid rules differ for people under and over the age ...

The Financial Alignment Initiative for Medicare-Medicaid Enrollees targets dual enrollees and consists of a capitated model that provides prospective payment for coordinated care. 9 CMMI has also ...