CMS Finalizes 2026 Updates for Medicare Advantage and Part D Programs
CMS issued final rules and updates for Medicare Advantage and Part D programs for 2026, including Inflation Reduction Act implementations and inpatient care protections.
Navigating Healthcare Liability Regulation Changes Under the 2025 Administration
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 Chief Dr. Mehmet Oz Targets $100B Medicare and Medicaid Waste
CMS Administrator Dr. Mehmet Oz prioritizes eliminating $100B waste, fraud, and abuse in Medicare and Medicaid to protect federal health spending and vulnerable beneficiaries.
Genetic Testing Fraud Settlement: $6M Paid to Resolve Medicare False Claims
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 for Service and Documentation Failures
CMS fines three PACE organizations totaling $142,788 for failure to meet essential service and documentation requirements, highlighting compliance challenges in managed care programs.
Prior Authorization Reforms and AI: Transforming U.S. Healthcare Compliance in 2025
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 Settles $8M Covid Testing False Claims Case
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.
Medicare Genetic Testing Fraud Case Settled for $6M Over False Claims
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.
Maryland Faces Growing Psychiatric Bed Shortage Amid Legal Compliance Challenges
Maryland's Department of Health struggles with psychiatric bed shortages, leading to legal challenges and increased judicial fines amid mounting patient backlogs.
CMS Releases 2026 Final Rule for Medicare Advantage and Part D Programs
CMS finalizes key aspects of the 2026 Medicare Advantage and Part D programs rule, including expanded insulin coverage, payment plans, and new pharmacy requirements for network participation.