EmblemHealth is required to cover gender reassignment surgery and pay $250,000 in civil rights penalties to the state after the attorney general reached a settlement with the not-for-profit insurer.
The U.S. Department of Justice has intervened in a whistle-blower lawsuit against Sutter Health that accuses the health system of submitting unsupported diagnosis codes to inflate its Medicare Advantage payments.
Federal and Massachusetts authorities allege Minneapolis-based Target violated federal and state False Claims Acts by automatically refilling Medicaid recipients' prescriptions and seeking payment from Medicaid.
Five metro Detroit doctors and one from the Grand Rapids area have been indicted for allegedly running a $464 million healthcare fraud scheme that involved millions of opioid drugs and unnecessary medical procedures in Southeastern Michigan.
The CMS found Medicare Advantage plans' provider directories have widespread inaccuracies for the third year in a row, which could lead to fines for the insurers.
Nursing homes with lower-than-average weekend staffing will face more frequent weekend inspections by state survey agencies checking up on quality of care and resident safety, the CMS said.
A government watchdog warned that Medicare could end up spending more money on laboratory tests, even though the CMS has reformed its payment system.
The CMS has accepted Vanderbilt University Medical Center's correction plan to maintain its Medicare contract, after threatening to pull it for failures around the 2017 wrongful death of a patient.
The hackers installed ransomware on the systems of Allscripts, Medstar Health, and others, sealing off access to data until the companies paid a ransom in bitcoin.
The CMS overpaid some hospitals at least $140.5 million due to an often inaccurate tool used to set Medicare payments. HHS' Office of Inspector General says the wage index system needs to be overhauled to mend vulnerabilities.
The FDA hired a research firm to find out if its current process for approving or denying human testing requests needs to be revamped.
MACPAC expressed concern to HHS about the number of Arkansans who have lost health coverage by failing to comply with the work requirement.