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Cotiviti Names Erin Schmuker Chief Operating Officer

Karen Tiano — Wed, 11 Nov 2026 00:50:05 GMT

Veteran healthcare executive joins Cotiviti to scale operations and accelerate execution as the company expands its role as critical infrastructure for U.S. healthcare

SALT LAKE CITY, Utah, September 14, 2026 — Cotiviti, The Healthcare Infrastructure Company™, today announced the appointment of Erin Schmuker as Chief Operating Officer. Schmuker will join Cotiviti’s executive leadership team and report to President and Chief Executive Officer Ric Sinclair.

Schmuker joins Cotiviti at an important point in the company’s growth as it scales its operating model, becomes increasingly AI native and expands its role connecting the data, intelligence and workflows that underpin healthcare. Her appointment strengthens Cotiviti’s ability to translate its scale, technology and healthcare expertise into faster execution and greater value for clients.

“Healthcare doesn’t have a data problem. It has a coordination problem,” said Sinclair. “Our opportunity is to connect data and intelligence to the workflows where decisions are actually made and turn that intelligence into action at scale. Erin is a proven operator who understands how to do that. She knows healthcare, she knows our clients and she knows how to bring people, technology and operations together to deliver results. She will help us move faster, operate better and scale Cotiviti for what healthcare needs next.”

Schmuker brings more than two decades of healthcare leadership addressing healthcare’s most challenging issues. She joins Cotiviti from Optum, where she most recently served as President of Integrated Pharmacies at OptumRx. Previously, she served as Managing Director of Optum Ireland and UK, leading an organization with capabilities spanning technology, pharmacy and other areas supporting healthcare systems. Earlier in her career, Schmuker held leadership roles across healthcare consulting, client operations, and product solutions.

As Chief Operating Officer, Schmuker will lead Cotiviti’s enterprise operations, with a focus on scaling the company’s operating model, strengthening execution and accountability, and driving operational excellence as the business continues to grow. She will work across the enterprise to simplify how Cotiviti operates, accelerate execution and help translate investments in technology, AI and innovation into measurable outcomes for clients.

“Cotiviti has a rare combination of scale, healthcare expertise and opportunity,” said Schmuker. “The company is already deeply embedded in some of healthcare’s most important financial, administrative and clinical workflows. Our opportunity now is to build on that foundation with even greater speed, discipline and execution. I’m excited to work across Cotiviti to simplify how we operate, accelerate innovation and help our teams deliver even greater impact for our clients.”

Cotiviti works with more than 200 healthcare organizations, including all 25 of the largest U.S. health plans, with its customers collectively providing coverage and care for more than 300 million members and patients. That reach, combined with Cotiviti’s data, technology, connectivity and deep healthcare expertise, provides a foundation few companies can replicate.

Cotiviti has extended its intelligence and capabilities across critical healthcare workflows. Increasingly, the company is using AI, advanced analytics, interoperability and automation to move intelligence upstream, identifying and preventing problems earlier rather than finding and fixing them after they occur. By connecting data, intelligence and workflows across the healthcare ecosystem, Cotiviti serves as critical infrastructure that absorbs complexity behind the scenes and helps healthcare organizations operate more accurately, efficiently and intelligently at scale.

“AI amplifies infrastructure. It doesn’t replace it,” Sinclair added. “As AI becomes table stakes, differentiation comes from the trusted infrastructure around it: the data, connectivity, workflows, domain expertise and operating scale required to make intelligence useful. Cotiviti has spent decades building those assets. Erin brings the leadership and operating discipline to help us connect them more effectively, scale them across the enterprise and turn innovation into measurable outcomes for our clients and the healthcare system.”

About Cotiviti

Cotiviti’s infrastructure platform enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. Cotiviti’s solutions increase transparency and collaboration between payers and providers while empowering them to reduce medical and administrative costs, enable better health, improve claims payment efficiency, streamline operations, drive interoperability, and advance value-based care. Its customers serve the majority of U.S. healthcare consumers, providing coverage and care for over 300 million members and patients. For more information, visit www.cotiviti.com.

