The history of HCBS demonstrates that its growth is not, in fact, evidence of massive undetected fraud, but rather is based ...

Fraud is one reason Republicans in Congress say they don't want to extend enhanced subsidies for Affordable Care Act health insurance premiums. The Government Accountability Office recently issued a ...

UnitedHealth rolls out AI in Optum Rx to flag pharmacy fraud, billing anomalies and medication risks, aiming to curb cost leakage and improve compliance.

Government auditors tried to enroll 24 fictional people in health insurance plans offered via the Affordable Care Act exchanges—the marketplaces where taxpayer-subsidized health insurance plans are ...

This report discusses the preliminary results of the GAO’s work on fraud risk management in the advance premium tax credit—a subsidy that the government pays to insurance companies to make premiums ...

The U.S. health insurance system is facing a trust crisis. Satisfaction with coverage and care quality has dropped sharply in recent years, weighed down by rising costs, quality and coverage.

A key strategy in the Trump administration’s crackdown on gender medicine is identifying and prosecuting insurance fraud. A common form of potential billing fraud involves use of the diagnosis ...