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 →
120 articles: 15 new or updated, 88 continuing, 17 closed.
All articles are listed below, including continuing and closed findings. The approved report also includes horizons, trends and implementation material.
120 articles shown, grouped by category.
Active high- and medium-priority findings, organized by topic.
AB 2448 proposes requiring covered sensitive-record businesses to enable specified security functions, with an express direct-provider/plan/contractor exclusion.
Medium priority · Sep 27, 2026 editionRead story →
SB 1447 revises surveillance reporting and related health provisions; the December 2028/notification trigger applies to entity data submission.
Medium priority · Sep 27, 2026 editionRead story →
AB 1018 remained a proposal to regulate consequential automated decisions, with distinct developer and deployer duties.
Medium priority · Sep 27, 2026 editionRead story →
AB 1405 sets January 1, 2029 registration for covered third-party AI audits and preserves independence, reporting and recordkeeping safeguards.
Medium priority · Sep 27, 2026 editionRead story →
AB 1979 proposes preserving clinician judgment around clinical AI and extending CMIA protections to defined consumer healthcare chatbots.
Medium priority · Sep 27, 2026 editionRead story →
AB 2575 proposed protections for direct-care workers’ clinical judgment and a limited change to AI-related liability defenses.
Medium priority · Sep 27, 2026 editionRead story →
California’s HHA moratorium has separate October 9 applicant and March 31 management-information requirements, with defined exceptions.
Medium priority · Sep 27, 2026 editionRead story →
AB 1760 revises dental licensure, permit and assistant-training provisions, including a January 2028 radiation-course approval transition.
Medium priority · Sep 27, 2026 editionRead story →
AB 1199 proposes three-year medical-staff reappointment and competency-review intervals, retaining professional oversight and ethical controls.
Medium priority · Sep 27, 2026 editionRead story →
SB 1302 revises nursing medication orders and education while setting separate 2028 state-recognition and 2029 renewal-documentation milestones.
Medium priority · Sep 27, 2026 editionRead story →
AB 1930 was signed September 26, replacing its pending status with an enacted protected-care legal-process notice framework.
Medium priority · Sep 27, 2026 editionRead story →
AB 2311 permits a limited health-care-district physician-employment pathway with hospital eligibility and professional-independence conditions.
Medium priority · Sep 27, 2026 editionRead story →
AB 2562 proposes suicide-prevention plans for licensed residential facilities and certified programs, with a separate DHCS rulemaking deadline.
Medium priority · Sep 27, 2026 editionRead story →
AB 2598 proposes documented next-of-kin notification, conditional public-administrator notice and separate penalty clocks for hospitals and SNFs.
Medium priority · Sep 27, 2026 editionRead story →
CMS’s September 18 CAH survey-guidance revision addresses emergency protocols, implementation and adequate provisions, including obstetrical emergencies.
Medium priority · Sep 27, 2026 editionRead story →
AB 1983 distinguishes resale-conditioned and sequential-order continuing-care repayments, with different funding, disclosure and payment triggers.
Medium priority · Sep 27, 2026 editionRead story →
AB 1930 adds Attorney General notice before specified protected-care records production, with federal timing and other express exceptions.
Medium priority · Sep 27, 2026 editionRead story →
SB 1023 extends HIV-prevention product protections and requires specified non-self-administered products under both medical and prescription benefits from 2027.
Medium priority · Sep 27, 2026 editionRead story →
AB 2150 creates employer-paid, EMSA-approved naloxone training for employees required to hold CPR certification, with documented equivalency and scope limits.
Medium priority · Sep 27, 2026 editionRead story →
The federal IDR correction restores omitted payment-determination language, with August 28 effectiveness and August 3 applicability.
Medium priority · Sep 27, 2026 editionRead story →
DMHC requires contracted-PBM information by October 1 and reminds plans of PBM licensing before January 1, 2027.
Medium priority · Sep 27, 2026 editionRead story →
DOJ’s Justice Manual revisions distinguish binding law from guidance and require consideration, rather than automatic dismissal, of declined qui tam cases.
Medium priority · Sep 27, 2026 editionRead story →
AB 2613 adds opted-in electronic provider-termination notices alongside mail and sets separate notice clocks when a contract is restored.
Medium priority · Sep 27, 2026 editionRead story →
AB 1907 adds household and eligible Indian plan options and complete-application intake from July 1, 2027, while retaining enrollment and notice conditions.
Medium priority · Sep 27, 2026 editionRead story →
AB 2341’s emergency-translation rule uses two separate 5-percent calculations and has been effective since August 31.
Medium priority · Sep 27, 2026 editionRead story →
OCR’s September 3 letter describes protected-ground discrimination, harassment and retaliation in funded care and training, with jurisdiction and speech safeguards.
Medium priority · Sep 27, 2026 editionRead story →
AB 173 was enacted September 18; its Medi-Cal affiliation-risk provisions retain federal approval and funding conditions.
Medium priority · Sep 27, 2026 editionRead story →
SB 16 makes emergency physicians an eligible county 5150 designation discipline while retaining county approval, training and review requirements.
