HMS presenter Matt told the HP 23 1295 RAC advisory board that Colorado Medicaid requires a single claim for continuous inpatient stays even when patients transfer between distinct part units within the same hospital; separate claims may be identified as overpayments during audits.

Manitoba's dialysis management faces criticism as audit reveals inefficiencies amid rising kidney disease rates. Government urged to act.

kairos ransomware targeted Arbeitsgemeinschaft Wirtschaftlichkeitsprüfung Niedersachsen e.V. (ARWINI), a Lower Saxony statutory health-insurance audit body in Germany that coordinates efficiency and appropriateness reviews for outpatient care under SGB V through the KVN and health insurers. The incident affected ARWINI’s operations and threatened its ability to deliver inspection and billing-related workflows supporting contractual outpatient services in #Germany

HMS presented five automated audit scenarios — duplicate behavioral-health claims, pediatric behavioral therapy place-of-service and provider-type issues, missing ordering providers, and NEMT trips without a qualifying medical claim — and providers raised concerns about FQHC exceptions, record burdens for disputes, and the automated approach to high-volume services.

Forvis Mazars presented the audited financial statements for the El Paso County Hospital District for the year ended Sept. 30, 2025. Auditors highlighted material items: patient accounts receivable allowances, Medicaid supplemental funding (~$145M), adoption of GASB 101, and a net position increase of about $16.4M; commissioners accepted the presentation.

Steve Anderson, inspector general in the attorney general's office, told the Committee on Welfare Reform that audits and investigations identified millions in waste and overpayments in Medicaid and related programs, and recommended fixes including technology updates, staffing and policy changes that could yield multimillion-dollar savings.