Georgia Lawmakers Investigate High Insurance Costs Amid Fraud and Profit Concerns
Georgia lawmakers probe high insurance premiums driven by fraud, profits, and claims processing amid impacts from Hurricane Helene.
Funeral Home Payment Scam Targets Grieving Families in Central Georgia
A phone scam in Central Georgia targets grieving families by impersonating funeral home staff to demand immediate payments, raising concerns about payment security during vulnerable times.
US Health Subsidy Reform: Targeting Fraud and Eligibility Verification
The One, Big, Beautiful Bill implements reforms to curb fraud in Obamacare subsidies and Medicaid, restricting illegal immigrant access and enhancing subsidy eligibility verification to protect taxpayer funds.
Senators Propose Bill to Tighten Medicare Advantage Risk Adjustment, Curb Overpayments
Senators introduce bipartisan bill targeting Medicare Advantage overpayments by refining risk adjustment and supporting CMS audits to enhance program integrity and save Medicare billions.
Medicare Fraud Prevention Week Emphasizes Beneficiary Vigilance
Medicare Fraud Prevention Week spotlights methods to reduce Medicare fraud and errors, with tips from the Senior Medicare Patrol to help beneficiaries monitor their claims effectively.
New Medicare Initiative Aims to Stop $60B in Fraud Losses
Medicare loses $60 billion annually to fraud, impacting beneficiaries' health and the program's finances. Senior Medicare Patrol leads prevention education during Medicare Fraud Prevention Week.
Payment Integrity Focus Shifts from Fraud to Preventing Overpayments in Healthcare
CMS reports $86B in improper payments, emphasizing payment integrity's role in preventing overpayments and improving healthcare claims accuracy.
Analysis Reveals Medicaid Spending Waste from Eligibility Verification Lapses
A new analysis reveals extensive Medicaid spending waste tied to weakened eligibility verification rules since 2012 and estimates future improper payments could total $2 trillion. Legislative reforms aim to restore verification and reduce fraud without cutting care for eligible recipients.
CMS Intensifies Medicare Advantage Audits, LTC Research Highlights, and Nursing Home Compliance Issues
CMS escalates Medicare Advantage audits targeting upcoding and overpayments; research shows benefits of closer heart failure patient monitoring to reduce rehospitalizations; federal probe into nursing home COVID policies; nursing home financial fraud uncovered.
Medicare Phone Scams Target Beneficiaries, Prompt Security Alerts
Medicare phone scams are rising, with fraudsters posing as representatives to steal personal info. Learn how insurance professionals can help protect beneficiaries.