The healthcare giant agreed to a $556 million settlement over claims it overstated illnesses to increase Medicare Advantage ...

In the largest Medicare Advantage fraud settlement to date, Oakland, Calif.-based Kaiser Permanente agreed to pay $556 million to resolve allegations it violated the False Claims Act by submitting ...

Over the last few years, there has been an uptick in Medicare billing privileges deactivations for failure to timely and fully update or revalidate Medicare enrollment information and respond to ...

Pharmacy claim reversals can be costly. Not only can they have an immediate impact on pharmacies’ cash flow; but, in many cases, they can lead to additional consequences as well. Pharmacies accused of ...

CMS has proposed two rules that would pay for more hospital inpatient services under Medicare Part B when a Medicare Part A claim is denied. The first rule would allow CMS to pay hospitals additional ...

CMS proposes a 0.09% Medicare Advantage payment increase for 2027 and plans to eliminate chart review payments, impacting insurers’ revenue.

Waltham, Mass.-based Alere, a medical diagnostics products company, is defending allegations from CMS that its subsidiary, which specializes in providing diabetic testing supplies to customers by mail ...