In this article, we outline actionable strategies for strengthening one of the most essential administrative data assets—encounter data—and explain how improving this resource can unlock the ...

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 ...

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 ...

Minnesota plans to centralize Medicaid eligibility determinations under DHS, moving away from the current county-based system ...

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 ...

Kentucky's House Bill 2 could introduce new work requirements and copays for thousands of Medicaid recipients. Here's what to know.