Medicaid

Grand jury says $10m from a Medicaid settlement was improperly diverted to Hope Florida, raising concerns about oversight and use of public funds.

The agency says machine-learning and AI analytics contributed to increased enforcement.

Our in-brief roundup of notable healthcare and life sciences stories from the last two weeks.

The American Hospital Association warns against accelerating clawbacks and reducing reimbursements under CMS’s 2027 OPPS rule.

The US DOJ memo outlines fraud enforcement priorities, spotlighting healthcare, tax, trade, and corporate misconduct.

The 5th Circuit struck down parts of the No Surprises Act’s QPA calculation while upholding federal limits on air ambulance payment challenges.

A Brookings study argues Medicaid work requirements rely on invented evidence, fail to improve employment, and could reduce healthcare access for vulnerable populations.

New CMS rule bars federal dollars from covering puberty blockers, hormones, and surgeries for minors, citing safety concerns and insufficient evidence.