News

Feds arrest scores in $14 billion Medicare/Medicaid fraud. South Florida high on list
Justice Department officials said 96 doctors, nurses and pharmacists were among those arrested across all 50 states.
Becker's Hospital Review2d
CMS to add prior authorization for traditional Medicare services
CMS has unveiled the Wasteful and Inappropriate Service Reduction model, a new Innovation Center initiative that will add prior authorization for some traditional fee-for-service Medicare services.
Health Affairs9d
Learning From The Failure Of A CMS Emergency Medical Services Model
The Emergency Triage, Treat, and Transport model, which CMS ended early in 2023, failed due to problems with program ...
American Hospital Association5d
CMS announces new prior authorization program pilot
The Centers for Medicare & Medicaid Services June 27 announced the rollout of a 6-year technology-enabled prior authorization ...
Home Health Care News1d
‘The Largest Cut Ever’: CMS Proposed Home Health Payment Rule Shakes Industry Leaders
On Monday, the U.S. Centers for Medicare & Medicaid Services (CMS) unveiled its proposal for the 2026 home health payment ...
McKnight's Long-Term Care News12h
‘Immense requirements‘ bearing down on providers and states as Senate passes record Medicaid cuts
The Senate passed its version of a massive 10-year reconciliation bill Tuesday, keying up a new fight in the House, where some Republicans said they remain ardently opposed to the bill’s steep ...
Managed Healthcare Executive2d
CMS’s RADV Strategy Will Reverberate Throughout Health Plan Operations
To prepare for CMS’ new risk adjustment data validation (RADV) strategy, Medicare Advantage plans must take a coordinated, ...
American Hospital Association2d
CMS proposes 6.4% decrease to home health payments for CY 2026, updates to quality and value-based purchasing programs
The Centers for Medicare & Medicaid Services June 30 issued its calendar year 2026 proposed rule for the home health ...
Fierce Healthcare2d
CMS study: Healthcare spending likely to grow by 7.1% in 2025
A new report from federal actuaries estimates that national health spending will increase by 7.1% in 2025, with spending ...
Are the federal Medicaid changes really addressing fraud and abuse?
Lawmakers from different sides of the aisle, and sometimes even on the same side of the aisle, have had different messages on ...
Becker's Spine Review2d
CMS to add prior authorization for spine procedures in traditional Medicare
Some fee-for-service spine procedures in traditional Medicare will have prior authorizations added, according to CMS’ new Wasteful and Inappropriate Service Reduction model. CMS is partnering with AI ...
Fierce Healthcare1d
Exclusive look at Cadence's Advanced Primary Care Management business launched under new CMS pathway
Cadence, a remote monitoring service provider, has stealthily created an advanced primary care business to help health ...