Billing fraud & false claimsEnforcement BriefingClosed
The Villages Health System agrees to a $541.5 million settlement over invalid Medicare Advantage diagnosis codes after self disclosing
High priority · Sep 27, 2026 editionRead story →
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120 published findings
Audits & program integrityMedicare & MedicaidContinuing
CMS reports $1.6 billion in Medicare laboratory program integrity actions across revocations, suspensions, recoupments and referrals
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 →
Medicare Advantage & Part DMedicare & MedicaidClosed
CMS opens the second CY 2027 Medicare Plan Finder benefit and drug-pricing preview through September 11
High priority · Sep 27, 2026 editionRead story →
Medicare Advantage & Part DMedicare & MedicaidClosed
CMS opens CY 2027 Medicare Advantage provider-directory preview and sets September 18 attestation deadline
High priority · Sep 27, 2026 editionRead story →
Consumer & business misconductEnforcement BriefingContinuing
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 27, 2026 editionRead story →
Consumer & business misconductEnforcement BriefingContinuing
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 27, 2026 editionRead story →
Audits & repaymentsEnforcement BriefingContinuing
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 27, 2026 editionRead story →
Billing fraud & false claimsEnforcement BriefingNew in this edition
Skilled-nursing company and executives agree to pay $1 million to resolve therapy overbilling allegations
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 →
Billing & paymentMedicare & MedicaidNew in this edition
CMS revises the October NCD coding update and moves stem-cell changes to April 2027
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 →
Billing & paymentMedicare & MedicaidNew in this edition
Noridian posts MolDX billing-article revisions for October 1
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 →
Payment & health plan rulesCompliance SweepContinuing
Federal independent dispute resolution rule corrected, payment determination text restored and applied back to August 3
The federal IDR correction restores omitted payment-determination language, with August 28 effectiveness and August 3 applicability.
Medium priority · Sep 27, 2026 editionRead story →
Billing fraud & false claimsEnforcement BriefingClosed
Monogram Health agrees to $2.4 million settlement over Medicare Advantage diagnosis codes
Medium priority · Sep 27, 2026 editionRead story →
Consumer & business misconductEnforcement BriefingClosed
OCR settles its 55th right of access case for $50,000 over a records request that took two years
Medium priority · Sep 27, 2026 editionRead story →
Consumer & business misconductEnforcement BriefingContinuing
Walmart agrees to $50 million opioid-prescription settlement and dispensing safeguards
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 →
Provider operationsMedicare & MedicaidContinuing
CMS proposes a new annual Acute Hospital Care at Home reporting requirement, comments close October 26
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 →
Coverage & clinical policyMedicare & MedicaidContinuing
Noridian finalizes two MolDX coverage policies for California effective October 12 and retires the thrombophilia policy October 11
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 →
Billing & paymentMedicare & MedicaidContinuing
Medi-Cal requires quarterly validation of the public fee for service provider directory beginning October 1, 2026, with Provider Portal Transaction Center access at stake
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 →
Licensing & workforceCompliance SweepContinuing
California imposes a home health agency licensure moratorium under Senate Bill 164, with pending applicant responses due October 9, 2026 and management personnel filings due March 31, 2027
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 →
Health plan oversightEnforcement BriefingClosed
DMHC issues four letters of agreement totaling $331,000 against California health plans
Medium priority · Sep 27, 2026 editionRead story →
Consumer & business misconductEnforcement BriefingClosed
CDPH issues ten California facility citations and penalties totaling $73,750, including two class A citations
Medium priority · Sep 27, 2026 editionRead story →
Licensing & workforceCompliance SweepContinuing
California signs AB 1760 dentistry changes
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 →
Medi-Cal & Medicaid policyMedicare & MedicaidContinuing
California challenges Medicaid and CHIP funding restrictions scheduled for October 13
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 →
Medicare Advantage & Part DMedicare & MedicaidContinuing
OIG identifies $587.7 million in Part D payments involving obsolete prescription labeling
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 →
Billing & paymentMedicare & MedicaidContinuing
OIG flags organ acquisition reimbursement and documentation risks
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 →
Consumer & business misconductEnforcement BriefingContinuing
Florida DME operators sentenced in $34.8 million brace fraud scheme
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 →
Billing & paymentMedicare & MedicaidContinuing
Medi-Cal fee-for-service hospices must use the new attestation portal within five days of election
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 →
Governance & business operationsCompliance SweepContinuing
AB 2341 changes local-agency emergency translation calculations immediately
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 →
Governance & business operationsCompliance SweepContinuing
OCR clarifies civil-rights protections against antisemitic discrimination
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 →
Drugs & prescribingEnforcement BriefingContinuing
Med spa owner sentenced for counterfeit injections
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 →
Billing fraud & false claimsEnforcement BriefingContinuing
Heuser Health settles skin-substitute overbilling allegations
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 →
Payment & health plan rulesCompliance SweepContinuing
DMHC requires contracted PBM information by October 1
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 →
Privacy & health informationCompliance SweepClosed
DHCS seeks youth data-sharing toolkit comments by September 9
Medium priority · Sep 27, 2026 editionRead story →
Governance & business operationsCompliance SweepContinuing
AB-173 Health
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 →
Medi-Cal & Medicaid policyMedicare & MedicaidContinuing
AB-220 Medi-Cal: subacute care services
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 →
Coverage & clinical policyMedicare & MedicaidContinuing
AB-280 Health care coverage: provider directories
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 →
Coverage & clinical policyMedicare & MedicaidContinuing
AB-350 Health care coverage: fluoride treatments
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 →
Payment & health plan rulesCompliance SweepClosed
AB 539 Health care coverage: prior authorizations
Medium priority · Sep 27, 2026 editionRead story →
AI & digital healthCompliance SweepContinuing
AB-1018 Automated decision systems
AB 1018 remained a proposal to regulate consequential automated decisions, with distinct developer and deployer duties.
