The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses.

CMS says Medicare Advantage overpayment recoveries will begin soon, prioritizing audits from 2018 to 2024 and expanding medical coder support.

CMS names medications 2028 for Medicare price negotiation, including Trulicity and Biktarvy, targeting high-cost drugs in ...

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

On May 28, 2025, CMS requested comments from hospitals to determine the quality of care being provided for gender dysphoria in children. CMS cites its prior communication and a prior report released ...

Vast changes are swiftly approaching regarding the efforts Workers’ Compensation practitioners must make in protecting Medicare’s interests in future medical settlements. The Centers for ...

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