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Audit finds New York failed to recover $93M in Medicaid overpayments
A follow-up audit released this month by New York State Comptroller Thomas P. DiNapoli revealed that the Department of Health ...
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Audit Finds Gaps in Medicaid Checks; Majority of Enrollees Not Fully Screened
From the Arizona Senate and House majority leaders' press conference on Medicaid fraud Sen. Janae Shamp (R) discusses findings of the audit ...
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CMS warns of phishing fax scheme; AHA monitoring other reported social engineering schemes
The Centers for Medicare & Medicaid Services today announced it has identified a fraud scheme targeting Medicare providers ...
Kearney Hub7mon
Nebraskans leaving Medicaid over ‘aggressive,’ costly audits. State says system working as it should.
Dru McMillan opened the envelope, saw the number and felt sick. “If you agree with the determination, please submit ... $21,042.73 within 30 days,” it read. McMillan is a Lincoln therapist who ...
Managed Healthcare Executive5d
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, ...
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Auditors find the state paid another $103M for ineligible Medicaid recipients
An audit by the Louisiana Legislative Auditor follows a 2023 report that identified $112 million covered for ineligible individuals by the state’s Medicaid program.. In 2023, the Louisiana Legislative ...
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Indiana Medicaid audit finds questionable payments for ABA autism therapy | STAT
The report’s central finding is that Indiana made at least $56.6 million in improper Medicaid payments plus $76.7 million in potentially improper payments for ABA in 2019 and 2020, or at least ...
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Medicare Shake-Up: New Audits Target Billions in Overpayments - MSN
WASHINGTON, D.C. – The Centers for Medicare & Medicaid Services (CMS) has unveiled a significant expansion of its Medicare Advantage (MA) auditing program aimed at addressing fraud, waste, and ...