On February 25, 2026, the Centers for Medicare & Medicaid Services (“CMS”) announced several program integrity actions impacting Medicaid funding and Medicare supplier enrollment, along with a request ...

Organizations across the health care continuum, including the home-based care industry, have responded to the Centers for Medicare and Medicaid (CMS)’ ...

State modernizes quality assurance and expands tools to bolster program integrity and access to careIRVING, Texas, April 08, 2026 (GLOBE NEWSWIRE) -- Gainwell Technologies LLC today announced that New ...

As previously reported by Sheppard, the Centers for Medicare & Medicaid Services (“CMS”) has announced several program ...

The Centers for Medicare & Medicaid Services is implementing the Substance Access Beneficiary Engagement Incentive, a new ...

Amber Nigam is CEO and cofounder of basys.ai, a Harvard-based company streamlining prior authorization for health plans with agentic AI. Fraud, waste and abuse (FWA) has historically been addressed at ...

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 ...

President Donald Trump’s administration has moved to shut down a long‑running Medicaid financing loophole that officials say allowed states to shift billions in costs onto federal taxpayers. The ...

Since 1992, the 340B drug discount program has entitled certain federal grantee clinics and hospitals (called “covered entities”) to purchase outpatient drugs at substantial discounts. The discounted ...

Medicare Advantage could see major payment and oversight changes. Learn how the proposal may affect plan costs, coverage, and ...