HHS OIG finds widespread errors in Medicare cost report desk reviews by NGS and recommends enhanced reviewer training and procedures to improve audit accuracy and compliance.

TeamHealth’s TeamACO reduces Medicare post-acute care costs by $15.8M in 2024 through readmission reductions and value-based care strategies across 33 states.

Key Medicare enrollment rules for HR managing employees over 65 with employer health benefits. Guidance on timing, documentation, and regulatory compliance to avoid coverage gaps.

Medicare's pay-for-performance programs face criticism for inefficacy and inequity. Experts advocate shifting to supportive models rewarding incremental improvement and incorporating patient-reported outcomes to enhance quality care.

Congress returns from recess with five key U.S. health policy priorities including FY26 appropriations, OTC drug fee program reauthorization, drug pricing reform, Medicare/Medicaid extenders, and ACA tax credits.

Explore how frequent health insurance churn in the U.S. reduces insurers' incentives to invest in preventive care and chronic disease management, worsening health outcomes and increasing costs.

CMS to start AI-driven prior authorization pilot for traditional Medicare in Washington and five other states in 2026, targeting low-value procedures to reduce waste and improve compliance while maintaining clinician oversight.

CMS extends the AHEAD Model to 2035, introducing payment reforms and transparency to improve Medicare cost control, prevention, and population health outcomes.

Explore how Medicare Advantage's growth reshapes retiree coverage, employer health benefits, and taxpayer costs amid evolving Medicare policy and enrollment trends.

Rep. Mariannette Miller-Meeks outlines Medicaid reforms, rural healthcare funding, and economic growth initiatives for Southeast Iowa, emphasizing sustainability and community engagement requirements.