Lack of Medicaid oversight results in $10M in overpayments

The New York comptroller said it flagged the over payments the state Health Department made due a lack of oversight.

Oregon rejects federal claims of Medicaid spending on undocumented immigrants

Federal officials say Oregon misused millions on Medicaid coverage for undocumented immigrants. The state says that’s false ...

State audit identifies $1.7M in Medicaid overpayments

A lack of adequate oversight around third-party cost-sharing claims resulted in more than $1.7 million in Medicaid ...
JD Supra

CMS Lifts Medicare Claims Hold Amid Government Shutdown

On October 21, 2025, CMS released a Medicare Learning Network (MLN) Connects Newsletter announcing that the claims hold ...
Becker's Hospital Review

Almost All Non-Medicare and Non-Medicaid Claims are Governed by ERISA — And That’s Good News

Hospital executives, contracting personnel and revenue cycle teams may have heard about The Employee Retirement Income Security Act of 1974 — better known as ERISA — but few clearly understand how ...

Fall River pediatrician will pay $175K to settle Medicaid fraud claims

Tural Pediatrics on Walnut Street will pay $175,000 to resolve allegations that the pediatric group was submitting false ...
Governing

Illinois Clinics Struggle Under Unpaid Medicaid Claims

On a weekend night, long after her last patient had gone home, Crystal Stone sat at her desk at New Leaf Behavioral Health, sifting through a growing stack of unpaid Medicaid claims. The numbers ...