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Fraud › Artificial Intelligence › Medicare

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
Davis Wright Tremaine LLP

CMS Launches WISeR Model to Curb Overuse of Medicare Services

Davis Wright Tremaine LLP on

The Centers for Medicare and Medicaid Services (CMS) is looking to reduce the volume of "low value" services furnished to Original Medicare beneficiaries through the recently announced Wasteful and Inappropriate Service...more

Stevens & Lee

New Changes to Medicare and Private Prior Authorization Processes

Stevens & Lee on

Both the Centers for Medicare & Medicaid Services (CMS) and dozens of the nation’s largest insurance companies have revealed upcoming changes to their prior authorization processes. These changes aim to reduce the prevalence...more

Arnall Golden Gregory LLP

Government Investigations Team Insights - July 2024

Arnall Golden Gregory LLP on

AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics. Our team, which includes former federal prosecutors, SEC enforcement attorneys, and federal agency attorneys, has...more

Arnall Golden Gregory LLP

Wave of the Future: Are AI and Data Mining the Next Generation of “Professional Whistleblowers”?

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In the realm of False Claims Act (“FCA”) litigation, the emergence of artificial intelligence (“AI”) and data mining technologies has introduced both opportunities and complexities for defense strategies. Historically, qui...more

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