Digital Government

White House withholds $1.3B in Medicaid payments to California amid broader fraud crackdown

Vice President JD Vance said the administration will audit states’ Medicaid Fraud Control Units and threatened to “turn off” federal funding for the watchdogs if their fraud prevention efforts are found to be deficient.

Artificial Intelligence

Agency leader says AI is helping resource-strained workforce identify more fraud

The Centers for Medicare and Medicaid Services official also said the Trump administration’s efforts to combat fraud in government are enabling her to “push the needle” with using the technology.

Digital Government

CMS rule looks to kill faxed, mailed claims in favor of e-submissions

CMS Administrator Dr. Mehmet Oz said the new rule “will modernize American healthcare by standardizing electronic claims attachments and enabling secure electronic signatures.”

Artificial Intelligence

CMS seeks to expand tech-driven fight against Medicaid fraud

The agency is looking at “testing new approaches and really being able to think outside of the box” to claw back improper payments, according to CMS COO Kim Brandt.

Artificial Intelligence

AI ‘nihilism’ is a barrier to better health care, CMS lead says

CMS Administrator Dr. Mehmet Oz said the agency has had internal discussions about introducing an agentic AI tool “for every beneficiary.”

Digital Government

CMS touts early uses of new biometric verification tools for Medicare.gov

Amy Gleason, acting administrator of the U.S. DOGE Service and strategic advisor to CMS, said 60% of accounts created since the rollout “have all been using one of these modern credentials.”

Artificial Intelligence

CMS saved $2 billion by using AI to fight fraud, official says

Centers for Medicare and Medicaid Services COO Kim Brandt talked about her agency’s use cases for artificial intelligence in the ongoing battle against fraudulent medical claims.

Artificial Intelligence

CMS built a waitlist for its AI chatbot — and that drove momentum — official says

The approach helped the agency get more targeted insights from those familiar with the emerging capabilities. 

Artificial Intelligence

CMS launches ‘chili cook-off competition’ to source AI that can detect fraud

The agency said it is looking for innovative solutions that can “uncover unusual patterns, anomalies, or trends that may signal fraudulent activity” in Medicare claims data. 

Digital Government

White House launches digital health initiative backed by leading tech firms

President Trump said the effort to create a more robust digital health ecosystem will give providers and patients more streamlined access to health information.

Ideas

CMS findings identify barriers to effective healthcare

COMMENTARY | Many of these issues are multifaceted and complex to address, and they would require collaboration between public and private sectors.

Modernization

ATO ASAP: Let’s finally fix the security compliance problem

The process federal agencies go through to prove a system is secure may actually be making us less secure. This is a problem that we must fix today, not tomorrow.

Digital Government

Accenture rebuffed again in Healthcare.gov protest

Accenture Federal Services lost yet another protest in its effort to hold on to a contract operating the Healthcare.gov exchange that connects health insurance applicants to coverage available under the Affordable Care Act.

Cybersecurity

Advanced tech and human operators

Artificial intelligence and machine learning tools are helping perform cybersecurity tasks, but humans remain central to the process, experts say.

Modernization

AI faces growing pains in the federal workplace

Auditors want artificial intelligence tools to monitor fraud and abuse, but the new tech is slow to penetrate agencies.

Modernization

Agencies seek betters ways to track past performance

Federal officials want new methods to get feedback on their vendors into the Contractor Performance Assessment Reporting System.

Acquisition

QSSI gets a 1-year extension on health care data hub

A long and drawn-out procurement including four rounds of protests and multiple federal lawsuits means that the incumbent contractor charged with maintaining a key piece of the Affordable Care Act infrastructure gets another year on the job.

Digital Government

USDS in action

Steve Kelman digs into the actual mechanics of a U.S. Digital Service team's partnership with a particular agency.

Digital Government

CMS launches API for Medicare claims data

The Centers for Medicare and Medicaid Services is flipping the switch on a service that lets Medicare beneficiaries more easily download and share their health data.