Medicare Advantage (MA) has reshaped healthcare coverage for beneficiaries, offering comprehensive benefits through private insurers. However, the program’s expansion has also introduced complex challenges, notably fraud, waste, and abuse (FWA)…
Program Integrity
We offer solutions…
We offer solutions as a trusted & reliable program integrity partner. With 30+ years of proven expertise, we deliver successful results for government agencies like CMS and the commercial sector….
How to Write an Effective Healthcare Fraud Investigative Report
A well-written healthcare fraud investigative report can help to identify and prevent improper payments – having a significant impact on individuals and organizations, including federal and state government agencies. The…
Healthcare Secret Shopping: An Effective Tool for Detecting Fraud and Abuse
The Government Accountability Office (GAO) made headlines recently when sharing news that 11 of 12 fictitious applicants obtained coverage for health insurance through the Federal marketplace. GAO targeted the Federal…
