Latest news with #CentersforMedicare&MedicaidServices
Yahoo
4 days ago
- Business
- Yahoo
CMS AI Implementer Skyward Launches SkyAI Hub, Pioneering Government-Ready Agentic AI to Boost Federal Efficiency
WASHINGTON, May 29, 2025 (GLOBE NEWSWIRE) -- Skyward, a leader in AI infrastructure for the public sector, today announced the launch of its SkyAI Hub, a first-of-its-kind ecosystem of intelligent agents designed to transform government operations. In partnership with the Centers for Medicare & Medicaid Services (CMS), Skyward is deploying AI agents that are delivering significant operational cost savings across critical federal services. The SkyAI Hub provides federal agencies with secure, modular, and audit-ready AI Control Center and Agents that automate complex workflows, reduce manual workload, and improve service delivery at scale. Through its pilot integration with CMS, Skyward's AI assistants have demonstrated a reduction in administrative processing time by over 70%, directly translating into millions of dollars in cost savings and enhanced efficiency. 'This partnership marks a pivotal step toward modernizing public service through AI,' said Dmitry Yun, CEO of Skyward. 'The Skyward AI Hub is not just about automation—it's about rethinking how the government works for the people by deploying intelligent systems that are fast, compliant, and cost-effective.' SkyAI agents are purpose-built to meet federal compliance and security standards while offering seamless integration with existing government systems. The marketplace offers a growing catalog of AI modules covering procurement, claims processing, research and data analytics, fraud detection, compliance auditing, and real-time customer support. 'We're proving that ethical, scalable AI can solve real administrative pain points and generate tangible value for taxpayers not only at CMS but across the Federal government,' added Vitaly Baklikov, CTO of SkywardFounded in 2013, Skyward is a Maryland-based digital services company and trusted federal partner specializing in AI/ML, Agile DevSecOps, Data Science, and Customer Experience. As an 8(a) small business and proud member of the Digital Services Coalition, Skyward is committed to delivering secure, scalable, and user-centered technology solutions that serve the American people. For over a decade, Skyward has worked shoulder-to-shoulder with U.S. federal agencies to modernize mission-critical systems and improve public service delivery. Our clients include the Centers for Medicare & Medicaid Services (CMS), the U.S. Small Business Administration, Department of Transportation and the Department of Homeland Security.. With a deep focus on outcomes, transparency, and agility, Skyward is redefining how the government leverages next-generation technology to operate smarter, faster, and more cost-effectively. Contact:-Ksenia Kapoor PR Lead kkapoor@ This is a paid post and is provided by Skyward. The statements, views, and opinions expressed in this content are solely those of the content provider and do not necessarily reflect the views of this media platform or its publisher. We do not endorse, verify, or guarantee the accuracy, completeness, or reliability of any information presented. This content is for informational purposes only and should not be considered financial, investment, or business advice. All investments carry inherent risks, including the potential loss of capital. Readers are strongly encouraged to conduct their own due diligence and consult with a qualified financial advisor before making any investment decisions. Neither the media platform nor the publisher shall be held responsible for any inaccuracies, misrepresentations, or financial losses resulting from the use or reliance on the information in this press release. Speculate only with funds you can afford to lose. In the event of any legal claims or concerns regarding this article, we accept no liability or responsibility. Legal Disclaimer: This media platform provides the content of this article on an "as-is" basis, without warranties or representations of any kind, express or implied. We assume no responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained herein. Any complaints, copyright issues, or inquiries regarding this article should be directed to the content provider listed above. Photos accompanying this announcement are available at:
Newsweek
5 days ago
- Health
- Newsweek
Dr. Oz's Plan to Save 400 Ostriches Rejected by Farm Owners' Daughter
