The complete edition, organized by topic. Every published finding remains available.
Archived edition. This edition reflects its original coverage dates and may not reflect current requirements. Read the latest edition →
82 articles: 65 new or updated, 17 continuing, 0 closed.
All articles are listed below, including continuing and closed findings. The approved report also includes horizons, trends and implementation material.
82 articles shown, grouped by category.
Active high- and medium-priority findings, organized by topic.
DHCS opened youth data-sharing toolkit feedback through September 9 without creating new disclosure permission.
Medium priority · Sep 6, 2026 editionRead story →
AB 2448 proposed requiring covered medical-information businesses to enable sensitive-service security features.
Medium priority · Sep 6, 2026 editionRead story →
AB 1018 proposed role-specific automated-decision controls with important health-sector boundaries.
Medium priority · Sep 6, 2026 editionRead story →
AB 1405 remained a September 3 enrolled proposal for an AI-auditor registry and 2029 registration controls.
Medium priority · Sep 6, 2026 editionRead story →
AB 1979 proposed clinical AI judgment safeguards and CMIA coverage for defined consumer health chatbots.
Medium priority · Sep 6, 2026 editionRead story →
AB 2575 proposed protected clinical AI judgment and a limited bar on a superseding-cause defense.
Medium priority · Sep 6, 2026 editionRead story →
CDPH explains the HHA licensing moratorium and two separate application and management-information milestones.
Medium priority · Sep 6, 2026 editionRead story →
California enacted AB 1760 dentistry revisions with separate ordinary commencement and radiation-course transition dates.
Medium priority · Sep 6, 2026 editionRead story →
AB 1199 proposed extending routine medical-staff reappointment and competency cycles to three years.
Medium priority · Sep 6, 2026 editionRead story →
AB 1930 proposed Attorney General notice for certain protected-care legal demands, with four express exemptions.
Medium priority · Sep 6, 2026 editionRead story →
AB 2311 proposed a limited district-hospital physician-employment route with eligibility and independence protections.
Medium priority · Sep 6, 2026 editionRead story →
AB 2343 proposed a funded consumer platform for qualifying substance-use treatment programs, with public-system exemptions.
Medium priority · Sep 6, 2026 editionRead story →
AB 2562 proposed suicide-prevention planning in licensed facilities and certified-program operation manuals.
Medium priority · Sep 6, 2026 editionRead story →
AB 2598 proposed documented death-notification attempts and conditional public-administrator notice with separate penalty clocks.
Medium priority · Sep 6, 2026 editionRead story →
Federal agencies restored missing IDR rule text on August 28, applying the corrections beginning August 3.
Medium priority · Sep 6, 2026 editionRead story →
DMHC’s September 3 APL requires an October 1 PBM filing and separate licensing readiness before January 2027.
Medium priority · Sep 6, 2026 editionRead story →
AB 539 proposed a minimum authorization period for in-network services, with drug and coverage-termination limits.
Medium priority · Sep 6, 2026 editionRead story →
AB 2341 immediately changes local emergency-translation calculations using two different population thresholds.
Medium priority · Sep 6, 2026 editionRead story →
OCR’s September 3 letter explains protected-status discrimination, harassment and retaliation in HHS-funded care and training.
Medium priority · Sep 6, 2026 editionRead story →
AB 173’s September 1 enrolled proposal would change Medi-Cal affiliation screening subject to federal conditions.
Medium priority · Sep 6, 2026 editionRead story →
Lower-priority and watch items, plus closed matters kept for the edition record.
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Watch · Sep 6, 2026 editionRead story →
Active high- and medium-priority findings, organized by topic.
A $541.5 million settlement addresses allegedly unsupported Medicare Advantage diagnoses and chart amendments at The Villages Health System. DOJ credited self-disclosure and cooperation. Bankruptcy approval and the plans’ separate repayment responses are part of the resolution; liability was not determined.
High priority · Sep 6, 2026 editionRead story →
Monogram’s $2.4 million resolution concerns four diagnosis categories submitted under in-home Medicare Advantage risk-sharing arrangements. DOJ describes clinical accuracy, documentation and relevance to care during 2021–2023, credits cooperation and provides a whistleblower share. The allegations were not adjudicated.
Medium priority · Sep 6, 2026 editionRead story →
Heuser Health agreed to pay $2,646,186.72 over allegations that skin-substitute claims overstated actual invoice costs.
Medium priority · Sep 6, 2026 editionRead story →
Rebecca Fadanelli received a 46-month sentence for counterfeit injections, with separate restitution and forfeiture orders of $1,001,562 each.
Medium priority · Sep 6, 2026 editionRead story →
Four named August 26 DMHC matters total $331,000 in agreed administrative penalties. They concern distinct timely-access data, cancellation-notice, grievance-initiation and surprise-billing reporting failures. The specific records do not establish complete weekly enforcement discovery or completed payment.
Medium priority · Sep 6, 2026 editionRead story →
Azul Vision’s $50,000 HIPAA resolution concerns a records request fulfilled almost two years after submission. The agreement covers a 31-clinic provider and imposes a two-year corrective action plan. Its August 13 effective date and case-specific monitoring clocks are distinct from the August 27 announcement.
