The DOJ and HHS have established a joint False Claims Act Working Group to strengthen healthcare fraud investigations using advanced data analytics and interagency cooperation.
In July 2025, DOJ and HHS formed a joint Working Group to intensify False Claims Act enforcement, focusing on data-driven investigations and payment suspensions in healthcare fraud cases.
The DOJ and HHS reestablish the False Claims Act Working Group to enhance enforcement against healthcare fraud and abuse in federal programs, emphasizing compliance and whistleblower roles.
Astrana Health finalizes $708 million acquisition of Prospect Health, expanding its integrated care network and Medicaid, Medicare Advantage, and commercial coverage. The deal enhances provider scale and care delivery capabilities under California's Knox-Keene health plan regulations.
OIG audit finds $100,696 in Medicare overpayments to HRS Home Health, highlighting compliance challenges in home health billing and the impact of CMS oversight.
The AHA's Q2 2025 Health Care Plan Accountability Update details key regulatory and legislative changes affecting Medicare Advantage and private health insurer compliance, essential for insurance professionals.
Analysis of budget reconciliation effects on Medicaid, individual market coverage, and Medicare, highlighting health plans' response to potential coverage losses and the importance of health care tax credits.
Explore effective strategies to prevent Medicare fraud and reduce the estimated $60 billion in annual losses caused by fraud, errors, and abuse. Learn how beneficiaries and caregivers can safeguard against scams.
Texas recently expanded Medigap coverage options for Medicare beneficiaries under 65 with end-stage kidney disease, improving insurance access and affordability. NKF advocacy played a key role in this policy change.
CMS alerts 103,000 Medicare beneficiaries of a recent scam involving fraudulent Medicare.gov account creations, exposing sensitive personal and healthcare data. Learn about CMS's cybersecurity response and prevention measures.
