CMS launches 6-year model to curb wasteful Medicare spending with AI-driven reviews
Editor's Note The Centers for Medicare & Medicaid Services (CMS) announced the launch of a new model using artificial intelligence (AI) to target unnecessary Medicare spending, the agency reported in an October 17 update. The voluntary model will run from January 1, 2026, through December 31, 2031, and aims to…
AI-driven CMS pilot model could slow ASC care despite fraud-fighting goals
Editor's Note The Centers for Medicare & Medicaid Services (CMS) is enlisting artificial intelligence (AI) to combat wasteful spending, but ambulatory surgery centers (ASCs) warn the plan could slow care and increase administrative strain, Ambulatory Surgery Center News October 20 reports. The agency’s new Wasteful and Inappropriate Service Reduction (WISeR)…
Largest US healthcare fraud case reveals billions in false Medicare, Medicaid claims and vast schemes nationwide
Editor's Note The US Department of Justice (DOJ) has conducted the largest healthcare fraud takedown in US history, charging 324 individuals, including 96 licensed medical professionals, in schemes totaling more than $14.6 billion, HealthCare Business News July 8 reports. The nationwide crackdown involved 50 federal districts and 12 state attorneys…
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