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Dr. Mehmet Oz' offer to provide sanctuary to 400 ostriches facing death in Canada due to bird flu has been rejected. Katie Pasitney, whose parents own Universal Ostrich Farm, said they are not interested in moving the flock, although she said her family is grateful for the support. "We want to keep this in Canada," she told CBC News. Why It Matters In January, the Canadian Food Inspection Agency (CFIA) ordered the birds be killed after 69 of the same flock at Universal Ostrich Farm in the West Kootenays died from the highly infectious virus. The farm has been fighting the order in court. A judge dismissed a challenge this month that sought to stop the order. The U.S. is currently dealing with one of the largest outbreaks of avian flu in decades which sent egg prices soaring. The CFIA has said it believes some 14 million domestic birds in Canada have been hit by the disease. Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, attends a Make America Healthy Again (MAHA) Commission Event in the East Room of the White House, Thursday, May 22, 2025, in Washington.... Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, attends a Make America Healthy Again (MAHA) Commission Event in the East Room of the White House, Thursday, May 22, 2025, in Washington. More Jacquelyn Martin/AP What To Know Pasitney confirmed she spoke with Oz on Monday, echoing a New York Post report quoting him as saying he offered to relocate the nearly 400 ostriches to his ranch. "It's not like we're looking at transporting our ostriches anywhere, but I think what the message is (about) the growing support across the States," she said. "Even people like Dr. Oz want to be involved and (want to) see these animals live — even offering his 900-acre ranch in Florida." Pasitney added that New York billionaire businessman and radio host John Catsimatidis connected her with both Oz and Kennedy. "He's well connected and he's very passionate about this cause," she said. Kennedy wrote a public letter to CFIA president Paul MacKinnon last week, arguing that the birds should be spared, as there was "significant value" in studying their immune response to avian flu. However, on Monday, the agency stated in response to a question about Kennedy's letter that the "humane depopulation" of the flock would proceed. It added that dates and plans would not be shared publicly due to privacy protections for producers. Catsimatidis issued his own press release on Tuesday, calling on MacKinnon to stop the planned cull. "We're calling for a temporary halt and an independent review. Let the U.S. FDA and veterinary scientists evaluate these birds — don't destroy them before humane alternatives are considered," he said. "Dr. Oz is standing by to assist. We're not asking for miracles, just common sense and compassion." Protesters have also gathered at the farm to try to prevent the cull, while Universal Ostrich Farm filed an appeal on Monday in Vancouver, seeking a "stay of the execution and enforcement" of the culling order. The appeal argues that the Federal Court "made multiple reversible errors" when it upheld the agency's decision to cull the ostrich herd earlier this month. It claims the court "took an unduly narrow" view of the agency's mandate under the Health of Animals Act, wrongly concluded that expert reports were unnecessary, failed to fully consider the consequences of the cull decision, and did not properly determine if the agency's denial of further testing of the animals was reasonable. The appeal also alleges that the farm's lawyers in the Federal Court judicial review proceedings provided "ineffective assistance" that "amounted to incompetence, and resulted in a miscarriage of justice." It states that "prior counsel had a financial stake in the destruction of the appellant's ostriches, resulting in a blatant conflict of interest." Lee Turner, one of the farm's former lawyers, denied these allegations on Monday, stating he "certainly did not" have a conflict of interest and that his co-counsel, Michael Carter, did a "remarkable job with the short window of time that he had." What People Are Saying Dr. Oz, speaking to The Post, said: "It's not just about ostriches," Oz said. "It's about all the birds. I'd rather the scientists make the determination—not bureaucrats. We found out what happened during the COVID pandemic, when the bureaucrats made all the decisions." Catsimatidis told The Post on Monday: "I'm thrilled. Bring the ostriches to Dr. Oz in Florida where they will be safe. I agree with RFK and Dr. Oz that the ostriches aren't sick." Upholding the cull, Canadian Federal Court Justice Russel Zinn said, according to a May 13 CBC report: "Personal losses must be weighed against the broader public interest in protecting public health and maintaining trade stability. Avian influenza is a virus capable of causing serious harm to both animals and humans, with significant implications for Canada's poultry businesses and international trade status. To combat threats like this virus, Parliament has authorized the CFIA to act decisively, making swift decisions with far-reaching consequences, often under conditions of scientific uncertainty." What Happens Next The fate of the ostriches hangs in the balance.
