Our monthly Medicaid news summary highlights important developments shaping Medicaid programs nationwide. Syrtis Solutions tracks research, legislation, and industry updates related to program integrity, cost avoidance, coordination of benefits, improper payments, and fraud, waste, and abuse. Below is a recap of last month’s news. View the...
Payment prevention is becoming a defining priority across Medicaid program integrity. Federal agencies continue to expand fraud enforcement, while Congress has strengthened financial accountability through the One Big Beautiful Bill Act (H.R. 1). Together, these developments reflect a broader shift in Medicaid—from emphasizing post-payment recovery...
Syrtis' monthly Medicaid news summary highlights important developments affecting Medicaid programs nationwide. The roundup focuses on research findings, regulatory changes, and policy discussions related to program integrity, cost avoidance, coordination of benefits, and efforts to address improper payments and fraud. Below is a recap of...
Automated algorithmic analysis and insurance discovery engines (AAAIDE) are becoming cornerstones of modern Medicaid operations. By identifying liable third-party coverage at the point of claim adjudication, these technologies reduce improper payments, strengthen payment accuracy, and improve coordination of benefits. This priority is now reflected in...
Syrtis Solutions publishes a monthly summary highlighting important Medicaid news and policy developments. The roundup focuses on research, legislation, and program changes related to Medicaid integrity, coordination of benefits, cost avoidance, and efforts to address improper payments and fraud. The following section summarizes last month’s...
Drug pricing reform has become a major focus of Medicaid cost-containment efforts. Policymakers continue exploring supplemental rebate programs, alternative purchasing models, and initiatives such as CMS's GENEROUS Model in an effort to reduce prescription drug spending and improve purchasing efficiency. These strategies may help lower healthcare...
Our monthly Medicaid news roundup provides a concise overview of policy developments, research, and legislative updates affecting Medicaid programs. Topics include program integrity, cost avoidance opportunities, coordination of benefits, and initiatives aimed at reducing improper payments and fraud. Below is a recap of last month’s...
Stephen Konsin Jr. from Syrtis Solutions, a solution provider at the Marcus Evans Value-Based Care Summit 2026, discusses the growing need for proactive Medicaid payment accuracy and cost avoidance strategies. Interview with: Stephen Konsin Jr., Vice President of Sales, Syrtis Solutions “The window for demonstrating proactive prevention...
Syrtis Solutions publishes a monthly summary highlighting important Medicaid news and policy developments. The roundup focuses on research, legislation, and program changes related to Medicaid integrity, coordination of benefits, cost avoidance, and efforts to address improper payments and fraud. The following section summarizes last month’s...
Medicaid remains one of the most critical public programs in the United States, delivering healthcare coverage to millions of individuals across diverse and often vulnerable populations. As its role has expanded, so has the responsibility to manage its resources with precision. However, fraud, abuse, and...