Agentic AI can connect historical behavior, evolving utilization signals and payment integrity requirements into a single control framework that adapts over time.

The buck stops here. We’ve got to clean up the system. With these words, Dr. Mehmet Oz, now at the helm of the Centers for Medicare and Medicaid Services (CMS), signaled a pivotal moment for Medicaid ...

A constant refrain from the Trump administration about rooting out fraud, waste and abuse isn’t just about budget cuts. For nursing homes, it may signal increasing audit risk and a rise in burdensome ...

The Deficit Reduction Act of 2005 provided the resources to establish the Medicaid Integrity Program (MIP), the first national strategy in the 40-year history of the Medicaid program to promote the ...

The Government Accountability Office has issued a report recommending CMS more clearly communicate its goals for the Medicare Integrity Program and improve the reliability of data used to calculate ...

Neal Dunn led 2 letters last year urging approval, but Florida remains one of a handful of states still awaiting action.

Since 1992, the 340B drug discount program has entitled certain federal grantee clinics and hospitals (called “covered entities”) to purchase outpatient drugs at substantial discounts. The discounted ...