CMS 2026 outpatient rule proposes major changes including inpatient-only list elimination and expanded ambulatory surgery center procedures, impacting Medicare payment and compliance.

Aetna implements a new inpatient reimbursement policy for Medicare Advantage plans to streamline payments and align with CMS two-midnight rule, effective Nov 15, 2023.

Analysis of Virginia Foxx's legislative positions affecting healthcare, insurance regulation, and employer health data management, with insights into compliance and market implications.

Understand the Medicare Part A requirements for skilled nursing facility coverage, including qualifying hospital stays, coverage limits, and copay costs essential for healthcare professionals and insurers.

CMS offers a range of Medicare Learning Network web-based training courses for providers covering billing, coding, fraud prevention, and compliance. Courses are self-paced but do not provide continuing education credits. Subscribe to MLN Connects® for updates.

Villages Health System files Chapter 11 bankruptcy following a $350 million Medicare overbilling investigation amid increased Medicare Advantage audits and tighter regulatory scrutiny.

OIG audit finds $100,696 in Medicare overpayments to HRS Home Health, highlighting compliance challenges in home health billing and the impact of CMS oversight.

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.

Detailed analysis of recent Medicare Advantage enforcement activities focused on broker arrangements, Oak Street settlement, and DOJ False Claims Act litigation impacting healthcare compliance and beneficiary protection.

Michigan physician sentenced to four years for involvement in $6.3 million Medicare fraud, emphasizing the need for robust fraud detection and compliance in healthcare.