Media Contact:

Karen Tiano
Director, Public Relations
karen.tiano@cotiviti.com
215-259-5716

Cotiviti Convenes Healthcare Leaders at 2026 Annual Client Conference

Jeff Robinson — Wed, 11 Nov 2026 00:49:15 GMT

Three-day event will focus on igniting innovation and breaking down silos through cross-industry collaboration

SALT LAKE CITY, May 7, 2026 – Cotiviti, a leader in enterprise healthcare software and data-driven technology solutions, is hosting the Cotiviti Client Conference 2026 (CCC26) next week in Atlanta, Georgia. Under the theme of Igniting Innovation Through Partnership, the event will bring together numerous healthcare leaders, industry experts, and Cotiviti executives for an in-person gathering focused on navigating complexity, improving financial and clinical outcomes, and accelerating innovation across the healthcare ecosystem.

“Healthcare’s complexity is not new, but the stakes continue to rise for organizations striving to maximize efficiency and improve patient outcomes,” said Ric Sinclair, CEO of Cotiviti. “That complexity won’t be solved by another point solution—it will be solved by providing the core infrastructure that makes the whole system work better for all stakeholders. We’re rapidly evolving Cotiviti into that structural utility layer, connecting data, workflows, and responsible AI so our clients can move faster, operate with confidence, and deliver outcomes they can defend. As a trusted strategic partner to our clients, there is no better time to convene these conversations and chart an actionable and sustainable path forward.”

CCC26 will highlight Cotiviti’s expanded vision, capabilities, and momentum following recent business and leadership developments, with an emphasis on customer-driven success. As the central hub between payers and providers, value-based care organizations, government entities, and partners, Cotiviti plays an increasingly vital role in streamlining the flow of data between these entities for greater operational alignment. The conference will serve as a forum for industry leaders to share strategies, learn from peers, and gain critical insights into how to improve performance, efficiency, and patient outcomes through smarter use of data and technology.

“Healthcare’s challenges are not one-dimensional, and our clients are increasingly being asked to do more with less,” said Bob Kopanic, Chief Revenue Officer at Cotiviti. “In an increasingly fragmented ecosystem, partnerships are the catalyst to unlocking clinical, financial, and administrative success across several dimensions. Together with our clients, industry peers and company experts, we’re creating new ways to drive sustained value and achieve tangible business and clinical outcomes.”

In addition to the conference sessions, this year’s event will include a signature Cotiviti Cares activity to contribute meaningful, hands-on service to the local Atlanta community. Attendees will assemble hygiene kits for Gateway Center, a nonprofit organization dedicated to supporting unhoused individuals and families as they work toward stability and long‑term wellbeing.

To learn more about Cotiviti’s solutions and the markets it serves, visit Cotiviti’s website.

About Cotiviti

Cotiviti enables healthcare organizations to deliver better care at lower cost through advanced technology and data analytics that improve the quality and sustainability of healthcare in the United States. Cotiviti’s solutions increase transparency and collaboration between payers and providers while empowering them to reduce medical and administrative costs, enable better health, improve claims payment efficiency, streamline operations, drive interoperability, and advance value-based care. Its customers serve the majority of U.S. healthcare consumers, providing coverage and care for over 300 million members and patients. Additionally, Cotiviti offers data management and recovery audit services to the retail sector to improve business outcomes. For more information, visit www.cotiviti.com.

Media Contact:

Jeff Robinson
Sr. Director, Marketing Communications
jeffrey.robinson@cotiviti.com
425-435-2340

Cotiviti and MedCity News Index Finds Healthcare AI Adoption is Outpacing Governance and Cybersecurity Preparedness

Karen Tiano — Wed, 11 Nov 2026 00:48:17 GMT

70% of surveyed healthcare organizations have begun using AI, but fewer than 40% have detailed policies governing employee use
Just 42% of payers and 32% of providers feel “very prepared” to respond to AI-assisted cyberattacks
90% expect investment in AI and cybersecurity to increase over the next year

SALT LAKE CITY & NEW YORK, September 8, 2026 — Cotiviti, The Healthcare Infrastructure Company™, and MedCity News, the leading online news source for the business of innovation in healthcare, today announced the results of their 2026 Healthcare AI Readiness Index (the Index), which found that healthcare organizations are adopting AI faster than they’re building the governance and cybersecurity frameworks needed to use it safely.