Medium priority · Sep 27, 2026 editionRead story →
Licensing & workforceCompliance SweepContinuing
AB-1199 Medical staff: health care provider credentialing
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 →
AI & digital healthCompliance SweepContinuing
AB-1405 Artificial intelligence: auditors: registration
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 →
Coverage & clinical policyMedicare & MedicaidContinuing
AB-1682 Health care coverage: scalp cooling
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 →
Coverage & clinical policyMedicare & MedicaidContinuing
AB-1876 Health care coverage: nondiscrimination
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 →
Patient care & rightsCompliance SweepContinuing
AB-1930 Abortion or gender-affirming health care services: subpoenas, discovery requests, or other requests for information
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 →
AI & digital healthCompliance SweepContinuing
AB 1979 Health care services: artificial intelligence
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 →
Patient care & rightsCompliance SweepContinuing
AB-2311 Health care districts: employment
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 →
Patient care & rightsCompliance SweepClosed
AB-2343 Alcohol and other drug programs: consumer protection platform
Medium priority · Sep 27, 2026 editionRead story →
Privacy & health informationCompliance SweepContinuing
AB 2448 Medical information: confidentiality
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 →
Billing & paymentMedicare & MedicaidContinuing
AB-2499 Health care coverage: claims payments
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 →
Billing & paymentMedicare & MedicaidContinuing
AB-2571 Reimbursement for pharmacist services
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 →
Patient care & rightsCompliance SweepContinuing
AB-2562 Alcohol or other drug recovery and treatment programs and facilities: suicide prevention
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 →
AI & digital healthCompliance SweepContinuing
AB-2575 Health care services: artificial intelligence
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 →
Patient care & rightsCompliance SweepContinuing
AB-2598 Health care facilities: notification of next of kin
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 →
Payment & health plan rulesCompliance SweepContinuing
DOJ revises False Claims Act enforcement policy on sub-regulatory guidance and declined qui tam dismissals
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 →
Patient care & rightsCompliance SweepContinuing
CMS makes revised Critical Access Hospital emergency-services readiness guidance effective immediately
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 →
Billing fraud & false claimsEnforcement BriefingContinuing
DOJ sues former laboratory executives over $13.7 million in allegedly unnecessary Medicare testing
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 →
Billing & paymentMedicare & MedicaidContinuing
CMS announces broad state participation in the GENEROUS Medicaid drug payment model and a September 30 signing date
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 →
Provider operationsMedicare & MedicaidContinuing
CMS expands ACCESS to heart failure, COPD, substance use disorder, nicotine dependence, and extended musculoskeletal care in spring 2027
CMS announced spring 2027 ACCESS expansion for additional chronic conditions under voluntary Original Medicare participation.
Medium priority · Sep 27, 2026 editionRead story →
Provider operationsMedicare & MedicaidContinuing
CMS corrects two October EDI spreadsheet errors, with October 1 applicability and October 5 implementation
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 →
Payment & health plan rulesCompliance SweepContinuing
California requires added electronic notices when health plan provider contracts terminate
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 →
Billing & paymentMedicare & MedicaidContinuing
California limits added billing barriers for Medi-Cal providers after other coverage pays
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 →
Payment & health plan rulesCompliance SweepContinuing
California expands Covered California plan options and application intake
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 →
Patient care & rightsCompliance SweepContinuing
California establishes sequencing and disclosure rules for repayable continuing-care contracts
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 →
Governance & business operationsCompliance SweepContinuing
California requires county procedures for involuntary-commitment designations
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 →
Privacy & health informationCompliance SweepContinuing
California health omnibus changes patient-safety and surveillance requirements
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 →
Provider operationsMedicare & MedicaidContinuing
CMS names final 2027 mandatory Ambulatory Specialty Model participants and reporting steps
CMS published the final 2027 mandatory Ambulatory Specialty Model participant list and highlighted reporting and attestation duties.
