HHS Office of Inspector General urges CMS to recover $3 million in overpayments and enhance billing accuracy through improved claim reviews and system edits to ensure regulatory compliance.

LIAM states Malaysian insurance agents act as intermediaries without formal roles in medical claims, highlighting insurer-controlled claims processing and FMOS dispute resolution.

GAO report reveals significant fraud risks and mismanagement in Obamacare's Advance Premium Tax Credit program, highlighting challenges in eligibility verification and fraud risk controls.

CMS announces the ACCESS Model, a 10-year voluntary value-based payment program to expand tech-enabled care for Medicare chronic condition patients, linking payments to health outcomes.

EMC Insurance to sell EMC National Life to Avocet Partners as EMC National Life Mutual Holding Co. demutualizes, focusing EMC Insurance on commercial lines.

Explore the Health Information Privacy Reform Act, a proposed federal bill aimed at broadening health data protections beyond HIPAA, addressing regulatory fragmentation and enhancing compliance in the U.S. healthcare and insurance sectors.

Curative Health Insurance secures $150M Series B funding, elevating valuation to $1.25B to expand nationally and enhance AI-powered member services focused on preventative care and regulatory compliance.

GAO report reveals extensive fraud and subsidy misuse in ACA exchanges, highlighting federal oversight failures and risks to taxpayer funds.

GAO undercover probe reveals major fraud vulnerabilities in ACA exchanges; 6.4 million improper enrollees in 2025 could cost taxpayers $27B. Insights on regulatory compliance challenges and insurance market impact.

The GAO report reveals significant enforcement gaps in detecting and preventing fraud among ACA Marketplace agents and brokers, highlighting the need for strengthened regulatory oversight to protect taxpayer funds and ensure market stability.