Search this edition. Continuing and closed findings remain available.
53 published findings
CMS restored three nursing-home complaint-procedure sections deleted in error, covering investigation preparation, past noncompliance and reporting sustained individual findings.
Medium priority · Oct 18, 2026 editionRead story →
CMS’s October 16 public-inspection proposal implements CAA 2026 provisions on low-income Part D cost sharing, MA directories and PBM contracts. It preserves distinct 2028/2029 phases and proposes detailed remuneration, reporting and enrollee protections. The posted text requests comments by December 15, 5 p.m. EST.
Medium priority · Oct 18, 2026 editionRead story →
The October 15 Treasury proposal addresses premium tax credit verification, eligibility and reconciliation across different effective periods. Its Medicaid community-engagement provision has a narrow sole-basis condition and timing exceptions. Comments are due November 30; the December 8 hearing depends on submitted outlines.
Medium priority · Oct 18, 2026 editionRead story →
Steven Powell received 12 months and a day in prison after signing brace orders without evaluating beneficiaries. The scheme generated more than $1.9 million in Medicare claims; $761,202.75 was paid and ordered as restitution. Rapid signing of prefilled orders was central to the conduct.
Medium priority · Oct 18, 2026 editionRead story →
Leo Anzivino Jr. pleaded guilty to laundering proceeds from a DME operation that billed Medicare more than $6 million. Nominee ownership, forged physician orders and beneficiary returns accompanied transfers of $1,494,938.09. Sentencing is scheduled for January 21, 2027.
Medium priority · Oct 18, 2026 editionRead story →
CVS executed settlements totaling $315 million in principal, plus interest on the civil settlement, without admitting liability. A related DEA agreement establishes controls for covered CVS retail pharmacies through August 15, 2032. Its operational requirements and implementation clock apply to CVS under the agreement.
Medium priority · Oct 18, 2026 editionRead story →
Ronnie Lorenzo Robinson Jr. admitted using concealed ownership and other people's identifiers to submit psychotherapy claims through The Fisher of Men Project. Approximately $735,000 was claimed and $440,000 paid. His prior Medicaid exclusion makes actual ownership and operational control central to the case.
Medium priority · Oct 18, 2026 editionRead story →
Brett Blackman received a 19-year sentence for a platform used to generate fraudulent medical orders and connect suppliers with kickback-funded telemedicine approvals. More than $1 billion was billed and more than $450 million paid. Restitution and forfeiture remain for later determination.
Medium priority · Oct 18, 2026 editionRead story →
Jose Llerena pleaded guilty to a conspiracy involving more than 87,000 oxycodone pills, with 3,735 attributed personally to him. Paid recruits obtained unnecessary prescriptions that were filled at participating pharmacies. The plea highlights coordinated recruitment, cash payments and resale indicators.
Medium priority · Oct 18, 2026 editionRead story →
Somerset's executed agreement requires $4 million plus interest as restitution over prescription labeling after an OTC switch. It resolves common-law payment-by-mistake and unjust-enrichment claims without admitting liability. False Claims Act liability is expressly reserved rather than released.
Medium priority · Oct 18, 2026 editionRead story →
DOJ announced 24-month sentences for Steven Churchill and Samson Solomon in a pharmacy scheme that caused $897,405 in Medicare payments. Concealed ownership, inaccurate retail-pharmacy representations, unsupported telemedicine prescriptions and unsolicited shipments formed the reported conduct. A third defendant awaits sentencing.
Medium priority · Oct 18, 2026 editionRead story →
Steven Murphy and two practices agreed to pay $866,539 and accept a three-year federal-program exclusion. Allegations involved uninsured-program claims despite insurance information in patient files, and billing laboratory components that could not be performed because required reagents were unavailable.
Medium priority · Oct 18, 2026 editionRead story →
The October14 notice delegates Social Security Act section1128(b) permissive exclusion authority to the CMS Administrator. OIG retains its authority; hearings and regulation issuance are excluded from the CMS delegation. This is an agency-authority change, not an exclusion of a named provider.
Medium priority · Oct 18, 2026 editionRead story →
DEA’s October14 published administrative order revokes Katherine Curtis’s registration effective November13. It rests on loss of Indiana authority and public-interest findings following default. The case illustrates credential and prescribing controls; it is not a criminal conviction.
Medium priority · Oct 18, 2026 editionRead story →
The October 15 policy coordinates DOJ corporate-enforcement and OIG self-disclosure benefits for qualifying criminal healthcare disclosures. A duplicate OIG portal submission is unnecessary, but eligibility conditions, prosecutorial discretion and mandatory-exclusion limits remain.
Medium priority · Oct 18, 2026 editionRead story →
The October 14 final rule adopts the 2025 interim rule without change. The filing cutoff remains October 30, 2025; eligible earlier renewals and extensions provided by law or notice retain their separate treatment.
Medium priority · Oct 18, 2026 editionRead story →
DEA’s October14 notice proposes revised threshold-based ScheduleI controls for 7-hydroxymitragynine and mitragynine pseudoindoxyl. A later temporary order, announced for on or after November13, is required. The existing pseudoindoxyl order continues; below-threshold status is not a safety finding.
Medium priority · Oct 18, 2026 editionRead story →
An October 13 coordinated enforcement announcement identifies healthcare companies among victims of alleged North Korean remote IT-worker schemes. The new arrests and announcement are distinct from the September searches.