Conducted in summer 2026, the Index tapped into the perspectives of payer and provider organizations to assess AI adoption, governance and cybersecurity preparedness and better understand how healthcare leaders are balancing AI's potential with the operational, regulatory and security challenges accompanying its deployment.

The Index found that more than 70% of respondents have begun using AI tools, with nearly 40% of health insurers describing AI as a core aspect of their business. Providers are earlier in the process, with more than 70% still in the early stages of adoption.

At the same time, the findings reveal a significant readiness gap. Just 42% of payers and 32% of providers say they are "very prepared" to respond to AI-assisted cyberattacks. Sixty percent of payers and 64% of providers report employees are using unauthorized or non-integrated "shadow AI" tools, while fewer than 40% have detailed policies governing employee use of AI.

“AI is quickly becoming part of the infrastructure of healthcare, but the security and governance around it have to advance just as quickly,” said Ric Sinclair, CEO of Cotiviti. “And that responsibility increasingly extends beyond an organization's own four walls. As health plans and healthcare organizations rely on AI across more critical workflows, they need confidence that the technology and partners throughout their ecosystems meet the same high standards for security, governance and responsible use. Trust will be foundational to realizing AI's full potential in healthcare.”

“From a security standpoint, we treat every AI tool and workflow with the same rigor we apply to any other critical system,” said Sean Warren, Chief Information Officer of Cotiviti. “That means vetting AI vendors and models, monitoring for emerging threats and establishing clear policies for how AI can be used across the organization. As adoption accelerates, that discipline is what allows organizations to adopt AI with confidence and scale its use responsibly.”

The findings come as healthcare organizations prepare to increase spending significantly. Ninety percent of respondents expect their investment in AI and cybersecurity to grow over the next year, even as regulatory requirements and data security concerns remain leading barriers to adoption.

Despite those concerns, respondents are already reporting meaningful benefits from AI, including faster claims processing, reduced administrative burden, improved workflow efficiency, better member and patient experiences, and faster access to insights from healthcare data.

“The findings reveal a significant gap between AI adoption and AI governance,” said Ken Montgomery, publisher of MedCity News. “Healthcare organizations clearly recognize AI's potential and are investing accordingly, but many are still building the governance and security frameworks needed to deploy it responsibly. As AI becomes more deeply integrated across healthcare, closing that gap will be increasingly important.”

Taken together, the Index suggests healthcare’s next phase of AI adoption will be defined not by which organizations deploy AI, but by how effectively they govern, secure and operationalize it.

Read the full Index for additional findings and analysis.

About MedCity News

MedCity News is the leading online news source for the business of innovation in healthcare. MedCity delivers insight into what’s next and what matters, with a mix of breaking news and analysis on startups and established industry leaders, personalities, policies and the most important deals.

Healthcare leaders must stay on top of new technologies, new companies, future trends and the latest policies, with a perspective that includes the entire healthcare ecosystem: health IT and digital health, diagnostics and medical devices, biopharma and emerging tech be it from the Silicon Valley entrants like Apple or Google or e-commerce giants like Amazon or retailers like CVS Health. MedCity News is equally interested in payers and payment reform and the transformation of the industry toward rewarding value.

MedCity News also convenes and hosts conferences around the country homing in on topics that are timely, relevant and exciting. From daily news updates to annual events, MedCity gives readers the chance to speak to and learn from everyone who has a stake in improving healthcare.

About Cotiviti

Media Contact:

Karen Tiano
Director, Public Relations
karen.tiano@cotiviti.com
215-259-5716

Cotiviti Introduces AI-Enabled Proactive COB To Resolve Coordination of Benefits Issues at Enrollment

Karen Tiano — Wed, 11 Nov 2026 00:47:31 GMT

New capability validates other health insurance and determines benefit primacy before claims are submitted, preventing avoidable payment errors at their source

SALT LAKE CITY, August 13, 2026 — Cotiviti, The Healthcare Infrastructure Company™, has launched Proactive COB, a new coordination of benefits (COB) capability that identifies other health insurance (OHI) and determines the correct order of benefits at the time of member enrollment—before claims are submitted. Enabled through enrollment and maintenance transactions processed via Cotiviti’s standards-native gateway, Proactive COB extends intervention upstream, applying AI to interpret complex coverage signals and prioritize potential discrepancies early enough for health plans to prevent inaccurate payments before they occur.

