by David Valentine | May 15, 2026 | Fraud, Waste and Abuse
The Billion Dollar Blind Spot: Reducing PERM Errors Using Prepayment Precision in the Wake of H.R.1 Medicaid Oversight Reform Constellation Quality Health’s Director of Payment Integrity Robyn Winters, RN, QP, BSA, AHFI provides her insight into how states can...
by Ashadan Forbes | Mar 26, 2026 | Case Studies, Fraud, Waste and Abuse, Thought Leadership
Team Up for Patient Safety: Why Program Integrity is the Ultimate Safety Net By: Rolanda “Landi” Anderson, RN, CMRS – March 2026 At a Glance: In honor of Patient Safety Awareness Month, we explore how rigorous clinical reviews and 99% accuracy in program...
by Ashadan Forbes | Jan 27, 2026 | Fraud, Waste and Abuse
Blueprint for Integrity: Engineering Cohesive Oversight in Medicaid Laying the Foundation: Building Stronger Medicaid Oversight Through Collaboration Written by: Janet Ellis, CFE, RDH, CPC, CPCO According to Medicaid.gov (2025), Medicaid provides essential healthcare...
by Ashadan Dales | Dec 1, 2025 | Fraud, Waste and Abuse
Fraud, Waste, and Abuse in Medical Coding & Billing: What Every Provider Should Know In the complex world of healthcare, accurate coding and billing is not just a best practice, it is a legal requirement. Errors, intentional or accidental, can lead to costly...
by Ashadan Dales | Jun 30, 2025 | Fraud, Waste and Abuse
Using AI to Close the Provider Knowledge Gap and Reduce Improper Payments By Richard Mennuti, MBA, Associate Vice President, Fraud, Waste & Abuse Introduction Improperly submitted medical claims cost health care payors billions of dollars annually, while...
by Ashadan Dales | Mar 17, 2025 | Fraud, Waste and Abuse
Leveraging Awareness Campaigns to Combat Fraud, Waste, and Abuse in Dental Care By Janet Ellis, CFE, RDH, CPC, CPCO March is recognized as Fraud Prevention Month, an annual campaign dedicated to raising awareness about fraud, scams, and identity theft,...
