The Tungsten+PLUS™ platform delivers comprehensive downstream services, including MFP claims reconciliation, dispute ...

A cross-sectional analysis of Medicare beneficiaries found that one in six beneficiaries used telehealth between 2021 and 2023, with nearly half of all mental health visits conducted virtually. The ...

New Medicaid prior-authorization rules have advocates in Connecticut concerned about patients losing access to their prescription drugs.

As 2025 drew to a close, the Centers for Medicare & Medicaid Services (“CMS”) issued proposed rules for two mandatory pricing models aiming to reduce out-of-pocket costs for Medicare drugs.

The Centers for Medicare & Medicaid Services (CMS) has released a proposal outlining 2027 payment and policy updates to Medicare Advantage (otherwise known as Medicare Part C), a private‑plan ...

As CMS moves to replace four legacy Medicare claims platforms, it is seeking a vendor to design one platform that would assume all the systems’ responsibilities. In a Jan. 8 request for information, ...

The Centers for Medicare & Medicaid Services has implemented an online form for providers to submit complaints regarding Medicare Advantage plans. CMS announced the form in a memorandum issued Dec. 22 ...

Question from Elaine: I'm 66, still working, and getting health insurance through my employer. I'd like to continue to work for at least a couple more years. However, there's talk that my office ...

If you did not sign up for Medicare during your Initial Enrollment Period, then that means you should be coming in to Medicare during your Special Enrollment Period Investigators seize luxury goods ...

The Centers for Medicare & Medicaid Services is again postponing skilled nursing facilities’ mandatory off-cycle revalidation deadline — this time indefinitely, according to sources. This is the ...