by Blog Master | Jun 10, 2026 | MarketingBlog, Uncategorized
The Medicaid Corrupted Provider Loop. In a scheme mirroring the “corrupted retailer” scheme seen in SNAP, fraud in Medicaid is on a massive scale; transnational criminal organizations (TCOs) partner with or establish dishonest medical providers and durable...
by Blog Master | Jun 9, 2026 | MarketingBlog, Uncategorized
The explosion of telehealth has eliminated the need for physical, face-to-face interaction, providing the perfect cover for synthetic networks. When state auditors or MCO compliance teams implement automated liveness or identity-verification protocols to confirm that...
by Blog Master | Jun 8, 2026 | MarketingBlog, Uncategorized
CMS’ recent push for states to revalidate high-risk Medicaid providers is a clear signal: program integrity scrutiny is increasing. As states work to meet these expectations, Medicaid managed care organizations may be asked to support significant provider validation...
by Blog Master | Feb 6, 2026 | MarketingBlog, Uncategorized
In case you missed it, the Office of Inspector General (OIG) has released Industry Segment-Specific Compliance Program Guidance. This comprehensive guide covers several key areas: • Access to Care• Marketing and Enrollment• Risk Adjustment• Quality of Care• Oversight...
by Blog Master | Jan 27, 2026 | MarketingBlog, Uncategorized
Register Here: https://zoom.us/webinar/register/WN_AAZF-9mnSfWcbWG6AQKicg Join us on Wednesday, Feb 18 at 1pm EST for a 1 hour live (recorded) session on exploring how effective payment integrity programs reduce waste, improve accuracy, and deliver measurable value...
by Blog Master | Jan 6, 2026 | MarketingBlog, Uncategorized
In case you missed it, the Office of Inspector General (OIG) has released Industry Segment-Specific Compliance Program Guidance. This comprehensive guide covers several key areas: • Access to Care• Marketing and Enrollment• Risk Adjustment• Quality of Care• Oversight...