Tag: Healthcare Compliance

New CMS Payment Rule for Home Health Services Set for 2027

Discover CMS's proposed payment rule for home health services, increasing rates for 2027 but introducing temporary adjustments. Learn more about its impact.

CMS Requests Feedback on PBM Regulation Under CAA 2026

Explore how CMS is regulating Pharmacy Benefit Managers under CAA 2026, seeking feedback on compensation models and data reporting requirements. Act by July 20, 2026!

Significant Findings in New York State Comptroller Audits

Explore New York's audit findings on Medicaid payments and property management. Learn about fiscal responsibility, compliance issues, and operational improvements.

Medicare Fraud Settlement: Advanced Pathology Solutions Agrees to $30M

Advanced Pathology Solutions settles Medicare fraud allegations for $30 million, enters Corporate Integrity Agreement amid ongoing investigations and compliance measures.

CMS Enhances Oversight of Accrediting Organizations for Medicare and Medicaid

CMS introduces new rules enhancing the oversight of accrediting organizations to improve patient care and safety in Medicare and Medicaid facilities.

Nurse Practitioner Sentenced for $12 Million Medicare Fraud

A Louisiana nurse practitioner receives 7 years for fraudulent Medicare claims totaling $12M, emphasizing critical healthcare compliance and fraud prevention.

Understanding Medicare Advantage Risk Adjustment

Explore the complexities of Medicare Advantage risk adjustment, AI's role, and compliance challenges facing insurers. Learn about emerging accountability frameworks.

Updates from CMS on Shared Savings Program and Chronic Care Management

Discover essential updates from CMS regarding the Shared Savings Program and chronic care management, offering vital information for healthcare organizations.

Lawsuit Against Federal Restrictions Impacting HIV Care for Transgender Individuals

A coalition of medical organizations sues federal authorities, claiming new regulations hinder HIV care for transgender individuals. This lawsuit has significant implications for healthcare.

Healthcare Fraud Scheme Results in 17-Year Sentence for Florida Businessman

Michael Kochen sentenced to 17 years for Medicare fraud, involving $35 million in unnecessary services. Key insights on the healthcare fraud landscape.