The new model incorporates artificial intelligence to help make decisions and is being tested in six states beginning in ...

As lawyers who represent whistleblowers under the False Claims Act, we expect a new era of fraud cases tied to GLP-1 drugs, ...

Traditional Medicare will face greater use of prior authorizations under a pilot program by the Centers for Medicare & ...

The Centers for Medicare & Medicaid Services (CMS) will use AI to help make prior authorization decisions via the new ...

Medicare costs are projected to rise by their highest amount in years. Here’s what to expect if you’re on Part B or Part D.

You may be aware that if you're old enough to get Medicare, it means you're also old enough to sign up for Social Security.

House Democrats are sounding the alarm and demanding more information about a new Department of Health and Human Services (HHS) demonstration they say will increase red tape by adding prior ...

In every way, a study published this January in a major medical journal was a win for UnitedHealth Group. It showed that ...

When I took on the role of leading Medicare, one of my primary goals was to crush the chronic fraud, waste and abuse in the ...

Since 2019, Medicare Advantage plans have been allowed to cover select long-term services and supports — such as in-home support, adult day health, caregiver support, home-based palliative care and ...

Medicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some ...

House Democrats are sounding the alarm and demanding more information about a new HHS demonstration they say will increase red tape by adding prior authorization requirements in Medicare. A group of ...