Newsweek
5 days ago
- Health
- Newsweek
Trump Administration Takes Action on Illegal Immigrants Getting Medicaid
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. The Centers for Medicare & Medicaid Services (CMS) has announced heightened oversight to stop states from using federal Medicaid funds to provide nonemergency health care to undocumented migrants. The policy change, linked to an executive order President Donald Trump signed in February, places states on notice for potential recoupment of funds spent in violation of federal law. Newsweek has contacted the CMS for comment via email. Why It Matters This effort marks a significant escalation in federal and state tensions over the boundaries of Medicaid eligibility and the use of taxpayer funds, particularly as debates over immigration policy and public program funding sharpen nationwide. Medicaid, which serves tens of millions of low-income Americans, operates with shared funding and regulatory authority by both federal and state governments. The new measures could affect state budgets and access to care for some populations in states with broader interpretations of Medicaid eligibility. A stock image of migrants gathering for a rally at the U.S.-Mexico border. A stock image of migrants gathering for a rally at the U.S.-Mexico border. Aimee Melo/dpa via AP What To Know The CMS said in a news release on Tuesday, "Under federal law, federal Medicaid funding is generally only available for emergency medical services for noncitizens with unsatisfactory immigration status who would otherwise be Medicaid-eligible, but some states have pushed the boundaries, putting taxpayers on the hook for benefits that are not allowed." The heightened federal oversight includes focused evaluations of selected state Medicaid spending reports, in-depth reviews of states' financial management systems and assessments of eligibility policies to close loopholes. States found to have misallocated funds would face federal recoupment. The CMS announcement did not specify which states were under review or directly affected by the new enforcement, simply citing "select states." Currently, 14 states and Washington, D.C., offer health coverage to undocumented migrants: California, New York, Illinois, Washington, New Jersey, Oregon, Massachusetts, Minnesota, Colorado, Connecticut, Utah, Rhode Island, Maine and Vermont. These states offer different kinds of support for those without legal status in the U.S. Some offer coverage to those over 65 years old, while others offer covered care to children and pregnant women. The agency's action focuses specifically on states using federal Medicaid dollars, not state funding only, in ways CMS deems improper. CMS urged all states to immediately review and update internal controls, eligibility systems and cost allocation policies to ensure federal compliance. The agency made clear that "any improper spending on noncitizens will be subject to recoupment of the federal share." The CMS announcement directly ties the initiative to Trump's Ending Taxpayer Subsidization of Open Borders executive order, which seeks to ensure that federal programs serve only those eligible under law. What People Are Saying Dr. Ben Sommers, a professor of health care economics at Harvard T.H. Chan School of Public Health, Boston, told Newsweek: "Federal law already prohibits Medicaid funds for nonemergency care for undocumented immigrants. I have not seen any data to suggest that what the administration is discussing here is a substantial problem. Emergency Medicaid (which is legal) already represents a very small share of Medicaid spending, which suggests that this additional enforcement is unlikely to yield any notable savings. It sounds more like a political message and posturing about immigration, rather than a genuine attempt to detect fraud or improve the financial circumstances of the Medicaid program." He added: "More notably, when you couple this with the ongoing legislative efforts in the Congressional Budget Bill to cut millions of people from Medicaid, it appears that the administration is more interested in cutting health care services and satisfying its conservative anti-immigrant base than in making health care more affordable for people." Tiffany Joseph, a professor of sociology and international affairs at Northeastern University, told Newsweek: "This move will have a significant impact on the health care access and health of undocumented and even documented immigrants in states that use their own funds to provide nonemergency care to these populations. As those states will be under more scrutiny from the federal government, they will have to make hard choices between complying with the law and extending care to some of the most vulnerable in their states. The targeting of immigrants will have ripple effects for naturalized and U.S.