“Coordination of benefits has long been treated as a downstream payment issue, when the underlying problem begins much earlier with incomplete or outdated coverage information,” said Naomi Murphy, J.D., Executive Vice President of Data Mining and COB for Cotiviti. “When payers don’t have timely visibility into other health insurance coverage, incorrect order of benefit determinations are frequently not discovered until claims have already been paid. By combining AI-enabled analysis with one of the industry's largest validated member datasets and decades of COB expertise, Proactive COB advances Cotiviti's mission to become the structural utility layer connecting American healthcare—resolving the information asymmetry between payers and providers.”

COB errors often begin when member coverage changes due to life events such as employment changes, changes to family dynamics, or other circumstances that can alter payment responsibility. Because many health plans do not receive complete, accurate, or up to date coverage information, these issues frequently remain undetected until after claims have been paid, creating costly recovery efforts, administrative burden, and provider rework. Traditional approaches typically rely on retrospective discovery methods that can leave a significant portion of identified overpayments unrecovered.

Proactive COB addresses this challenge by identifying and validating OHI, determining the appropriate order in which benefits should be paid, and automatically updating eligibility systems with validated information. The solution combines embedded AI-driven prioritization, one of the industry’s largest validated member databases, and more than 25 years of COB experience to help plans maintain more accurate member coverage records throughout the benefit lifecycle.

“Even when health plans have access to current coverage information, they have still historically lacked a reliable mechanism to continuously validate that data between enrollment and claims processing,” continued Murphy. “As a result, they’re often forced into a reactive cycle of identifying errors after claims have been paid, recovering overpayments, and managing the downstream administrative friction that follows. Proactive COB shifts the focus from recovery to prevention, enabling plans to act on coverage changes as they happen and maintain more accurate primacy information throughout the member lifecycle.”

Unlike traditional COB programs that depend primarily on claim activity or member outreach, Proactive COB operates on member enrollment data, enabling health plans to identify and address coverage discrepancies even for members who have not yet generated claims. The capability also supports automated updates of validated OHI and primacy data to major eligibility and member management platforms, reducing manual intervention while maintaining a complete audit trail.

By embedding AI and human expertise within Cotiviti’s connected enrollment, validation, and eligibility workflows, Proactive COB moves intelligence to the earliest point in the COB lifecycle, helping health plans establish a more comprehensive and connected approach to payment accuracy. The solution is designed to reduce administrative waste, improve accuracy, and support more predictable cost avoidance by preventing errors before claims are generated.

About Cotiviti

Media Contact:

Karen Tiano
Director, Public Relations
karen.tiano@cotiviti.com
215-259-5716

Cotiviti Certifies all NCQA Digital HEDIS® Measures for Measurement Year 2025

Jeff Robinson — Wed, 11 Nov 2026 00:46:33 GMT

Advancement enables health plans to support both traditional and digital reporting with validated quality as NCQA transitions toward digital-only measurement

SALT LAKE CITY, UT, June 2, 2026 — Cotiviti, a leader in enterprise healthcare software and data-driven technology solutions, today announced that its Quality Intelligence solution has achieved Digital HEDIS Certification from the National Committee for Quality Assurance (NCQA) for Measurement Year (MY) 2025. This certification of all available digital quality measures (dQMs) positions Cotiviti as a large-scale quality measurement and reporting vendor that fully supports digital workflows alongside traditional HEDIS reporting as the industry advances toward fully digital measurement by NCQA’s 2030 goal.

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“Health plans are working hard to fully transition to digital HEDIS reporting by 2030, but still need the flexibility to report traditional, state, and custom quality measures as they continue to adopt FHIR standards,” said Ric Sinclair, CEO of Cotiviti. “Cotiviti’s quality platform with FHIR ingestion simplifies our customers’ ability to meet traditional and digital reporting requirements—while continuing to scale with an integrated ecosystem of value-added solutions and services for Star Ratings improvement, risk adjustment, and member engagement.”

