Kim Brandt, CMS’s chief operating officer and deputy administrator, said AI tools are helping the agency stop money from going out the door to fraudsters.

LUTZ, Fla., Nov. 19, 2025 /PRNewswire/ -- MyCare Medical, a participant in the CMS Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, expressed strong ...

Vermont and nine other states received letters from a Congressional committee this week in the latest push to challenge Medicaid spending.

BOSTON, Dec. 15, 2025 /PRNewswire/ -- Basys.ai, an agentic AI-powered prior authorization and utilization management platform, has been selected by the Centers for Medicare & Medicaid Services (CMS) ...

EXCLUSIVE — The Centers for Medicare & Medicaid Services will testify before Congress this month on what steps the agency is taking to actively address healthcare fraud across the country, following ...

OIG issued a new report finding that in 2022 some Medicaid managed care plans self-reported making no or very few potential provider fraud, waste, and abuse referrals. OIG reported that 33 plans, ten ...

President Donald Trump and Elon Musk’s Department of Government Efficiency (DOGE) have taken a chainsaw to the US federal government, slashing programs, personnel, research, and global aid. The ...

CMS will share its data analytics tools and best practices for preventing medical claims fraud, waste and abuse with the U.S. Department of Veterans Affairs, the agencies announced Jan. 23. Under the ...

Mehmet Oz, head of the Centers for Medicare & Medicaid Services, appears on Capitol Hill in Washington on March 14. His agency is scouring Medicaid payments for immigrants without permanent legal ...

This article is the latest in the Health Affairs Forefront featured topic, Accountable Care for Population Health, featuring analysis and discussion of how to understand, design, support, and measure ...

The HHS Office of the Inspector General (OIG) called out sky-high spending on pricey skin substitutes and voiced concerns about potential waste, fraud, and abuse in a report released earlier this ...