-born citizens in mixed-status families and deter those individuals from applying for and using Medicaid and other social safety nets for which they are eligible due to fear of increased surveillance." She added: "If people do not have access to health coverage through Medicaid or some other means, they will have less access to regular preventive care and go to emergency rooms for care with more severe health problems. As this is the most expensive form of health care, this will increase health care costs for everyone and significantly increase already very long wait times in emergency departments around the country. Though focused on immigrants, this enhanced federal oversight will negatively affect health care access for the broader population. This decision alongside the proposed Medicaid cuts in the recently approved GOP House Budget Bill show that the Trump administration and supporting legislators are not concerned about health care access or the collective health of people living in the United States." Alexandra Filindra, a professor of political science and psychology at the University of Illinois, Chicago, told Newsweek: "If people are excluded from routine care, they may not get vaccinated for all kinds of contagious diseases, increasing the risk of disease for children and susceptible adults. People may delay care until their symptoms are acute, landing in the ER. Emergency care is far more expensive than routine care, and the costs will either have to be absorbed by hospitals, leading to financial trouble, or states, leading to higher taxes. Pregnant women may not get necessary prenatal care leading to health problems in American citizen babies that will have to be addressed by the health care system for the next century. Excluding undocumented people from health insurance will not make them self-deport, it will make Americans less healthy and poorer. It is also cruel and unbecoming of a civilized, democratic society." Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, said in a news release: "Medicaid is not, and cannot be, a backdoor pathway to subsidize open borders. States have a duty to uphold the law and protect taxpayer funds. We are putting them on notice—CMS will not allow federal dollars to be diverted to cover those who are not lawfully eligible." He told Fox News' Sunday Morning Futures: "We do have to support Americans who are most vulnerable. That stated, we have to make the program sustainable. We have to protect it." "There's much we can do as a country. It's a shared responsibility. We have to do it together. But the buck stops here. We've got to clean up the system. We're not paying $200 million for housekeeping anymore a year. We're not going to pay for illegal immigrants in states that are submitting those claims. Why should people living in Mississippi, Texas, or Florida be paying for illegal immigrants getting health care in California?" Drew Snyder, the deputy administrator of the CMS, said in the news release: "Medicaid funds must serve American citizens in need and those legally entitled to benefits. If states cannot or will not comply, CMS will step in." What Happens Next CMS said it would continue "to act decisively to ensure Medicaid dollars serve their true purpose—protecting people eligible for the program under federal law."
Yahoo
5 days ago
- Business
- Yahoo
Feds increase oversight of Medicaid benefits for ‘non-citizens'
May 27 (UPI) -- The Centers for Medicare & Medicaid Services is increasing its oversight of states to prevent misuse of Medicaid funding to provide services for those who unlawfully entered the United States. Federal Medicaid funding is only available for emergency medical services for "non-citizens with unsatisfactory immigration status" when they otherwise would qualify for Medicaid coverage, the Health and Human Services Department said in a news release shared with UPI. Some states, though, "have pushed the boundaries" and made taxpayers liable for benefits that are not allowed by federal law. "Medicaid is not and cannot be a backdoor pathway to subsidize open borders," CMS Administrator Dr. Mehmet Oz said. "States have a duty to uphold the law and protect taxpayer funds," Oz added. "We are putting them on notice - CMS will not allow federal dollars to be diverted to cover those who are not lawfully eligible." CMS is increasing federal oversight of Medicaid at the state level to identify and stop unlawful spending through: Focused evaluations of state Medicaid spending reports. In-depth reviews of states' financial management systems. Assessments of eligibility rules and policies to close loopholes. "Medicaid funds must serve American citizens in need and those legally entitled to benefits," said Drew Snyder, deputy administrator and director of the Center for Medicaid & CHIP Services. "If states cannot or will not comply, CMS will step in," Snyder said. Any unlawful spending of Medicaid dollars by states on "non-citizens" is subject to recoupment of the federal share of such expenses, according to the HHS Department. Snyder on Tuesday notified respective state officials of the increased oversight in a letter with the subject, "Ending taxpayer subsidization of open borders." He cited President Donald Trump's Feb. 19 executive order requiring federal agencies to uphold the rule of law, thwart the waste of taxpayer dollars and protect benefits for U.S. citizens. CMS "is committed to faithfully implementing the president's executive order," Snyder said. "The plain text of federal law ... generally prohibits illegal aliens from obtaining most taxpayer-funded benefits," he wrote. Federal law makes it national policy that "'aliens within the nation's borders not depend on public resources to meet their needs,'" and "'it is a compelling government interest to remove the incentive for illegal immigration provided by the availability of public benefits,'" Snyder said. He encouraged all states to review their policies, systems and internal controls to ensure each legally complies with federal law when claiming medical assistance and administrative expenditures. The Congressional Budget Office in October reported that the Biden administration's open-border policy cost taxpayers more than $16.2 billion to provide Medicaid-funded emergency services for "illegal aliens" after President Joe Biden took office.