Medium priority · Sep 27, 2026 editionRead story →
Coverage & clinical policyMedicare & MedicaidContinuing
Noridian aligns JE nerve policies and revises facet-joint and MolDX articles
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 →
Billing & paymentMedicare & MedicaidContinuing
DHCS prepares a January 1 transition to fee-for-service for specified immigration-status coverage
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 →
Drugs & prescribingEnforcement BriefingContinuing
Long-term care pharmacy agrees to pay over $5.3 million to resolve prescription-billing allegations
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 →
Provider operationsMedicare & MedicaidContinuing
FY 2027 IPPS and LTCH instructions separate October 1 discharges from October 5 systems implementation
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 →
Provider operationsMedicare & MedicaidContinuing
DHCS explains reinstated asset limits for Pickle, DAC, and Disabled Widow or Widower groups
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 →
Patient care & rightsCompliance SweepNew in this edition
California expands protections for records and testimony involving protected health care
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 →
Governance & business operationsCompliance SweepNew in this edition
California updates restrictions involving conversion therapy
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 →
Patient care & rightsCompliance SweepNew in this edition
California changes health coverage requirements for antiretroviral products
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 →
Governance & business operationsCompliance SweepNew in this edition
California changes disclosure rules for sexual orientation, gender identity, and intersex data
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 →
Billing fraud & false claimsEnforcement BriefingNew in this edition
Crown Medical Solutions and owners agree to pay $825,000 over DME billing allegations
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 →
Patient safety & protectionEnforcement BriefingNew in this edition
California secures guilty plea and prison sentence in $400,000 Medi-Cal fraud case
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 →
Billing & paymentMedicare & MedicaidNew in this edition
CMS releases preliminary 2027 Clinical Laboratory Fee Schedule rates
CMS opened October 21 comment and reconsideration routes for preliminary 2027 laboratory payment determinations.
Medium priority · Sep 27, 2026 editionRead story →
Billing & paymentMedicare & MedicaidNew in this edition
DHCS seeks comment on payment responsibility for psychiatric emergency services
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 →
Patient care & rightsCompliance SweepNew in this edition
AB 2150 adds employer-paid naloxone training for employees required to certify in CPR
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 →
Licensing & workforceCompliance SweepNew in this edition
SB 1302 changes nursing medication-order authority, education and credentialing requirements
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 →
Patient safety & protectionEnforcement BriefingNew in this edition
CDPH records fourteen in-window facility citations, including patient-care and unreported-abuse penalties
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 →
Governance & business operationsCompliance SweepNew in this edition
California reaffirms disability-integration enforcement after reported federal Section 504 regulatory vacatur
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 →
Governance & business operationsCompliance SweepClosed
HHS vaccine-category RFI’s September 20 assured-consideration date has passed
Lower priority · Sep 27, 2026 editionRead story →
Consumer & business misconductEnforcement BriefingClosed
DermTech resolution provides a $5.04 million bankruptcy claim over unreliable test allegations
Lower priority · Sep 27, 2026 editionRead story →
Consumer & business misconductEnforcement BriefingClosed
FTC finalizes the Ascension and AmSurg consent order with seven surgery center divestitures and a prior notice duty
Lower priority · Sep 27, 2026 editionRead story →
Billing & paymentMedicare & MedicaidContinuing
October Medicare and Medi-Cal claims changes combine service dates, systems updates and Noridian limitations
Lower priority · Sep 27, 2026 editionRead story →
Billing & paymentMedicare & MedicaidContinuing
Medicare colorectal biomarker coverage: June 8 effective date, January 4 claims implementation
Lower priority · Sep 27, 2026 editionRead story →
Billing & paymentMedicare & MedicaidContinuing
2027 Medicare HCPCS releases and $0.270 clotting-factor fee have separate service and system dates
Lower priority · Sep 27, 2026 editionRead story →
AI & digital healthCompliance SweepContinuing
FCC seeks comment on rural healthcare telecommunications funding
Lower priority · Sep 27, 2026 editionRead story →
Licensing & workforceCompliance SweepContinuing
OIG identifies weaknesses in oversight of contract nursing home surveyors
