The Centers for Medicare & Medicaid Services is warning healthcare providers and suppliers about a new fraud scheme involving fake faxed requests for medical records. According to a June 26 alert ...

Client Rankings Guide Health Plans to Advanced IT Solutions for Superior Compliance, Performance, and Member Outcomes for 2026 & Beyond. WASHINGTON, D.C., WASHINGTON, D.C. / ACCESS Newswire / May 25, ...

Past audits of Medicare Advantage bills by the Centers for Medicare and Medicaid Services found that overpayments totaled between 5% and 8% of total expenditures, he said, ...

Shares of Humana and other health insurers fell Thursday after the Centers for Medicare & Medicaid Services said it plans to take a more "aggressive" approach to auditing Medicare Advantage plans.

The Trump administration plans to expand government audits of private Medicare health plans, adding more scrutiny to an industry that’s been a profit driver for insurers.

UnitedHealth, Humana, CVS drop on expanded Medicare Advantage audits. Lenovo Q4 profit hit by higher costs, but revenue rises on AI-fueled demand.

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President Trump’s federal Medicare agency will expedite audits of Medicare Advantage insurers, a move that could claw back nearly $500 million a year for taxpayers, according to previous federal ...

Independent Health settles with Justice Department over alleged Medicare Advantage upcoding The $100 million settlement is one of the larger recent sums agreed to by an MA payer accused of ...

Using AI tools, Medicare Advantage plans can create audit-ready operations and help ensure positive outcomes from risk adjustment validation. Applying AI tools to risk adjustment.