Medicare telehealth waivers enabling expanded coverage during COVID-19 expire in 2025. Providers must prepare for significant Medicare and regulatory changes affecting telehealth reimbursement and compliance.
Alexandra Gehrke faces sentencing for a $600 million Medicare healthcare fraud scheme targeting elderly patients, highlighting regulatory and compliance challenges in healthcare billing and Medicare oversight.
OIG finds nursing homes underreporting major injury falls affecting accuracy of CMS Care Compare data; CMS to enhance compliance and reporting measures.
UnitedHealth expects about 78% of its Medicare Advantage members to be enrolled in plans rated four stars or above in 2027, signaling strong quality performance under CMS metrics.
Two New York medical supply companies face allegations of fraudulent billing to Medicare and insurance agencies, with numerous consumer complaints reported to the BBB.
Intensified efforts to combat Medicare fraud improve detection and prevention, safeguarding U.S. healthcare insurers and ensuring compliance with federal regulations.
Major US health insurers commit to streamlining prior authorization to speed medical approvals and reduce patient/provider friction by 2027.
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.
U.S. Representatives urge a probe into Medicare Advantage plans acquiring health businesses, potentially affecting compliance with medical loss ratio standards.