Lower priority · Sep 27, 2026 editionRead story →
Provider operationsMedicare & MedicaidContinuing
CMS refreshes hospice telecommunications recertification reporting guidance
Lower priority · Sep 27, 2026 editionRead story →
Medicare Advantage & Part DMedicare & MedicaidContinuing
CMS opens separate comment windows for Medicaid quality, pharmacy, BHP and Part D collections
Lower priority · Sep 27, 2026 editionRead story →
Patient safety & protectionEnforcement BriefingContinuing
CDPH issues $3,000 Class B citation to San Bernardino nursing facility
Lower priority · Sep 27, 2026 editionRead story →
Consumer & business misconductEnforcement BriefingContinuing
FDA orders permanent services debarment and 20-year import debarment
Lower priority · Sep 27, 2026 editionRead story →
Provider operationsMedicare & MedicaidContinuing
CMS explains January Medicare Secondary Payer adjustment-code processing
Lower priority · Sep 27, 2026 editionRead story →
Coverage & clinical policyMedicare & MedicaidContinuing
Noridian opens three proposed MolDX policies for comments through October 11
Lower priority · Sep 27, 2026 editionRead story →
Payment & health plan rulesCompliance SweepContinuing
HHS announces Do Not Pay matching for grant payments
Lower priority · Sep 27, 2026 editionRead story →
Billing fraud & false claimsEnforcement BriefingContinuing
Researcher pleads guilty to diverting CDC grant funds
Lower priority · Sep 27, 2026 editionRead story →
Governance & business operationsCompliance SweepClosed
FTC extends personalized-pricing policy comments to September 25
Lower priority · Sep 27, 2026 editionRead story →
Governance & business operationsCompliance SweepContinuing
OLC broadens its interpretation of state immigration-status reporting
Lower priority · Sep 27, 2026 editionRead story →
Billing fraud & false claimsEnforcement BriefingContinuing
Caregiver admits diverting client funds
Lower priority · Sep 27, 2026 editionRead story →
Billing fraud & false claimsEnforcement BriefingClosed
Medical-practice manager sentenced for payroll embezzlement
Lower priority · Sep 27, 2026 editionRead story →
Consumer & business misconductEnforcement BriefingContinuing
Novum settles PPP affiliate-size allegations
Lower priority · Sep 27, 2026 editionRead story →
Billing & paymentMedicare & MedicaidContinuing
CMS adjusts September plan payment user fees
Lower priority · Sep 27, 2026 editionRead story →
Privacy & health informationCompliance SweepContinuing
CalPrivacy targets inaccurate data-broker registrations
Lower priority · Sep 27, 2026 editionRead story →
Patient safety & protectionEnforcement BriefingClosed
CalPrivacy orders SalesIntel to pay $36,400 for late registration
Lower priority · Sep 27, 2026 editionRead story →
Governance & business operationsCompliance SweepContinuing
USPS requires barcodes on Free Matter parcels October 4
Lower priority · Sep 27, 2026 editionRead story →
Medi-Cal & Medicaid policyMedicare & MedicaidContinuing
California directs DHCS to establish Medi-Cal vision performance measures
Lower priority · Sep 27, 2026 editionRead story →
Patient care & rightsCompliance SweepContinuing
California changes the deadline for updating an adult community care facility email address
Lower priority · Sep 27, 2026 editionRead story →
Audits & program integrityMedicare & MedicaidContinuing
CMS releases FY 2025 SNF PEPPER reports
Lower priority · Sep 27, 2026 editionRead story →
Patient care & rightsCompliance SweepContinuing
AB-96 Mental health services: peer support specialist certification
Watch · Sep 27, 2026 editionRead story →
Governance & business operationsCompliance SweepContinuing
AB-1575 Lanterman Developmental Disabilities Services Act
Watch · Sep 27, 2026 editionRead story →
Patient care & rightsCompliance SweepContinuing
AB-1598 Behavioral sciences
Watch · Sep 27, 2026 editionRead story →
Licensing & workforceCompliance SweepContinuing
AB-1703 Osteopathic physicians and surgeons: unauthorized practice: unauthorized use of titles
Watch · Sep 27, 2026 editionRead story →
Patient care & rightsCompliance SweepContinuing
AB-1794 Pharmacy: enteral nutrition supplements or replacements
Watch · Sep 27, 2026 editionRead story →
Governance & business operationsCompliance SweepContinuing
AB-1811 Health professionals
Watch · Sep 27, 2026 editionRead story →
Governance & business operationsCompliance SweepContinuing
AB-1973 Abortion: authorized procedures
Watch · Sep 27, 2026 editionRead story →
Patient care & rightsCompliance SweepContinuing
AB-2041 Emergency medical services
Watch · Sep 27, 2026 editionRead story →
Governance & business operationsCompliance SweepClosed
AB 2150 proposal closed after enactment, final implementation appears in GC-2026-0136
Watch · Sep 27, 2026 editionRead story →
Patient care & rightsCompliance SweepContinuing
AB-2460 Pupil health: mental health: model referral protocols
Watch · Sep 27, 2026 editionRead story →
No matching stories.
Compliance Sweep: complete report →Enforcement Briefing: complete report →Medicare & Medicaid: complete report →