States can align capitation withholds with value-based payment state-directed payment arrangements to incentivize managed care plans and providers to improve outcomes for dually eligible individuals.

IRVING, Texas, April 08, 2026 (GLOBE NEWSWIRE)-- Gainwell Technologies LLC today announced that New Mexico has deployed a comprehensive suite of the Health Management Systems, Inc. (HMS) program ...

As Medicaid programs continue to grow in size, cost, and complexity, program integrity can no longer function as a standalone role—it must be built into the fabric of how programs operate daily.

On October 3, the Office of Inspector General (OIG) of the US Department of Health and Human Services issued a report titled “UPICs Hold Promise to Enhance Program Integrity Across Medicare and ...

Medicaid is the joint federal-state health insurance program that provides medical coverage to almost five million low-income, elderly, disabled Floridians and children. Although the federal ...

Auditors say the increase coincided with an overall increase in Medicaid enrollment during the first year of the pandemic. The value of improper Medicaid capitation payments made by states to managed ...

The Deficit Reduction Act of 2005 provided the resources to establish the Medicaid Integrity Program (MIP), the first national strategy in the 40-year history of the Medicaid program to promote the ...

The Trump administration and 119th Congress are preparing to reduce federal expenditures by targeting Medicare and Medicaid fraud, waste, and abuse. Medicare enrollment revocations, Medicaid ...

Many healthcare delivery organizations have adopted some form of value-based payment model in recent years, shifting the healthcare focus from quantity of services to quality of outcomes. In a ...

Gov. Joe Lombardo on Thursdd ayvoiced support for recent federal efforts to strengthen Medicaid program integrity and ...

(MENAFN- GlobeNewsWire - Nasdaq) State modernizes quality assurance and expands tools to bolster program integrity and access to care IRVING, Texas, April 08, 2026 (GLOBE NEWSWIRE) -- Gainwell ...