Beginning January 2026, six states will pilot an AI-driven prior authorization program in traditional Medicare to target fraud and waste, sparking industry concerns over increased claim denials and access delays.

Medicare Open Enrollment 2025 in Massachusetts sees a surge in scams targeting beneficiaries. The Massachusetts SMP program urges vigilance and offers fraud prevention resources to protect Medicare coverage.

AAASWFL's SHINE Program offers free Medicare counseling for Southwest Florida beneficiaries during the 2025 Open Enrollment Period, facilitating informed insurance decisions and fraud awareness.

CMS launches AI-driven pilot to streamline Medicare prior authorization for select services, prompting legislative calls for independent oversight to ensure patient safety and regulatory compliance.

New CMS data and state audits reveal rising fraud risks and improper payments in Medicaid and Obamacare exchanges, prompting regulatory reforms to enhance program integrity and protect taxpayer funds.

House GOP doctors outline reforms targeting Medicare fraud, PBM-driven drug costs, and graduate medical education funding to address Medicare insolvency and healthcare cost inflation.

U.S. consumers spent $90.6 billion on social media shopping last year, with high rates of buyer regret and reports of scams prompting calls for financial awareness and fraud prevention measures.

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.

CMS warns Medicare providers of rising phishing scams via fraudulent fax requests for medical records falsely linked to audits. Providers urged to verify requests to protect patient data.

New York StateWide Senior Action Council warns of Medicare fraud involving doctor spoofing calls targeting seniors, urging vigilance and reporting to curb $60B annual losses.