H.R. 3467 proposes automatic enrollment into low-premium Medicare Advantage plans with a three-year lock-in, raising concerns about beneficiary choice, network limitations, and coverage variability.
In July 2025, DOJ and HHS formed a joint Working Group to intensify False Claims Act enforcement, focusing on data-driven investigations and payment suspensions in healthcare fraud cases.
The 2025 reconciliation bill introduces substantial Medicaid funding cuts and changes to ACA enrollment, with significant implications for healthcare access and provider reimbursement across the U.S.
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.
Analysis of budget reconciliation effects on Medicaid, individual market coverage, and Medicare, highlighting health plans' response to potential coverage losses and the importance of health care tax credits.
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.
Texas recently expanded Medigap coverage options for Medicare beneficiaries under 65 with end-stage kidney disease, improving insurance access and affordability. NKF advocacy played a key role in this policy change.
CMS alerts 103,000 Medicare beneficiaries of a recent scam involving fraudulent Medicare.gov account creations, exposing sensitive personal and healthcare data. Learn about CMS's cybersecurity response and prevention measures.
Survey by Civitas Networks for Health shows Medicare Quality Improvement Organizations generated $4.7B savings and highlights recommendations for program enhancements focusing on data interoperability, onsite training, and workforce retention.
A federal court has blocked key staffing requirements in the 2024 CMS rule for long-term care facilities, creating regulatory uncertainty amid ongoing litigation and legislative attempts to pause implementation until 2034.
