On February 25, 2026, the Centers for Medicare & Medicaid Services (“CMS”) announced several program integrity actions impacting Medicaid funding and Medicare supplier enrollment, along with a request ...

States scramble submit Medicaid revalidation plans to CMS by May 23 as part of a federal effort to audit high-risk providers and reduce fraud.

The Centers for Medicare and Medicaid Services (CMS) issued a Request for Information (RFI) on February 27, 2026, that signals a potential expansion of federal health care fraud, waste, and abuse ...

The 340B rebate pilot model set to begin in January 2026 starkly presents the key tradeoff between program integrity and support for safety net providers and poses an important question: can the 340B ...

While the fraud scandal in Minnesota has set in motion renewed scrutiny of Medicaid and other low-income support programs, the potential for losses in another large entitlement, namely Medicare, ...

President Donald Trump’s administration has moved to shut down a long‑running Medicaid financing loophole that officials say allowed states to shift billions in costs onto federal taxpayers. The ...

Amber Nigam is CEO and cofounder of basys.ai, a Harvard-based company streamlining prior authorization for health plans with agentic AI. Fraud, waste and abuse (FWA) has historically been addressed at ...

As Congress continues to debate next steps on the Affordable Care Act's (ACA's) enhanced subsidies, insurers are urging legislators to consider an extension with additional program integrity measures ...