Irene Oshiyoye, who operated Advance Visiting Physicians in Farmington Hills, Mich., with her late husband, has agreed to pay $250,000 to settle accusations that she violated the False Claims Act. Authorities say she submitted claims to Medicare and Medicaid for home health services provided by unlicensed, unsupervised foreign doctors, which violates the programs' rules.

Fraud charges have been filed against 12 people in the second phase of Operation Nightingale, which targets the sale of fraudulent nursing diplomas and transcripts from now-closed nursing schools in Florida. They are accused of conspiring to sell the fraudulent diplomas, enabling buyers to take licensing exams and obtain nursing jobs. The scheme generated around 7,300 fake diplomas.

Gordon Skinner of New Haven, Conn., has been charged with larceny and health insurance fraud. Investigators say Skinner defrauded Medicaid of $5,584 by submitting timesheets for more than 200 hours of day support services that were not rendered between May 2024 and December 2024.

Hospital leaders are encouraged to actively engage with AI to better understand its impact and to serve as role models for their staff. By integrating AI into their workflows, executives can gain firsthand experience and effectively evaluate AI's real-world applications. This initiative is crucial in aligning with the transformative potential of AI. "You cannot take full advantage of [AI] if you don't have that level of operational discipline and knowledge to know how this tool, this capability, this new thing can completely transform and change the way that we think about that process," Fairview Health Services President and CEO James Hereford says.

Medicare has introduced advanced primary care management and behavioral health service codes that could significantly boost primary care revenue for some practices, physician and associate professor of health care policy Dr. Zirui Song wrote in a Journal of the American Medical Association viewpoint. However, uptake of similar codes has been hindered by documentation burdens, capacity constraints and patient cost-sharing.

Senate Majority Leader John Thune, R-S.D., said expiring Affordable Care Act subsidies will be addressed later this year but not as part of a stopgap funding measure. "I think the ACA subsidies will be an issue that will be addressed, but I think right now we've got to keep the government open so we can do appropriations bills and work on that, with that solution," Thune said.