Key Takeaways - CMS imposed nationwide six-month moratoria effective May 13, 2026, barring new Medicare enrollments for hospice and home ...

CMS is gathering information for and seeking industry feedback on a project that would consolidate the audit and investigation services for Medicare and Medicaid integrity functions, creating new ...

On April 23, 2026, Dr. Mehmet Oz, in his capacity as Administrator of the Centers for Medicare & Medicaid Services ("CMS"), ...

Workload data used by CMS to oversee Zone Program Integrity Contractors has been inaccurate and inconsistent, and this has led to several ZPIC reporting errors and inconsistencies within information ...

A constant refrain from the Trump administration about rooting out fraud, waste and abuse isn’t just about budget cuts. For nursing homes, it may signal increasing audit risk and a rise in burdensome ...

CMS has announced it is consolidating its efforts with new program-integrity contractors that will look at billing trends and patterns across Medicare. These contractors will focus on companies and ...

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 ...

CMS finalized a rule this week that ends what it called a healthcare‑related 'financing gimmick,' marking one of the most sweeping Medicaid program‑integrity actions in years. CMS said some states set ...

CMS agency is recruiting engineers, cybersecurity specialists and data scientists while expanding its use of AI tools to identify fraudulent payments.

The final guidance for the 2028 cycle of the Medicare drug price negotiation reflects CMS’s continued effort to balance statutory requirements with transparency, responsiveness to stakeholder input, ...