The Centers for Medicare & Medicaid Services (CMS) is a department of Health and Human Services (HHS). The current administrator is Seema Verma, appointed by President Donald Trump.
CMS oversees the Medicare and Medicaid programs. CMS collects and analyzes data, produces research reports, and works to eliminate instances of fraud, waste and abuse within the health care system.
WASHINGTON—Top United States health insurance providers pledged to streamline and improve the prior authorization processes for Medicare Advantage, Medicaid Managed Care, Health Insurance Marketplace and commercial plans covering nearly eight out of 10 Americans, Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz announced on Monday, June 23.
Responding to charges that President Donald Trump’s tax and spending bill would cut Medicaid coverage for millions of Americans, Trump administration officials misleadingly counter that it targets only waste, fraud and abuse.
WASHINGTON—In its recently released budget documents, the Department of Health and Human Services (HHS) has indicated that the Centers for Medicare & Medicaid Services (CMS) is likely to start the next round of competitive bidding.
WISCONSIN—Michael G.V. Comino was sentenced to 22 months; imprisonment for conspiracy to pay and receive health care kickbacks in violation of the Anti-Kickback Statute. Comino was also ordered to pay over $2 million in restitution to Medicare.
TEMPE, Arizona—PocketRN, a provider of virtual nursing care, and SYNERGY HomeCare, a homecare company, announced they will form a national partnership to test the Centers for Medicare & Medicaid Services (CMS) alternative payment model designed to support people living with dementia and their family caregivers.
BALTIMORE, Maryland—The Centers for Medicare & Medicaid Services (CMS) announced it has released its final national coverage determination (NCD) for the treatment of chronic respiratory failure associated with chronic obstructive pulmonary disease (COPD).
WASHINGTON—A federal jury convicted the CEO of Power Mobility Doctor Rx, LLC (DMERx) for his role in operating a platform that generated false doctors’ orders to defraud Medicare and other federal health care benefit programs of more than $1 billion.
ST. PAUL, Minnesota—High school senior Joshua Yang understands sacrifice. When he was midway through 10th grade, his mom survived a terrible car crash. But her body developed tremors, and she lost mobility. After countless appointments, doctors diagnosed her with Parkinson’s disease, saying it was likely triggered by brain injuries sustained in the wreck.
At 15, Yang, an aspiring baseball player and member of his school’s debate team, took on a new role: his mother’s caregiver.
NEW YORK—A Florida man who allegedly sold fake prescriptions for durable medical equipment prescriptions was sentenced to 42 months in prison.
WASHINGTON—Following the recent release of the Health Technology Ecosystem request for information (RFI), the Centers for Medicare & Medicaid Services (CMS) hosted an in-person listening session to discuss the RFI and ways to use the health technology innovations to enhance patient care and promote efficiencies in the health care system.
LOUISVILLE, Kentucky—A former Kentucky resident was sentenced last week to two years and nine months in federal prison for engaging in a conspiracy to commit health care fraud in connection with durable medical equipment businesses.
WASHINGTON—The Department of Health and Human Services (HHS) released more details on the agency’s budget request for the 2026 fiscal year in its 51-page Budget in Brief, along with a 194-page Justification of Estimates for Appropriations Committees for the Centers for Medicare and Medicaid Services (CMS).
OWINGS MILLS, Maryland—The Board of Certification/Accreditation (BOC), a CMS-deemed accrediting organization serving the durable medical equipment, orthotics, prosthetics and supplies (DMEPOS) industries for more than 40 years, shared updates regarding a three-year cessation in accepting new accreditation and reaccreditation applications in four states: Florida, Texas, California and New York.
BOSTON, Massachusetts—The owner of Pharmagears, LLC (Pharmagears) and RR Medco, LLC (RR Medco) has agreed to plead guilty in connection with a nearly $30 million health care fraud conspiracy involving medically unnecessary durable medical equipment (DME), including orthotics such as back and knee braces.
SAN DIEGO, California—Chula Vista resident and businessowner Fernando Valenzuela Ayub pleaded guilty in federal court, admitting that he conspired with others to launder millions of dollars of health care fraud proceeds and paid unlawful kickbacks.
BALTIMORE, Maryland—The Centers for Medicare & Medicaid Services (CMS) announced a significant expansion of its auditing efforts for Medicare Advantage (MA) plans. Beginning immediately, CMS will audit all eligible MA contracts for each payment year in all newly initiated audits and invest additional resources to expedite the completion of audits for payment years 2018 through 2024.
ALEXANDRIA, Virginia—Three people have been sentenced to prison for their roles in a multi-million-dollar Medicare billing scheme.
HOUSTON—A 64-year-old man has been convicted of all counts as charged for leading a Medicare fraud scheme involving the submission of falsified medical records. The jury deliberated for less than two hours before convicting Paul Njoku following a three-day trial.
WASHINGTON—House Republicans passed the “One Big Beautiful Bill” on Thursday morning after an overnight session with a vote of 215 votes to 214. The sweeping bill is being criticized by homecare industry organizations, with some saying it could harm millions of older adults who rely on at-home care.
ALEXANDRIA, Virginia & WASHINGTON—Ahead of the House Energy and Commerce Committee’s markup of proposed legislation impacting changes to the Medicaid program, aging and in-home care advocates urged Congress to protect Medicaid and preserve access to care.
