Service (FFS) estimated improper payment rate was 6.55%, or $28.83 billion, compared to the FY 2024 reported rate of 7.66%, ...

The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain traditional ...

CMS reports Medicare fee-for-service improper payments at $28.8 billion in fiscal 2025, with a 6.55% improper payment rate, down from 2024.

It’s March, which means one thing for sports fans: the madness of the NCAA men’s and women’s basketball tournaments. However, to folks in the regulatory world, it also means something else too: the ...

Original Medicare primarily operates on a fee-for-service (FFS) system, billing for each service provided. Some Medicare Advantage (Part C) plans also use this payment model via private FFS plans.

Private Fee-for-Service (PFFS) plans are one of four main types of Medicare Advantage policies that private insurance companies administer. The plans have specific rules relating to costs paid to ...

The authors of the study and the editorial note that a primary limitation on these findings is the concentration of Medicare ...

As described in a previous Regs & Eggs blog post, certain Medicare “extenders” got tied to the government shutdown. These policies are temporary in nature, but Congress routinely extends them every ...

Medicare Advantage payments are $76 billion above what spending would have been in fee-for-service Medicare in 2026, ...

A new Oklahoma executive order on Medicare Advantage may go further than any other state initiative to rein in practices largely seen as unfavorable to both beneficiaries and providers.

Medicare Advantage (MA) is privately administered health care insurance for seniors and persons with disabilities. The program has grown rapidly and now covers more than half of Medicare-eligible ...