News & Insights

What's moving in healthcare compliance.

Three layers, from short to long: the three weekly intelligence products, the full regulatory tracker behind them, and practical articles on what the rules actually require.

Layer 1 · Weekly intelligence

Three weekly products.

Recurring recaps of what moved across HHS, OCR, DOJ, OIG, CMS, DHCS, and California. The Regulatory Compliance Sweep covers new and changing obligations. The Enforcement Intelligence Briefing covers settlements, resolutions, and corporate integrity agreements. Medicare & Medicaid Actionable Updates covers government-payer developments and what operations has to do about them.

Compliance SweepPublished Oct 11, 2026

Compliance Sweep, week of Oct 4, 2026

Week of Oct 11, 2026: report published; corrected edition.

Coverage: Oct 4, 2026 to Oct 10, 2026

110 published findings covering Oct 4, 2026 to Oct 10, 2026.

Preview briefing points

Final TiC text separates March and September 2027 duties from July 2028 utilization posting.
CLIA changes remain proposed; FTC letters reinforce accurate total estimates.
California legislation carries distinct future implementation phases.
OHCA proposals remain drafts; the current quality-measure notice and enforcement manuals require scoped review, not an enacted duty claim.

systemsnetworkshealthtech

Read the stories →All 6 editions →

Listed sources reviewed through Oct 10, 2026

Enforcement BriefingPublished Oct 11, 2026

Enforcement Briefing, week of Oct 4, 2026

Week of Oct 11, 2026: report published; corrected edition.

Coverage: Oct 4, 2026 to Oct 10, 2026

67 published findings covering Oct 4, 2026 to Oct 10, 2026.

Preview briefing points

AHF diagnosis deletion queues and Heal 360 specimen-only encounters warrant control review.
Convictions, pleas, indictments and settlements are distinguished in each finding.
Audit recommendations are distinguished from court judgments and penalties.
Mishik and Britton are included under the saved scope decision, with their reported healthcare connections accurately limited.

systemsnetworkshealthtech

Read the stories →All 6 editions →

Listed sources reviewed through Oct 10, 2026

Medicare & MedicaidPublished Oct 11, 2026

Medicare & Medicaid, week of Oct 4, 2026

Week of Oct 11, 2026: report published; corrected edition.

Coverage: Oct 4, 2026 to Oct 10, 2026

102 published findings covering Oct 4, 2026 to Oct 10, 2026.

Preview briefing points

Unpaid qualifying APM participants must submit billing information by October 13 to avoid incentive forfeiture.
Medi-Cal youth-care preparation must preserve exceptions, required notices and HCAI continuity before October 13.
FQHC, RHC, IHS-MOA and Tribal FQHC institutional claims need diagnoses from October 15.
ALW eligibility and claim evidence should be reconciled with possible reprocessing.
BHSA claiming starts January 2027; DMEPOS bid dates and HCBS reporting have separate phases.

systemsnetworkshealthtech

Read the stories →All 6 editions →

Listed sources reviewed through Oct 10, 2026

Layer 2 · Regulatory Tracker

Every tracked development.

Tracked developments in compliance, privacy, and fraud-and-abuse regulation, with a plain read on what each one means for the organizations we serve.

This feed is rendered in the browser and needs JavaScript enabled. It tracks developments in healthcare compliance, privacy, and fraud-and-abuse regulation, grouped into upcoming duties, current obligations, implementation watch items and dated enforcement activity.The compliance tools work without it.

Entries reflect publicly reported regulatory developments and are summarized for general awareness. They are not legal advice, and details and effective dates change. Verify current requirements with primary sources and qualified counsel before acting.

Layer 3 · Practical Insights

Longer reads on what the rules require.

Practical perspective on the regulations and enforcement trends that shape how a compliance program gets run.

Program design

Show me this working in the last ninety days

Most programs can name the OIG's seven elements. Far fewer can show them operating. Here's how to tell the difference during a gap analysis.

Brandon Goulter · 6 min read

Privacy

HIPAA is the floor. In California, CMIA is the ceiling.

Why provider networks that build only to the federal standard still carry real exposure under California's stricter privacy regime, and where the gaps usually hide.

Brandon Goulter · 7 min read

AI governance

You don't need an AI governance framework. You need your compliance program.

Ambient scribes and AI coding tools are arriving faster than the contracts covering them. A mapping of each OIG element onto AI risk, and the five places the fit is genuinely imperfect.

Brandon Goulter · 8 min read

Risk defense

Reading a physician arrangement before Stark reads it for you

A field guide to the transaction reviews that keep fair-market-value and commercial-reasonableness questions from becoming enforcement questions.

Brandon Goulter · 8 min read