Miami Herald
5 days ago
- Health
- Miami Herald
Medicare Advantage plans come under fire from DOGE
Health insurers are on alert after the Centers for Medicare & Medicaid Services announced May 22 that it is immediately expanding audits of all Medicare Advantage (MA) contracts and adding resources to complete overdue 2018-2024 audits. Many older Americans flock to Medicare Advantage programs because of cheaper premiums and, in some states, more over-the-counter (OTC) benefits like vision, dental, prescriptions and even food. Related: Fed official sends strong message about interest-rate cuts However, repeated studies have shown that MA coverage costs the federal government more than traditional Medicare, despite significant concerns that private insurers may deny justifiable care. Of the 67.3 million Americans enrolled in Medicare, approximately 35 million are in Medicare Advantage plans. Total federal Medicare spending is approximately $1 trillion annually but an estimated $84 billion goes to MA plans. Because of the way Medicare Advantage payments are structured, payouts are often adjusted upwards, in part for the additional OTC benefits not found in traditional Medicare. Some MA plans may use more aggressive diagnosis findings than what the patient actually has, a practice known as upcoding that raises reimbursements. Medicare Advantage plans receive risk-adjusted payments based on the diagnoses they submit for enrollees, meaning higher payments for patients with more serious or chronic conditions. To verify the accuracy of these claims, CMS conducts Risk Adjustment Data Validation (RADV) audits to confirm that medical records support diagnoses used for payment. Related: UnitedHealth Group stock tumbles; Andrew Witty steps down as group CEO Currently, CMS is several years behind in completing these audits. The last significant recovery of MA overpayments occurred following the audit of payment year (PY) 2007, despite federal estimates suggesting MA plans may overbill the government by approximately $17 billion annually. The Medicare Payment Advisory Commission (MedPAC) estimates this figure could be as high as $43 billion per year. CMS's completed audits for PYs 2011–2013 found between 5 and 8 percent in overpayments. To address this backlog, the Trump Administration has introduced a plan to complete all remaining RADV audits by early 2026. Key elements of the plan include: Enhanced Technology: CMS will deploy advanced systems to efficiently review medical records and flag unsupported Expansion: CMS will increase its team of medical coders from 40 to approximately 2,000 by Sept. 1, 2025. These coders will manually verify flagged diagnoses to ensure Audit Volume: By leveraging technology, CMS will be able to increase its audits from ~60 MA plans a year to all eligible MA plans each year in all newly initiated audits (approximately 550 MA plans). CMS will also be able to increase from auditing 35 records per health plan per year to between 35 and 200 records per health plan per year in all newly initiated audits based on the size of the health plan. This will help ensure CMS's audit findings are more reliable and can be appropriately extrapolated as allowed under the RADV final rule. These and other financial issues are fueling the CMS audits of the four Medicare Advantage insurers, all ignited by President Trump and the Department of Government Efficiency, or DOGE, commitments to eliminate federal spending waste, fraud and overpayments. Related: Bankrupt retail chain closing hundreds of store locations UnitedHealthGroup (UNH) , rocked by months of personal and professional trauma, Elevance Health (ELV) , CVS Health's Aetna (CVS) and Humana (HUM) are the four healthcare insurers undergoing the CMS MA audits. CMS will collaborate with the Department of Health and Human Services Office of Inspector General (HHS-OIG) to recover uncollected overpayments identified in past audits to ensure all MA plans comply with federal requirements and accurately report patient diagnoses Dozens and dozens of MA plans are pulling coverage out of mostly rural, poor areas because their parent companies are losing money there. As a result, many hospitals and healthcare providers closed, leaving patients without nearby healthcare options. Also, the transition from an Medicare Advantage plan to a traditional Medicare plan is not easy in some states, especially for patients with serious existing medical conditions. These and other financial issues are fueling the CMS audits of the four MA insurers, all ignited by President Trump and the DOGE commitments to eliminate federal spending waste, fraud and overpayments. Related: Medicare recipients face a growing problem The Arena Media Brands, LLC THESTREET is a registered trademark of TheStreet, Inc.
