On February 25, 2026, the Centers for Medicare & Medicaid Services (“CMS”) announced several program integrity actions impacting Medicaid funding and Medicare supplier enrollment, along with a request ...

CMS require states audit Medicaid providers with plans due in 30 days to strengthen fraud detection and program integrity nationwide.

Assisted living operators that provide Medicaid home- and community-based services to their residents could be front and ...

CMS is gathering information for and seeking industry feedback on a project that would consolidate the audit and investigation services for Medicare and Medicaid integrity functions, creating new ...

As discussed in last week’s Regs & Eggs blog post, the US Department of Health and Human Services (HHS) recently released additional budget documents to support the department’s fiscal year (FY) 2026 ...

Amber Nigam is CEO and cofounder of basys.ai, a Harvard-based company streamlining prior authorization for health plans with agentic AI. Fraud, waste and abuse (FWA) has historically been addressed at ...

A constant refrain from the Trump administration about rooting out fraud, waste and abuse isn’t just about budget cuts. For nursing homes, it may signal increasing audit risk and a rise in burdensome ...

WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services (CMS) announced a new oversight initiative aimed at ensuring that enrollees in Medicaid and the Children’s Health Insurance Program ...

On September 30, 2025, the Centers for Medicare & Medicaid Services (CMS) published the final guidance for the third cycle of the Medicare Drug Price Negotiation Program, initial price applicability ...

With Hospice Fraud and Abuse in the West, NPHI Argues Temporary Pause is Critical to Preventing Fraudulent Operators Exploiting the Medicare Hospice Benefit WASHINGTON, March 27, 2026 /PRNewswire/ -- ...