OIG report identifies Medicare overpayments for continuous glucose monitors and urges CMS to reduce payment rates, highlighting potential savings.

A recent OIG audit identifies $4.7 million in Medicare overpayments to optometrists for nursing home services due to insufficient CMS review processes and billing controls. The report urges enhanced oversight and provider training to prevent future improper payments.

GAO's recent report uncovers persistent fraud vulnerabilities in the federal Marketplace advance premium tax credit program, revealing risks related to SSN misuse, unreconciled credits, and unauthorized enrollment changes.

The GAO's new report reveals ongoing fraud risks in the ACA's Advance Premium Tax Credit program, highlighting vulnerabilities in enrollment verification and CMS fraud management.

CMS announces ACCESS, a new Medicare model starting July 2026 to enhance chronic care using digital tools and outcome-based payments, supporting two-thirds of Original Medicare enrollees.

GAO report reveals significant fraud risks and mismanagement in Obamacare's Advance Premium Tax Credit program, highlighting challenges in eligibility verification and fraud risk controls.

CMS proposes 2027 Medicare Advantage and Part D updates to simplify Star Ratings and introduce a depression screening measure. Public comment open for 60 days.

GAO report reveals fraudulent enrollments in ACA marketplace led to improper premium subsidy payouts, prompting legislative calls for subsidy reform and enhanced fraud prevention.

CMS unveils the ACCESS Model to improve chronic disease management in Traditional Medicare using AI and digital technologies, targeting better access, quality, and cost efficiency in healthcare.

A recent case of Medicare billing fraud involving a Florida supplier reveals vulnerabilities in claim processing and CMS enforcement measures to combat provider fraud.