Enforcement Briefing · Sep 20, 2026

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Consumer & business misconductEnforcement BriefingNew in this edition

NYU and UPMC agree to end specified pediatric services and pay $9.45 million to resolve federal investigations

NYU and UPMC agreed to specified pediatric service restrictions and payments totaling $9.45 million to resolve investigations; both denied allegations and no liability determination was made.

High priority · Sep 20, 2026 editionRead story →

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Consumer & business misconductEnforcement BriefingNew in this edition

Abbott agrees to pay about $385 million over alleged WIC and Medicaid product-quality misrepresentations

Abbott's settlement provides approximately $385 million plus interest to resolve disputed WIC and Medicaid product-quality claims, with express denials and reserved claims.

High priority · Sep 20, 2026 editionRead story →

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Audits & repaymentsEnforcement BriefingNew in this edition

OIG hospital audits identify Medicare overpayments and recurring claim-control failures

OIG identified hospital billing errors in Methodist and McLeod samples, recommending an estimated $12.4 million refund for Methodist and $38,676 for McLeod, with different hospital responses.

High priority · Sep 20, 2026 editionRead story →

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Billing fraud & false claimsEnforcement BriefingContinuing

The Villages Health System agrees to a $541.5 million settlement over invalid Medicare Advantage diagnosis codes after self disclosing

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 20, 2026 editionRead story →

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Billing fraud & false claimsEnforcement BriefingNew in this edition

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Enforcement Briefing · Sep 20, 2026

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