With a track record of more than 25 years in HEDIS measurement and reporting, Cotiviti’s Quality Intelligence is an industry-leading platform that processes data at scale, supporting more than 129 million member lives reported to NCQA, and delivers advanced analytics, reporting, and insights to help health plans drive consistent quality improvement year-round.

“NCQA is committed to advancing a fully digital approach to quality measurement to improve accuracy, efficiency and comparability across the industry,” said Vik Wadhwani, Chief Product and Transformation Officer of NCQA. “Organizations like Cotiviti that achieve digital measure certification early are helping set the pace for this transformation. Cotiviti’s progress reflects strong momentum—and while there’s more work ahead, that continued commitment will help empower health plans to prepare for the transition to digital‑only reporting and realize a more streamlined, standardized future.”

“Achieving full digital HEDIS certification reinforces Cotiviti’s commitment to helping health plans confidently navigate the transition to digital quality measurement,” said Chad Kinkead, EVP of Health Enablement at Cotiviti. “With our single platform, we have the ability to support all traditional, digital, and state and custom workflows. This enables us to partner with our clients to move forward at their own pace while maintaining accuracy, efficiency, and performance.”

Quality Intelligence empowers health plans throughout the transition to digital measurement, enabling them to:

Leverage familiar tools to minimize disruption
Translate existing data intake files to the FHIR data model for measure processing
Reduce variables with comparative measure analysis during the transition

Quality Intelligence now helps plans increase focus on dQM reporting without requiring an immediate shift away from the data sources in use today. Easing the transition burden while delivering both traditional and digital HEDIS capabilities, Cotiviti is uniquely positioned to support health plans through each stage of NCQA’s digital transformation roadmap, enabling them to maintain current reporting needs while preparing for the future of quality measurement.

About Cotiviti

Media Contact:

Jeff Robinson
Sr. Director, Marketing Communications
jeffrey.robinson@cotiviti.com
425-435-2340

Cotiviti Launches Enhanced Dental Claim Accuracy Solution on Market-Leading Payment Policy Management Platform

Jeff Robinson — Wed, 11 Nov 2026 00:45:04 GMT

Modernized solution unifies claim workflows, expands transparency, and delivers scalability

SALT LAKE CITY, Utah, August 4, 2026 — Cotiviti, The Healthcare Infrastructure Company™, has launched an enhanced version of its prepay dental payment integrity solution to support real-time claim processing, expanded content and policy development through AI-assisted rule authoring, improved policy transparency, and streamlined fraud, waste, and abuse detection for both healthcare and standalone dental payers.

Delivered as a fully integrated offering on Cotiviti’s market-leading prepay claim editing platform, Payment Policy Management, the new Dental Claim Accuracy solution brings dental and medical payment accuracy workflows onto a single, scalable foundation, enabling plans to improve claim accuracy, increase transparency, and support future growth across lines of business. Accredited by URAC, Dental Claim Accuracy combines configurable, policy-driven code editing, professional clinical validation by licensed dentists, analytics, and review workflows within the same platform that payers already trust for medical claim editing, supporting both batch and real-time processing while providing clients with greater visibility into claim decisions.

“With dental spending reaching an estimated $198 billion per year, dental payers face increasing challenges from fraud, waste, and abuse, overtreatment, miscoding, inappropriate billing practices, and rising coding complexity. These issues contribute to improper payments, increased administrative burden, unnecessary utilization, and pressure on plan resources,” said Matthew Hawley, Executive Vice President of Payment Integrity for Cotiviti. “Dental Claim Accuracy brings the same proven platform, policy management capabilities, and transparency that payers rely on for medical claims into the dental space. By integrating dental claims onto our Payment Policy Management platform, both health and dental-only plans can simplify operations and strengthen payment accuracy as claim volumes grow.”

Dental Claim Accuracy also expands transparency for clients through integration with Cotiviti’s Payment Clarity^® platform, which provides clear explanations of why claims were flagged, the policies applied, and recommended next steps. It also delivers executive-ready reporting and analytics to measure savings, monitor trends, and demonstrate program effectiveness. Together, these capabilities provide payers with a more transparent, defensible, and operationally efficient dental payment integrity program.

