Investigation Reopens into Everest Insurance Fraud Scheme
Unveiling the Everest insurance fraud case: a major scheme involving inflated claims and regulatory failures, prompting necessary actions from Nepal authorities.
CMS Proposed Rule Adjustments for Medicare Inpatient Rehabilitation Facilities FY 2027
Explore the CMS proposed rule for Medicare payment policy changes in FY 2027, affecting inpatient rehabilitation facilities and compliance standards.
FTC Forms Health Care Task Force for Enhanced Regulation
The FTC's new Health Care Task Force aims to increase oversight and transparency in the health sector, impacting pharmacy benefit managers and mergers. Prepare for changes!
New Compliance Guidance for Medicare Advantage Organizations
Discover the new voluntary compliance guidance from OIG for Medicare Advantage Organizations, focusing on compliance risks and adherence to federal regulations.
CMS Considers Nationwide Pause on New Hospice Provider Enrollments
CMS is considering a nationwide pause on new hospice enrollments to combat fraud, protecting Medicare’s benefits and ensuring compliance within the sector.
The Impact of AI on Data Management in Insurance
Explore how AI transforms data management in insurance, addressing challenges in integration and enabling better decision-making.
Oklahoma Implements Robust Consumer Data Privacy Law SB 546
Oklahoma enacts SB 546, influencing consumer data privacy, enhancing compliance, and establishing clear rights for individuals with actionable business obligations.
Aetna Settles $117.7 Million in Medicare Advantage False Claims Act Allegations
Aetna agrees to $117.7 million settlements over Medicare Advantage claims, highlighting the need for compliance in healthcare risk adjustment practices.
Regulatory Actions Shape Insurance Compliance and Innovation
Explore how recent regulatory actions are shaping insurance compliance, transparency, and innovation in response to emerging consumer needs and technological advancements.
CMS Halts New Medicare Supplier Enrollment to Combat Fraud
CMS has paused new Medicare supplier enrollments for 6 months to combat healthcare fraud. Learn its implications for the industry and compliance challenges.