In the largest Medicare Advantage fraud settlement to date, Oakland, Calif.-based Kaiser Permanente agreed to pay $556 million to resolve allegations it violated the False Claims Act by submitting ...
A HHS study found physicians are still improperly billing Medicare enrollees for services of which they should be exempt, according to The New York Times. 1. Despite official warnings about fines or ...
Two recent Department of Justice settlements with health care providers shine a new spotlight on a long-standing risk for health care fraud and abuse. Two recent Department of Justice settlements with ...
The Biden administration has finalized a rule targeting fraudulent billing in Medicare’s largest value-based care program, after concerning reports of spiking spending on urinary catheters. The ...
Explore 2025 managed care enforcement trends under the Trump administration. Learn about Department of Justice (DOJ) and ...
Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...
The Centers for Medicare and Medicaid Services changes how it pays medical providers after a billing scheme for catheters tried to scam Medicare out of more than $3 billion. >> IT WAS A MASSIVE ...
Grassley described billing for multiple health conditions as fraud UnitedHealth will work with Grassley, defends its Medicare Advantage business Shares of insurers rise Feb 25 (Reuters) - U.S. Senator ...
Intensive coding by Medicare Advantage (MA) plans raised enrollees' risk scores and may have allowed companies to pocket tens of billions of dollars more than if traditional Medicare had covered the ...
Prolia (denosumab) is a medication for osteoporosis. A healthcare professional administers Prolia via injection under the skin every 6 months. Medicare covers Prolia for beneficiaries. Since a ...
The DeltaWave product portfolio expansion was informed by feedback from early adoption partners during REMSleep’s Q4 2025 soft launch. DME providers and sleep laboratories identified specific ...
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