Medicare & Medicaid
GAO identified systemic issues that impair Medicaid's ability to root out fraudulent activities and offered recommendations.
Medicare claims for catheters have increased, and CMS found a rise in billings by a small group of durable medical equipment supply companies.
Most states ended the unwinding process with higher total Medicaid and CHIP enrollment than in February 2020.
Payments to insurance agents incentivize them to base referrals on financial considerations, DOJ says.
This is an 8% decline following the expiration of pandemic-era policies that temporarily increased star ratings for some plans.
Walgreens allegedly billed the government for prescriptions never dispensed, says DOJ.
After the acquisition closes, IU Health Plans will operate as part of Anthem Blue Cross and Blue Shield in Indiana.
The analysis also finds a high prevalence of vertical integration of PBMs with health insurance companies.
Files containing protected health information, such as Medicare claims data were compromised in a cyberattack involving MOVEit.
CMS has directed that over $4 million in monetary relief be paid to consumers or providers.