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 ...

Organizations across the health care continuum, including the home-based care industry, have responded to the Centers for Medicare and Medicaid (CMS)’ ...

WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services (CMS) announced a new oversight initiative aimed at ensuring that enrollees in Medicaid and the Children’s Health Insurance Program ...

In this article, we outline actionable strategies for strengthening one of the most essential administrative data ...

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 ...

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 ...