As Medicaid programs continue to grow in size, cost, and complexity, program integrity can no longer function as a standalone role—it must be built into the fabric of how programs operate daily.

Florida Attorney General James Uthmeier announced a public assistance fraud task force on Wednesday. What we know. The task ...

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 ...

The Deficit Reduction Act of 2005 provided the resources to establish the Medicaid Integrity Program (MIP), the first national strategy in the 40-year history of the Medicaid program to promote the ...

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

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 ...

CMS finalized a rule this week that ends what it called a healthcare‑related 'financing gimmick,' marking one of the most sweeping Medicaid program‑integrity actions in years. CMS said some states set ...

President Donald Trump’s administration has moved to shut down a long‑running Medicaid financing loophole that officials say allowed states to shift billions in costs onto federal taxpayers. The ...