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 ...

ASCs will continue to receive separate Medicare reimbursement for certain non-opioid pain management devices in 2026 under the NOPAIN Act.  As part of the ruling, CMS confirmed the Game Ready Pro 2.1 ...

Two recent Department of Justice settlements with health care providers shine a new spotlight on a long-standing risk for health care fraud and abuse. Two recent Department of Justice settlements with ...

The Biden administration has finalized a rule targeting fraudulent billing in Medicare’s largest value-based care program, after concerning reports of spiking spending on urinary catheters. The ...

Explore 2025 managed care enforcement trends under the Trump administration. Learn about Department of Justice (DOJ) and ...

The Centers for Medicare and Medicaid Services changes how it pays medical providers after a billing scheme for catheters tried to scam Medicare out of more than $3 billion. >> IT WAS A MASSIVE ...

An analysis of differential coding patterns between Medicare Advantage (MA) and Traditional Medicare (TM) plans estimated how much coding differs between insurers and how much extra revenue insurers ...

Grassley described billing for multiple health conditions as fraud UnitedHealth will work with Grassley, defends its Medicare Advantage business Shares of insurers rise Feb 25 (Reuters) - U.S. Senator ...

The DeltaWave product portfolio expansion was informed by feedback from early adoption partners during REMSleep’s Q4 2025 soft launch. DME providers and sleep laboratories identified specific ...

Prolia (denosumab) is a medication for osteoporosis. A healthcare professional administers Prolia via injection under the skin every 6 months. Medicare covers Prolia for beneficiaries. Since a ...