The enhanced solution reflects Cotiviti’s broader strategy of helping health and dental plans move from fragmented point solutions toward a connected infrastructure that improves the accuracy and efficiency of healthcare transactions. By leveraging a common platform architecture, clients can extend established workflows, integrations, and policy management practices across both medical and dental claims while reducing operational friction and improving consistency.

“Dental plans need solutions that can keep pace with evolving billing practices, increasing claim complexity, and emerging fraud, waste, and abuse patterns,” said Steven Canfield, D.D.S., senior dental director at Cotiviti. “By combining advanced claim editing with professional clinical validation, documentation review, and decades of dental expertise, Dental Claim Accuracy helps plans identify suspect claims before payment, improve the precision of payment decisions, and better protect both plan resources and member benefits.”

Dental Claim Accuracy is the latest example of Cotiviti’s ongoing evolution beyond traditional point solutions toward becoming the structural utility layer connecting healthcare. By bringing more workflows, intelligence, policy management, and decision support onto a unified platform, Cotiviti helps payers govern financial accuracy more effectively, reduce information gaps, and create a more connected healthcare ecosystem.

About Cotiviti

Media Contact:

Jeff Robinson
Sr. Director, Marketing Communications
jeffrey.robinson@cotiviti.com
425-435-2340

Cotiviti Recognized by Everest Group as the Highest-Designated Leader for Market Impact in the 2026 Pre-payment Integrity Solutions PEAK Matrix® Assessment

Jeff Robinson — Wed, 11 Nov 2026 00:43:27 GMT

Distinction marks fourth consecutive year Cotiviti has been positioned as a Leader in this category

SALT LAKE CITY, July 1, 2026 – Cotiviti, a leader in enterprise healthcare software and data-driven technology solutions, has been named the highest-designated Leader for market impact by Everest Group in the Pre-payment Integrity Solutions PEAK Matrix^® Assessment 2026. Cotiviti was also positioned as one of the top Leaders for vision and capability. The recognition highlights Cotiviti's strong market adoption, client outcomes, innovation, and leadership in helping health plans identify and prevent improper payments before they occur.

"As healthcare organizations face increasing pressure to improve accuracy, reduce waste, and operate more efficiently, they need trusted partners capable of delivering payment integrity at scale," said Ric Sinclair, CEO of Cotiviti. "This recognition reinforces Cotiviti's leadership in helping health plans prevent improper payments while building the infrastructure healthcare needs to operate with greater precision, coordination, and trust. As AI becomes increasingly embedded across healthcare, intelligent decisioning within critical financial workflows will be essential."

“Cotiviti has been integral to our payment accuracy solutions, consistently delivering exceptional quality along with top-notch customer service and engagement,” said Angie Fedderson, AVP of Payment Integrity for Select Health. “They have never treated us as just a customer; instead, we operate as true partners. Without a doubt, they are the best vendor I have worked with.”

Everest Group’s PEAK Matrix^® is a globally recognized assessment that evaluates organizations based on key factors such as vision, capabilities, functionality, talent availability, market success, impact, and cost-effectiveness. Cotiviti has been recognized as a Leader in payment integrity solutions for each of the four years that this assessment has been published. This year, the company earned the position of the highest-designated Leader in market impact, reflecting its widespread market adoption, continuous innovation, commitment to accuracy, proven success, and responsible AI deployment that enables Cotiviti’s human experts to deliver improved client value.

Cotiviti is a trusted payment integrity partner of 23 of the top 25 national payers, preventing or correcting more than $10 billion in claims payment errors in 2025 across more than 100 clients. The company has delivered payment integrity solutions for healthcare payers for more than 25 years, serving national and regional health plans, Blue Cross Blue Shield organizations, government programs, and third-party administrators. Through its comprehensive payment integrity solutions, Cotiviti helps clients improve payment accuracy, enhance operational efficiency, and reduce healthcare waste across the claims lifecycle.

