As we await publication of the final 2026 Star Ratings, learn why scores are dropping and strategies for MA plans to close out the calendar year with stronger performance.

Cotiviti Blog

26.09.2025

Busted: The top fraud schemes of Q2 2025

Read our breakdown of 10 major healthcare FWA schemes from April through June 2025—and what they reveal about the evolving tactics of bad actors.

Cotiviti Blog

18.09.2025

Webinar: Deploying AI effectively and responsibly in payment integrity

Attend our webinar to learn a responsible, effective approach for AI in payment integrity.

Cotiviti Blog

16.09.2025

FWA Insights: Q&A with the SIU

Cotiviti's FWA investigators break down complex questions related to skin grafts and substitutes, a growing area of concern in healthcare.

Cotiviti Blog

12.09.2025

7 key steps to build a valuable COB program

Learn how to build a comprehensive, member-centric COB program with prompt monitoring, accurate data, and auditing expertise.

Cotiviti Blog

10.09.2025

eBook: Addressing dental overbilling to improve payment integrity

Learn how to identify common dental payment schemes to mitigate fraud, waste, and abuse

Cotiviti Blog

05.09.2025

Webinar: Prepare for risk adjustment in 2026

Learn key updates and gain strategic readiness in our September 9 webinar.

Cotiviti Blog

03.09.2025

Video | Perform Beyond Expectations: Delivering a true solution | Cotiviti

Learn how Cotiviti delivers holistic solutions that empower organizations to make informed decisions and take decisive action across quality improvement, payment accuracy, and more.

Cotiviti Blog

02.09.2025

Webinar: Decoding the HEDIS MY 2026 Tech Specs

Learn how to prepare for the shift to digital reporting and other updates to HEDIS requirements for 2026.

Cotiviti Blog

27.08.2025

Video | Perform Beyond Doubt: Turning uncertainty into informed action | Cotiviti

Learn how Cotiviti empowers health plans to perform beyond doubt with end-to-end support, critical industry benchmarks, and more.

Cotiviti Blog

25.08.2025

Video | Perform Beyond Hype: Going beyond buzzwords in healthcare | Cotiviti

Learn how Cotiviti performs beyond hype with deep clinical expertise, responsible innovation, and lasting partnerships.

Cotiviti Blog

25.08.2025

Decoding HEDIS® MY 2024 for success in MY 2025

Learn key takeaways from the HEDIS MY 2024 season along with measure and timeline changes that will impact health plans for MY 2025.

Cotiviti Blog

25.08.2025

FWA Insights: Identifying a DME dropshipping scheme

Learn how Cotiviti identified a DME provider that ordered items from a large online retailer, then billed the health plan at heavily marked up rates.

Cotiviti Blog

25.08.2025

Video | Perform Beyond Silos: Uniting people, programs, and partners across healthcare | Cotiviti

Learn how Cotiviti’s solutions and delivery model perform beyond silos by bridging program gaps and aligning efforts across departments.

Cotiviti Blog

08.08.2025

Webinar: Enhancing member engagement and communication

Learn how a comprehensive member engagement strategy can improve quality ratings and protect member benefits.

Cotiviti Blog

01.08.2025

Two key claim trends and their impact on payment integrity

Learn about key trends in emergency department billing and medical drug wastage that impact health plans and their payment integrity programs.

Cotiviti Blog

29.07.2025

FWA Insights: Uncovering improper billing in urine drug screens

Learn how Cotiviti's SIU identified a recent scheme in this common area of healthcare fraud, waste, and abuse (FWA).

Cotiviti Blog

16.07.2025

Unlocking business value through interoperability: 3 key strategies

Learn three essential strategies to help payers maximize the value of their interoperability investments as key industry deadlines draw closer.

Cotiviti Blog

11.07.2025

Case study: Prepay COB boosts payment integrity results for large national payer

Learn how health plans can prevent overpayments, reduce future erroneous payments, and confirm that primary payment responsibility is correctly assigned—all while lowering provider abrasion.

Cotiviti Blog

09.07.2025

CCC25: 3 key pillars required to perform beyond healthcare challenges

Learn about the three key values that guide Cotiviti's relationship with our clients: transparency, authenticity, and accountability.

Cotiviti Blog

02.07.2025

Webinar: Reflecting on HEDIS MY 2024 and preparing for what’s next

Join Cotiviti’s webinar for expert insights into the results of HEDIS MY 2024 and a strategy discussion for MY 2025.

Cotiviti Blog

19.06.2025

Webinar: Billing and policy trends impacting your payment integrity program

Sign up for Cotiviti's webinar as we break down key trends related to emergency department E/M claims and medical drug wastage.

Cotiviti Blog

17.06.2025

FWA Insights: Excessive dental restorations

Learn how Cotiviti's SIU identified excessive billing for dental restorations to safeguard payment integrity and appropriate member care.

Cotiviti Blog

13.06.2025

Webinar: Unlocking value from interoperability investments

Optimize your interoperability roadmap with these key insights.

Cotiviti Blog

11.06.2025

Risk adjustment: 4 strategies as CMS increases RADV audits

Learn how to prepare for CMS's new risk adjustment audit methodology for Medicare Advantage plans in 2025 and beyond.

