A HHS study found physicians are still improperly billing Medicare enrollees for services of which they should be exempt, according to The New York Times. 1. Despite official warnings about fines or ...

Two recent Department of Justice settlements with health care providers shine a new spotlight on a long-standing risk for health care fraud and abuse. Two recent Department of Justice settlements with ...

UnitedHealth Group leveraged “aggressive strategies” to get higher-paying Medicare Advantage diagnoses, according to a Jan. 12 Senate report that Becker’s viewed. The Wall Street Journal initially ...

The Centers for Medicare & Medicaid Services (“CMS”) has significantly increased its use of powerful program integrity tools that can revoke or deactivate billing privileges in a matter of days. These ...

An analysis of differential coding patterns between Medicare Advantage (MA) and Traditional Medicare (TM) plans estimated how much coding differs between insurers and how much extra revenue insurers ...

UnitedHealth Group is again responding to a Wall Street Journal story about billing practices for its Medicare Advantage plan. The Department of Justice’s criminal healthcare-fraud unit is ...

The Trump administration has released new estimates on improper payments in key government insurance programs. | The Trump ...

Prolia (denosumab) is a medication for osteoporosis. A healthcare professional administers Prolia via injection under the skin every 6 months. Medicare covers Prolia for beneficiaries. Since a ...

As it navigates three strikingly different class-action settlements that collectively tell a complex tale about consent, ...