Medicare fraud imposes a $60 billion annual cost and risks to beneficiaries. Rhode Island's Senior Medicare Patrol leads education during Medicare Fraud Prevention Week to enhance fraud awareness and protection measures.

Explore critical regulatory updates and compliance strategies for healthcare providers navigating evolving vaccine policies and Medicare billing rules. Learn from expert legal and clinical insights to manage outbreak risks and optimize revenue cycle operations.

CMS issued final rules and updates for Medicare Advantage and Part D programs for 2026, including Inflation Reduction Act implementations and inpatient care protections.

Explore essential strategies for healthcare providers and insurers to manage liability risks and insurance coverage amid anticipated regulatory changes under the 2025 U.S. presidential administration.

CMS Administrator Dr. Mehmet Oz prioritizes eliminating $100B waste, fraud, and abuse in Medicare and Medicaid to protect federal health spending and vulnerable beneficiaries.

Genexe, LLC and others pay $6 million to resolve allegations of Medicare fraud involving medically unnecessary genetic tests and kickbacks. Enforcement in healthcare compliance continues.

CMS fines three PACE organizations totaling $142,788 for failure to meet essential service and documentation requirements, highlighting compliance challenges in managed care programs.

Explore the 2024 CMS prior authorization rule and the impact of AI on healthcare administrative processes, improving compliance and patient care timelines.

Vault Medical Services agrees to pay $8 million to settle false claims related to Covid-19 testing reimbursements under the federal Uninsured Program, highlighting compliance challenges in pandemic healthcare billing.

Genexe and Immerge settle $6M case resolving false Medicare claims for unnecessary genetic tests involving kickbacks. Settlement addresses healthcare fraud and whistleblower suits under the False Claims Act.