They found that, in 2024, the Centers for Medicare & Medicaid Services (CMS) paid subsidies for all four of their fake ...

Companies running private Medicare and Medicaid insurance plans inaccurately list many mental health professionals as being available to treat the plans' members, a new federal watchdog report says.

Health care spending represents nearly $5 trillion of the United States economy, making it a prime target for scammers. Meanwhile, surging national medical costs and increasingly sophisticated attacks ...

A CMS pilot program will require providers in six states to submit select Medicare services for AI-enabled prior authorization or post-service medical review.

KBWB Operations LLC, known as KBWB-Atrium Health and Senior Living, and its former chief executive officer, Kevin Breslin, have been sentenced in a major federal case involving health care fraud and ...

The U.S. health care system is a major target for fraud, with older adults being particularly vulnerable. Artificial intelligence can both worsen fraud through sophisticated scams and help combat it ...

COLUMBUS − Nine Medicaid providers are accused of stealing a combined $530,888 from the government health-care program for the needy, according to indictments filed this month by the office of Ohio ...

A couple running an in-home health care agency in West Chester Twp. is accused of Medicaid fraud causing a loss totaling hundreds of thousands of dollars, according to the Ohio Attorney General’s ...

Federal authorities are cracking down on healthcare fraud in Massachusetts, with the Department of Justice expanding a special unit tasked with investigating and prosecuting complex schemes to the Bay ...

A physician from River Forest has been charged with theft, money laundering, managed care fraud and forgery. The Illinois attorney general's office alleges Dr. Mohammad Khamis received more than $1 ...

An Arizona woman was sentenced to 15.5 years in federal prison for her role in a $1.2 billion health-care fraud scheme. The scheme involved billing Medicare and other insurers for medically ...