Mehmet Oz, the Trump-appointed head of the Centers for Medicare & Medicaid Services (CMS), faces intense insurer lobbying as CMS moves to curb Medicare Advantage upcoding. Here, he leaves the White ...

Diagnosis-based payment systems can create incentives to upcode patients to a higher level of severity to increase payment. In some instances, upcoding can be a form of fraud if providers code ...

Polls show Americans are angry – and rightly so – at accelerating medical bills. Meanwhile, the insurers and hospitals keep raking in record profits. UnitedHealthcare just reported jumbo profits so ...

Alexandria Ocasio-Cortez came to a Medicare hearing with the receipts — and what followed was one of the most electric congressional confrontations of the year. AOC laid out the case with surgical ...

Last summer, I wrote about the DOJ and HHS relaunching their joint False Claims Act Working Group, with Medicare Advantage risk adjustment fraud listed as one of its top enforcement priorities. The ...

Healthcare workers, billing specialists, and medical professionals frequently encounter fraudulent practices that drain billions of dollars from Medicare programs annually. Yet many individuals who ...

ALBANY, N.Y., May 27, 2026 /PRNewswire/ -- Fraud costs Medicare an estimated $60 billion per year. It costs Medicare beneficiaries time, stress, their medical identities, and potentially their health.

DAVENPORT, Iowa (KWQC) - Federal officials are reminding Medicare users in Illinois and Iowa to watch for red flags and report suspected fraud. Here’s a quick to-do list to protect yourself: Then call ...

Polls show Americans are angry — and rightly so — at accelerating medical bills. Meanwhile, the insurers and hospitals keep raking in record profits. UnitedHealthcare just reported jumbo profits so ...

Polls show Americans are angry — and rightly so — at accelerating medical bills. Meanwhile, the insurers and hospitals keep raking in record profits. UnitedHealthcare just reported jumbo profits so ...