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)’ ...

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 ...

Gainwell Technologies LLC today announced that New Mexico has deployed a comprehensive suite of the Health Management Systems, Inc. (HMS) program integrity and quality assurance capabilities to ...

Nursing homes would see a significant increase in survey and enforcement activity under a budget proposed by President Trump ...

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 ...

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 ...