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CMS awarded Serco a $109 million contract to review a randomized sample of claims for the agency’s Comprehensive Error Rate Testing program The seven-year contract will be performe...
The payment by Elevance Health to the Centers for Medicare & Medicaid Services comes as the agency threatened to bar new enrollments in the company’s plans.
The Centers for Medicare & Medicaid Services has added language ...
Last year, we wrote in the Los Angeles Times that the Centers for Medicare and Medicaid Services was done chasing criminals after we'd already handed them money. We said we were bu...
The federal health insurance program can be complicated. Here’s how to start, and where to find help.
Beneficiaries face a series of complex decisions in enrolling in Medicare coverage. A key federal panel outlines some of the pain points, alongside other policy recommendations and...
CMS has launched the third RMADA contract vehicle with a $3.5 billion ceiling over five years Seventeen companies secured spots after a competition that drew 34 offers The contract...
The Centers for Medicare & Medicaid Services recently delivered good news to seniors on the Medicare Advantage (MA) program, guaranteeing a 2.48% increase for the 2027 MA rate...
The Centers for Medicare and Medicaid Services (CMS) aims to play a bigger role in health tech modernization efforts, including leading interoperability initiatives.
If you’re receiving care through a skilled nursing facility, home health agency, or outpatient rehabilitation center, there may come a day when your provider hands you a form title...
CMS is recalculating some 2026 Medicare Advantage Star Ratings after a court ruled it improperly calculated Clover Health’s rating, a decision that could boost payments for a small...
The Justice Department’s (DOJ) 2026 National Health Care Fraud Takedown will understandably be read by many health care organizations as another Medicare fraud announcement. The he...
CMS has awarded nearly $2 billion in contracts for Medicare claims modernization effort HealthEdge and Peraton were selected to help replace legacy fee-for-service processing syste...
A final rule updates performance reviews, codifies existing requirements and brings new conflict-of-interest protections for the nine organizations that regularly survey and accred...
Today’s adjustment offers insight into what the next phase of the program is focusing on and will subsequently reward, and why this moment matters, especially for newer and regiona...
An OIG report found that the three largest Medicare Advantage insurers denied prior authorization requests for long-term acute care and inpatient rehabilitation at higher rates tha...
Earlier this year, Congress enacted Section 6225 of the Consolidated Appropriations Act, 2026 (“CAA”), establishing a new Medicare condition of payment for off-campus hospital outp...
Federal investigators found the biggest Medicare Advantage insurers rejected over 70% of long-term care requests — leaving families facing bills up to $49,000.
On June 16, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule, “Medicare Drug Price Negotiation Program and Medicare Prescription Drug Benefit Pro...
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