CMS’s proposed crackdown on Medicare Advantage upcoding could save billions and mark a turning point in the fight against insurer fraud.
Retirees on Medicare will soon be unable to access this incredibly popular service.
On December 29, 2025, the Centers for Medicare & Medicaid Services (“CMS”) announced that it will distribute award amounts to ...
The Centers for Medicare & Medicaid Services (CMS) has notified Medicare Advantage organizations of a new system for managing and tracking provider complaints.
The CMS has proposed several key changes for 2027, to make sure Medicare "works better for the people it serves." ...
The Centers for Medicare & Medicaid Services (CMS) has pulled information on health equity for the Medicaid and Children’s Health Insurance Program (CHIP) through Section 1115 waivers. Now, CMS is ...
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12 services Medicare Part B covers (and 5 it won’t pay for)
Medicare Part B covers many essential services, but not everything. Learn the 12 services it pays for and the 5 common costs ...
CMS reports Medicare fee-for-service improper payments at $28.8 billion in fiscal 2025, with a 6.55% improper payment rate, down from 2024.
The Centers for Medicare & Medicaid Services (CMS) recently published its Proposed 2026 Physician Fee Schedule Rule (Proposed Rule), with extensive implications for drug pricing, Average Sales Price ...
Medicare primarily operates a fee-for-service (FFS) payment system. This means that healthcare professionals and facilities bill Medicare for each service they provide, with itemized costs appearing ...
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