CMS says Medicare Advantage overpayment recoveries will begin soon, prioritizing audits from 2018 to 2024 and expanding medical coder support.
On January 21, 2026, OIG released the Fall 2025 Semiannual Report to Congress, summarizing its activities between April 1, ...
Federal prosecutors allege that between 2009 and 2018, Kaiser carried out a multi-state scheme to inflate risk scores through ...
A growing disconnect between innovation and reimbursement could become one of gastroenterology’s most consequential disruptors in 2026, Tyler Berzin, MD, associate professor of medicine at Harvard ...
Follow X February 5, 2026 Affiliates of Kaiser Permanente have agreed to pay $556 million to resolve federal allegations that ...
Safety-net definitional ambiguity undermines targeted funding, limiting the ability to sustain staffing, infrastructure, and quality improvement needed for optimal stroke care across diverse ...
The mission of the Program of All-inclusive Care for the Elderly (PACE) isn’t changing in 2026, but the mechanics behind payment and measurement are. Leaders will face tighter risk scoring, higher ...
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