"For healthcare organizations, every improper payment prevented through payment integrity can be redirected toward improving member outcomes and strengthening the healthcare system," said Bob Kopanic, Chief Revenue Officer at Cotiviti. "This recognition underscores the value of our integrated approach to pre-payment integrity, combining market-leading data assets, sophisticated technology, clinical expertise, and a relentless focus on client success. We are honored to be recognized by Everest Group and remain committed to helping our clients stay ahead of emerging payment integrity challenges."

About Cotiviti

Disclaimer

Licensed extracts taken from Everest Group’s PEAK Matrix^® Reports may be used by licensed third parties for use in their own marketing and promotional activities and collateral. Selected extracts from Everest Group’s PEAK Matrix^® reports do not necessarily provide the full context of our research and analysis. All research and analysis conducted by Everest Group’s analysts and included in Everest Group’s PEAK Matrix^® reports is independent and no organization has paid a fee to be featured or to influence their ranking. To access the complete research and to learn more about our methodology, please visit Everest Group PEAK Matrix® Reports.

Media Contact:

Jeff Robinson
Sr. Director, Marketing Communications
jeffrey.robinson@cotiviti.com
425-435-2340

Cotiviti Pledges Support to CMS Digital Health Ecosystem

Jeff Robinson — Tue, 10 Nov 2026 23:31:58 GMT

“Friend of the Ecosystem” designation underscores long-standing commitment to advancing interoperability and regulatory alignment within government health systems

SALT LAKE CITY, UT, May 26, 2026 – Cotiviti GOV Services, a partner of federal government healthcare agencies and programs for more than 20 years, has completed the Centers for Medicare & Medicaid Services (CMS) “Friend of the Ecosystem” pledge. This voluntary commitment emphasizes Cotiviti’s role in supporting CMS efforts to modernize the nation’s digital health infrastructure and support Medicare beneficiaries by enabling secure, patient-centered health technologies.

“The U.S. healthcare system faces high costs, fragmented data, and outdated infrastructure,” said Ric Sinclair, CEO of Cotiviti. “Unlocking the full potential of a modern, patient-centered system requires greater alignment between CMS’ infrastructure and private sector innovation. As a Friend of the Ecosystem, Cotiviti is proud to collaborate with CMS and other industry leaders, providing support, technology, and feedback to help ensure real-time, consented health data can be accessed securely, reliably, and at scale.”

Chris Coloian, Chief Strategy Officer at Cotiviti and General Manager of Cotiviti GOV Services, added, “This pledge reflects our mission to provide interoperable, standards-based solutions that enable federal and commercial payers to comply with interoperability standards including CMS-0057-F while delivering better care outcomes to patients. It also builds upon our long-standing history of working with government health agencies to help ensure quality healthcare delivery and proper payment across the broad populations it serves.”

CMS’ Digital Health Ecosystem encourages voluntary alignment across payers, providers, EHR systems, health technology developers, and other stakeholders. The initiative focuses on interoperability frameworks, trusted data exchange, and digital tools that give patients more control over their health information. By joining the Friend of the Ecosystem initiative, Cotiviti signals its intent to support these industry efforts, driving the adoption of secure, scalable, and interoperable solutions that are intended to enable real-time data access and help modernize the delivery of care.

As the designated Recovery Audit Contractor (RAC) for Region 3, Region 4, and Region 5, Cotiviti performs postpay review of Medicare claims to efficiently identify and correct overpayments and underpayments made to healthcare providers. Cotiviti also supports the Department of Veterans Affairs. Cotiviti’s Interoperability Gateway (XEngine Server for FHIR) was recognized as 2026 Best in KLAS® for CMS Payer Interoperability.

To view the full list of organizations that have signed this pledge, visit CMS.gov. To learn more about Cotiviti GOV Services, visit Cotiviti’s website.

About Cotiviti

Media Contact:

Jeff Robinson
Sr. Director, Marketing Communications
jeffrey.robinson@cotiviti.com
425-435-2340

Cotiviti Helps Health Plans Act Earlier on Care Gaps and Member Needs

Karen Tiano — Tue, 10 Nov 2026 22:36:54 GMT

New Concurrent Quality and Engagement Hub capabilities give health plans earlier visibility into quality opportunities and help coordinate action across programs