Medium priority · Sep 6, 2026 editionRead story →
The $50 million resolution addresses alleged unlawful dispensing despite prescriber and prescription warning signs. A DEA agreement adds employee/patient reporting, pharmacy-pattern monitoring and suspect-prescriber review. The dated August 28 announcement reports allegations, not a determination of liability.
Medium priority · Sep 6, 2026 editionRead story →
Ten CDPH records carry August 26–27 issue dates and $73,750 in initial assessments across eight facilities. The data identify two class A citations, seven class B citations and one administrative penalty. They do not establish collections, completed appeals or a full account of the underlying incidents.
Medium priority · Sep 6, 2026 editionRead story →
Two Florida DME operators received prison sentences after guilty pleas in a $34.8 million brace-fraud scheme that used paid false orders and shifted billing among related suppliers.
Medium priority · Sep 6, 2026 editionRead story →
Lower-priority and watch items, plus closed matters kept for the edition record.
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Active high- and medium-priority findings, organized by topic.
DHCS’s August 26 notice requires quarterly validation of the public fee-for-service provider directory starting October 1. Administrators have a forty-five-day window and must save completed survey responses; missed updates affect every user’s Transaction Center access in the organization.
Medium priority · Sep 6, 2026 editionRead story →
OIG separates an estimated $380 million organ-counting policy conflict from $154,210 in specifically unsupported reimbursement. The findings call for different policy and documentation responses.
Medium priority · Sep 6, 2026 editionRead story →
Medi-Cal’s September 1 hospice notice separates the five-calendar-day portal attestation from the signed election form, which stays in the member’s medical record.
Medium priority · Sep 6, 2026 editionRead story →
Pending AB 2499 would require standard electronic supporting-document submission from May 26, 2028, including receipt confirmation and protections against system-only claim delays.
Medium priority · Sep 6, 2026 editionRead story →
Pending AB 2571 would expand pharmacist payment routes and advanced-practitioner reimbursement, with distinct commercial, Medi-Cal and FQHC/RHC conditions.
Medium priority · Sep 6, 2026 editionRead story →
Noridian’s August 27 notices finalize two MolDX policies for October 12 and retire the older thrombophilia policy October 11. Coverage remains conditional on each policy’s clinical and testing criteria; a test’s name alone does not establish coverage.
Medium priority · Sep 6, 2026 editionRead story →
Pending AB 280 proposes a central provider-directory utility, common standards and reasonable-reliance protections, with specific integrated-plan and Medi-Cal scope exceptions.
Medium priority · Sep 6, 2026 editionRead story →
Pending AB 350 addresses medically necessary fluoride varnish across medical and dental billing and proposes Medi-Cal guidance for members under twenty-one, with training and federal conditions.
Medium priority · Sep 6, 2026 editionRead story →
Pending AB 1682 would cover prescribed FDA-cleared scalp cooling for chemotherapy-related hair loss in large-group coverage and conditionally in Medi-Cal.
Medium priority · Sep 6, 2026 editionRead story →
Pending AB 1876 would strengthen plan and insurer nondiscrimination provisions and grievance notices while preserving legitimate, nondiscriminatory clinical and coverage decisions.
Medium priority · Sep 6, 2026 editionRead story →
CMS schedules the second 2027 benefit and drug-pricing preview for September 8–11. Plans need to compare the display with their submissions, accounting for the preview’s stated pricing and data limits.
High priority · Sep 6, 2026 editionRead story →
The MA provider-directory preview opens September 8 and continues on an ongoing basis. CMS separately sets September 18 for annual officer attestation and production-ready data.
High priority · Sep 6, 2026 editionRead story →
OIG attributes $587.7 million in ineligible Part D payments to obsolete prescription labeling and oversight gaps. The audit recommends a sponsor-rejection timeframe; it does not itself impose a universal new cutoff.
Medium priority · Sep 6, 2026 editionRead story →
California’s September 2 lawsuit challenges October 13 Medicaid and CHIP reimbursement restrictions. The filing seeks relief; it does not itself suspend the rule or establish a later court outcome.
Medium priority · Sep 6, 2026 editionRead story →
Pending AB 220 would limit extra pediatric subacute criteria and duplicate authorization forms, with specific protections for return from an acute-hospital bed hold.
Medium priority · Sep 6, 2026 editionRead story →
CMS is proposing an annual hospital-at-home services collection, with comments due October 26. The new CMS-10971 tool would describe clinician visits, food and pharmacy services; the notice seeks OMB approval and does not itself establish an approved reporting start date.
Medium priority · Sep 6, 2026 editionRead story →
CMS’s August 28 laboratory announcement combines projected savings, suspended payments, recoupments and referral-related prevention. Its examples describe rapid billing intervention, but the headline total is not a single recovered sum or an adjudication that every associated claim was fraudulent.
High priority · Sep 6, 2026 editionRead story →
Lower-priority and watch items, plus closed matters kept for the edition record.
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
Lower priority · Sep 6, 2026 editionRead story →
No articles in this topic. Choose All topics to return to the complete edition.