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WASHINGTON, D.C. — U.S. financial institutions flagged about $17.5 billion in activity potentially tied to health care fraud over a one-year period, giving federal investigators a broad view of suspected …
FinCEN Flags $17.5 Billion in Suspected Health Care Fraud Read More
WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services barred 11 medical-equipment suppliers from future Medicare Advantage and Part D payments after identifying more than $3.4 billion in suspected …
CMS Bars 11 Suppliers Over $3.4 Billion in Suspect Billing Read More WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services said its laboratory-fraud enforcement efforts have prevented or recovered more than $1.6 billion in potentially improper Medicare payments, including $732 …
CMS Says Lab Fraud Crackdown Blocked $1.6 Billion in Payments Read More
WASHINGTON, D.C. — The Department of Health and Human Services last week referred hospitals and clinics involved in pediatric gender-transition care for possible federal investigation after a commissioned report identified …
HHS Refers Pediatric Gender-Care Billing for Fraud Review Read More
WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services proposed a new pathway to shorten the lag between Food and Drug Administration authorization and national Medicare coverage for certain …
CMS Proposes RAPID Path to Cut Medicare Device Coverage Delays Read More WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services will require most eligible hospitals to participate in a national episode-based payment model for hip, knee and ankle replacements beginning …
CMS Expands Joint-Replacement Payment Model Nationwide Read More
WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services will end a temporary premium-stabilization program for standalone Medicare drug plans after 2026, returning Part D to traditional market conditions …
CMS Ends Part D Premium Stabilization for 2027 Read More
PHILADELPHIA, PA — Administrative costs for independent and provider-sponsored health insurance plans continued to rise in 2025, although at a slower pace than the previous year, reflecting higher labor expenses …
Health Plan Administrative Costs Rise as Staffing Ratios Decline Read More
WASHINGTON, D.C. — The Food and Drug Administration selected Dexcom Inc. as the first participant in a federal pilot linking digital health-device oversight with a Medicare payment model that rewards …
FDA Selects Dexcom for Medicare Digital Health Pilot Read More WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services has outlined a broad strategy to overhaul Original Medicare by expanding accountable care, revising physician payment methods, increasing price transparency …
CMS Outlines Medicare Overhaul to Expand Value-Based Care Read More