A New York doctor received a seven-year prison sentence and over $2.2 million restitution for a $24 million Medicare fraud scheme involving kickbacks for unnecessary lab tests and orthotic braces. The case highlights federal enforcement efforts against healthcare fraud.
CMS announces increases in Medicare Parts A and B premiums and deductibles for 2026, reflecting rising medical costs and usage. Explore implications for senior care, Medicaid, and insurance professionals.
Explore Medicaid intergovernmental transfers (IGTs) abuse, federal oversight challenges, and policy reform opportunities to restore Medicaid fiscal integrity and ensure equitable provider payments.
Senate Republicans are set to block ACA subsidy extensions, amplifying federal cuts to Medicaid and impacting millions of low-income workers across key states and districts.
Explore significant Medicaid and Medi-Cal changes brought by the One Big Beautiful Bill Act, including work requirements, co-pays, long-term care asset rules, and immigration-related coverage adjustments.
Nassau University Medical Center serves the highest percentage of Medicaid patients on Long Island, facing financial challenges due to low public insurance reimbursements and a high volume of psychiatric and emergency care cases.
CMS's 2027 Proposed Rule for Medicare Advantage revises Star Ratings by focusing on clinical quality and member experience, delaying equity-focused rewards, and enhancing integrated care for dual-eligible populations.
Texas HHSC to transition from Dual Demonstration Program to Integrated Dual-Eligible Special Needs Plan (D-SNP) model in 2026, enhancing Medicare and Medicaid integration for dual eligibles in STAR+PLUS.
The expiration of enhanced ACA health insurance subsidies could double premiums, reduce coverage for millions, and strain state budgets, with significant economic and healthcare impacts nationwide.
Health First Urgent Care agrees to $2.8 million settlement for Medicare and Medicaid overbilling linked to improper diagnostic test billing practices in Washington State.