Medium priority · Sep 27, 2026 editionRead story →
SB 934 defines prohibited efforts toward a predetermined sexual orientation or gender identity and retains nondirective and supportive-care exclusions.
Medium priority · Sep 27, 2026 editionRead story →
SB 1114 limits identifiable SOGISC disclosures by specified state entities and includes inference data, exceptions and staged implementation.
Medium priority · Sep 27, 2026 editionRead story →
California’s Attorney General reaffirmed integration enforcement and reported a federal regulatory vacatur, without withdrawing continuing disability-law protections.
Medium priority · Sep 27, 2026 editionRead story →
Lower-priority and watch items, plus closed matters kept for the edition record.
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Active high- and medium-priority findings, organized by topic.
RegalCare entities and two executives agreed to $1 million plus interest, with specific admitted billing facts; the signed agreement qualifies how clinical consultation and MDS certification occurred.
High priority · Sep 27, 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 27, 2026 editionRead story →
DOJ's pending laboratory complaint alleges $13.7 million in Medicare payments tied to mass-event genetic tests and added respiratory panels without valid individualized ordering.
Medium priority · Sep 27, 2026 editionRead story →
Crown Medical Solutions and its owners agreed to $825,000 based on ability to pay, resolving disputed Medicare DME claims without a liability determination.
Medium priority · Sep 27, 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 27, 2026 editionRead story →
Remedi SeniorCare agreed to pay more than $5.3 million over allegations of Medicare and Medicaid claims for drugs lacking valid prescriptions; payment is based on ability to pay and made over time.
Medium priority · Sep 27, 2026 editionRead story →
California announced a guilty plea and two-year prison sentence in a $413,643.30 IHSS and respite-care fraud case involving false claims about a disabled family member's care.
Medium priority · Sep 27, 2026 editionRead story →
Fourteen CDPH citations issued September 21–25 identify $115,500 in initial assessments across thirteen facilities, with care, reporting and record-integrity categories; later status or balance is not established at this cutoff.
Medium priority · Sep 27, 2026 editionRead story →
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 27, 2026 editionRead story →
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 27, 2026 editionRead story →
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 27, 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 27, 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 27, 2026 editionRead story →
Lower-priority and watch items, plus closed matters kept for the edition record.
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Active high- and medium-priority findings, organized by topic.
CMS’s revised October NCD coding instructions remove the stem-cell changes for a later April 2027 request. October 5 implementation remains scheduled for the retained coding updates, including some earlier effective dates. CMS distinguishes these maintenance changes from new coverage policy.
High priority · Sep 27, 2026 editionRead story →
Noridian’s September 24 MolDX notices announce October diagnosis-code changes and separately dated revisions. Article maintenance does not itself establish coverage for every listed test.
High priority · Sep 27, 2026 editionRead story →
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 27, 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 27, 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 27, 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 27, 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 27, 2026 editionRead story →
CMS reports applications from every state, DC and Puerto Rico, but fewer signed GENEROUS agreements. The September 30 signing date remains ahead; applications alone do not establish each state’s participation terms.
Medium priority · Sep 27, 2026 editionRead story →
AB 1126 limits excess Medi-Cal billing barriers after other coverage, with a Medicare exception and federal implementation conditions.
Medium priority · Sep 27, 2026 editionRead story →
DHCS’s September stakeholder notice prepares a January 1 managed-care-to-fee-for-service transition for specified members. It points to readiness meetings and member and provider resources.
Medium priority · Sep 27, 2026 editionRead story →
CMS opened October 21 comment and reconsideration routes for preliminary 2027 laboratory payment determinations.
Medium priority · Sep 27, 2026 editionRead story →
DHCS’s psychiatric emergency payment draft seeks October 12 feedback and distinguishes emergency care from admitted inpatient psychiatric specialty services.
Medium priority · Sep 27, 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 27, 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 27, 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 27, 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 27, 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 27, 2026 editionRead story →
Noridian’s September 17 JE notices set a nerve-policy transition and separate facet-joint coding and MolDX hyperlink revisions.
Medium priority · Sep 27, 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 27, 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 27, 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 27, 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 27, 2026 editionRead story →
CMS announced spring 2027 ACCESS expansion for additional chronic conditions under voluntary Original Medicare participation.
Medium priority · Sep 27, 2026 editionRead story →
The September 18 EDI transmittal replaces the August version to correct two 276/277 spreadsheet errors; systems implementation remains October 5.
Medium priority · Sep 27, 2026 editionRead story →
CMS published the final 2027 mandatory Ambulatory Specialty Model participant list and highlighted reporting and attestation duties.
Medium priority · Sep 27, 2026 editionRead story →
CMS’s September 11 instructions align FY 2027 inpatient rates, Grouper/MCE 44.0, Pricers and provider files with October 1 discharges and October 5 implementation.
Medium priority · Sep 27, 2026 editionRead story →
DHCS’s ACWDL 26-16 restores January 2027 asset tests for specified groups with application, renewal, cure and transfer-review protections.
Medium priority · Sep 27, 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 27, 2026 editionRead story →
Lower-priority and watch items, plus closed matters kept for the edition record.
Lower priority · Sep 27, 2026 editionRead story →
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