Payment Prevention is becoming the defining principle of modern Medicaid program integrity. Federal agencies have intensified efforts to combat Medicaid fraud, highlighted by the March 2026 announcement of a new Task Force to Eliminate Fraud. At the same time, Congress

Drug pricing reform has become one of the most discussed strategies for controlling Medicaid costs. As states face rising enrollment, increasing healthcare expenditures, specialty medications, and growing program complexity, policymakers are searching for ways to reduce spending without compromising access

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

As states begin planning their fiscal year (FY) 2027 budgets, many Medicaid programs are preparing for tougher financial conditions. State revenue growth has slowed while healthcare spending pressures continue, and recent federal policy changes under the 2025 budget reconciliation law

Medicaid COB has never been more critical as states confront mounting fiscal pressure and federal funding cuts. Many states have already begun reducing their Medicaid budgets — even before the most significant federal reductions take effect. According to the Medicare

With the passing of the Trump administration’s spending bill in the House, Medicaid is at the center of the healthcare policy conversation. The program now consumes roughly one-third of most state budgets, placing enormous strain on state finances. Medicaid expansion and pandemic-era

The latest House budget proposal presents serious threats to Medicaid funding, potentially cutting billions from state programs. With these looming reductions, Medicaid agencies and Managed Care Organizations (MCOs) must take immediate action to maximize every dollar spent. One of the

Syrtis Solutions, a leading provider of real-time Other Health Insurance (OHI) coverage information for payers of last resort, recently achieved a significant milestone by being named a preferred vendor for the Association for Community Affiliated Plans (ACAP). This designation is

Medicaid has evolved to become an integral safety net program that provides access to health care for millions of Americans. Payment for this health care is either delegated to Medicaid or other third party insurance coverage. In 2012, 7.6 million

The Coronavirus pandemic and the consequential economic recession accentuated the importance of the Medicaid program last year. By February, the Medicaid enrollment rate increased to 7.4 percent, and 76.5 million people were enrolled in the jointly funded program. In 2021,