Cotiviti Blog

30.05.2025

Case studies: Performing beyond expectations in payment integrity

Learn three examples of Cotiviti clients of varying sizes that have worked diligently to perform beyond expectations in payment integrity.

Cotiviti Blog

23.05.2025

White paper: Commercial risk adjustment updates to prepare for in 2026

Learn key changes to commercial risk adjustment coverage design, RADV audit methodology, and financial impacts coming in 2026.

Cotiviti Blog

21.05.2025

Star Ratings: 4 recommendations for the 2026 CMS Final Rule

Learn about key updates from the CMS Final Rule and how to prepare for Star Ratings success in 2026 and beyond.

Cotiviti Blog

14.05.2025

FWA Insights: Solving durable medical equipment (DME) challenges

Learn how Cotiviti's investigators took action when one provider stood out for excessive durable medical equipment (DME) billing of Medicare.

Cotiviti Blog

08.05.2025

Payment integrity: Unlocking the value of complex outpatient reviews

Learn about one of the most impactful and often underutilized tools in a high-performing payment integrity program: the complex outpatient review.

Cotiviti Blog

01.05.2025

Busted: The top fraud schemes of Q1 2025

Read our summary of how bad actors allegedly deployed kickbacks, false claims, and exploitation of vulnerable patients to defraud health plans in Q1 of 2025.

Cotiviti Blog

15.04.2025

3 updates from the 2026 CMS Final Rate Announcement

CMS has finalized a >5% payment increase in the Medicare Advantage and Part D Rate Announcement for calendar year 2026.

Cotiviti Blog

10.04.2025

FWA Insights: Skin grafts and substitutes

Learn how prepay FWA review identified over half a million dollars in skin substitute overpayments for one client.

Cotiviti Blog

03.04.2025

Case study: The value of cross-payer analytics

Learn how Cotiviti helped one large payer optimize its payment integrity policies through the value of cross-payer analytics.

Cotiviti Blog

20.03.2025

Busted: The top healthcare fraud schemes of Q4 2024

Some of the most prominent FWA cases of Q4 2024 included fraudulent billing, illegal kickbacks, and other misconduct that frequently jeopardized patient safety.

Cotiviti Blog

14.03.2025

Webinar: Confronting payment integrity challenges in 2025

New in 2025, Cotiviti’s Payment Integrity Pulse webinar series is tailored for payment integrity leaders and experts.

Cotiviti Blog

12.03.2025

FWA Insights: Reducing audit abrasion

Learn how a more collaborative, transparent approach to provider audits can help health plans maintain compliance while fostering productive provider relationships.

Cotiviti Blog

06.03.2025

White Paper: Preparing for success in Medicare Advantage risk adjustment

Discover how to strengthen Medicare Advantage risk adjustment efforts in our new white paper.

home›Cotiviti Blog›Health

Cotiviti Blog - Health

MY 2026: Breaking down the latest HEDIS Technical Specifications

Case study: Regional plan exceeds expectations with second-pass COB

Star Ratings Plan Preview: 4 key recommendations

Busted: The top fraud schemes of Q2 2025

Webinar: Deploying AI effectively and responsibly in payment integrity

FWA Insights: Q&A with the SIU

7 key steps to build a valuable COB program

eBook: Addressing dental overbilling to improve payment integrity

Webinar: Prepare for risk adjustment in 2026

Video | Perform Beyond Expectations: Delivering a true solution | Cotiviti

Webinar: Decoding the HEDIS MY 2026 Tech Specs

Video | Perform Beyond Doubt: Turning uncertainty into informed action | Cotiviti

Video | Perform Beyond Hype: Going beyond buzzwords in healthcare | Cotiviti

Decoding HEDIS® MY 2024 for success in MY 2025

FWA Insights: Identifying a DME dropshipping scheme

Video | Perform Beyond Silos: Uniting people, programs, and partners across healthcare | Cotiviti

Webinar: Enhancing member engagement and communication

Two key claim trends and their impact on payment integrity

FWA Insights: Uncovering improper billing in urine drug screens

Unlocking business value through interoperability: 3 key strategies

Case study: Prepay COB boosts payment integrity results for large national payer

CCC25: 3 key pillars required to perform beyond healthcare challenges

Webinar: Reflecting on HEDIS MY 2024 and preparing for what’s next

Webinar: Billing and policy trends impacting your payment integrity program

FWA Insights: Excessive dental restorations

Webinar: Unlocking value from interoperability investments

Risk adjustment: 4 strategies as CMS increases RADV audits

Case studies: Performing beyond expectations in payment integrity

White paper: Commercial risk adjustment updates to prepare for in 2026

Star Ratings: 4 recommendations for the 2026 CMS Final Rule

FWA Insights: Solving durable medical equipment (DME) challenges

Payment integrity: Unlocking the value of complex outpatient reviews

Busted: The top fraud schemes of Q1 2025

3 updates from the 2026 CMS Final Rate Announcement

FWA Insights: Skin grafts and substitutes

Case study: The value of cross-payer analytics

Busted: The top healthcare fraud schemes of Q4 2024

Webinar: Confronting payment integrity challenges in 2025

FWA Insights: Reducing audit abrasion

White Paper: Preparing for success in Medicare Advantage risk adjustment

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