Medium priority · Oct 18, 2026 editionRead story →
FDA's October 13 availability notice identifies final recommendations for manufacturing changes to licensed biosimilars and interchangeable biosimilars. HHS dates issuance October 9. The guidance addresses reporting categories, comparability evidence, shared manufacturing facilities and new strengths or dosage forms, without creating a general provider deadline.
Medium priority · Oct 18, 2026 editionRead story →
FDA launched a prospective rare-disease framework initiative October 14, seeking more consistent, tailored development and review while preserving statutory safety and effectiveness standards. A hybrid meeting is scheduled October 28, and the public docket will run October 28 through December 11.
Medium priority · Oct 18, 2026 editionRead story →
OHCA’s labor-cost adjustment process took effect October 12. Eligible requestors must support projected nonsupervisory organized labor costs under the adopted specifications; 2026 requests are due November 16. Submitted material, including labor agreements, is public by default unless OHCA accepts confidentiality.
Medium priority · Oct 18, 2026 editionRead story →
California's Dental Board proposes annual infection-control plan review, employer-provided training, package-level sterilization indicators, waterline testing and respiratory-hygiene measures. Written comments are due November 30. The proposal would revise the existing dental standard; it does not establish a new implementation date.
Medium priority · Oct 18, 2026 editionRead story →
The Civil Rights Council proposes broader pregnancy-accommodation guidance, tighter limits on medical-certification requests, faster individualized responses and removal of the two-week CFRA bonding-leave minimum. The package also addresses interaction with PWFA leave. Comments are due December 8 at 5 p.m.; the changes remain proposed.
Medium priority · Oct 18, 2026 editionRead story →
Cal/OSHA proposes regulatory procedures for existing SB 606 egregious and enterprise-wide violation categories, including penalties tied to exposed employees or covered worksites. The package also changes history, posting and abatement provisions. Written comments are due November 30, with further submission permitted at the December 3 hearing.
Medium priority · Oct 18, 2026 editionRead story →
An October 13 determination recognizes public health emergencies dating from October 6 in Florida and October 7 in Alabama. HHS’s October 14 announcement describes authority for temporary healthcare flexibilities. The declaration alone does not establish the terms of every waiver.
Medium priority · Oct 18, 2026 editionRead story →
CMS reported identifying 189,000 subsidized Federal Marketplace enrollees with duplicate public coverage or deceased records in 2026. HHS describes 30-day dispute processes and approximately $1.5 billion in potential savings over the next year. The figure is a projection, not recovered funds or an adjudicated fraud total.
Medium priority · Oct 18, 2026 editionRead story →
EPA's October 13 final rule will move the initial Clean Water Act hazardous-substance facility response-plan deadline from June 1, 2027, to June 1, 2030, effective December 14, 2026. Other facility categories retain distinct submission schedules. Hospitals appear among potentially affected industries, but coverage requires a facility-specific applicability determination.
Medium priority · Oct 18, 2026 editionRead story →
EPA's interim final rule, effective October 14, moves the Greenhouse Gas Reporting Program deadline for reporting-year 2025 annual reports from October 30, 2026, to March 10, 2027. It changes no other requirements. Comments are due November 30; the October 29 virtual hearing is conditional on a timely hearing request.
Medium priority · Oct 18, 2026 editionRead story →
Long-term-care providers face separate attending and referring NPI requirements from February 1, 2027. Initial, discharge and transfer claims need both; ongoing claims still need the attending NPI. Submitted identifiers must be valid individual NPIs for the billed service date.
Medium priority · Oct 18, 2026 editionRead story →
DHCS announced an updated English DHCS 7077 notice for people residing in or expecting to enter long-term care. The October 16 announcement describes reinstated non-MAGI asset limits and preserves spousal-protection exceptions; translated versions were still being prepared.
Medium priority · Oct 18, 2026 editionRead story →
DME and clinical-laboratory claims require a valid individual ordering NPI from February 1, 2027. The ordering provider must be actively enrolled in Medi-Cal by May 1. The announcement preserves specified DME replacement-code exceptions and requires a separate referring NPI when otherwise applicable.
Medium priority · Oct 18, 2026 editionRead story →
DHCS’s October 15 notice addresses claims affected by the October 1 DRG Mapper update. It identifies three denial codes for resubmission, calls for present-on-admission indicators and describes a separate erroneous-payment correction for eligible claims reimbursed incorrectly during system implementation.
Medium priority · Oct 18, 2026 editionRead story →
CDPH’s October 16 letter restates existing unusual-occurrence reporting for thirteen facility types during Public Safety Power Shutoff outages. It identifies the reporting recipients, outage and backup-power information to supply, and separate after-hours routes for facilities inside and outside Los Angeles County.
Medium priority · Oct 18, 2026 editionRead story →
DHCS’s October 15 draft proposes ending mandatory PSC-35 administration and corresponding FAST submissions, while preserving assessment-tool choices. Feedback is requested by November 3. The file retains draft markings, notice-number inconsistencies and an unspecified effective date, so current workflows should not be stopped on this evidence.
Medium priority · Oct 18, 2026 editionRead story →
The October 13 CANS alignment file describes a January 2027 Phase II start, age-specific IP-CANS use, administrator training transitions and reporting through 2029. Its notice numbers and appendix dates conflict. Confirm the authoritative issued version before using the stated timetable for implementation.
Medium priority · Oct 18, 2026 editionRead story →
A CDPH dashboard refreshed October 20 lists eight actions issued October 12–16, with $77,000 in initial and final assessed amounts. Two administrative staffing penalties account for $50,000. The records concern earlier violation periods and provide a retrospective view, without establishing the dataset or case status as it stood October 17.
Medium priority · Oct 18, 2026 editionRead story →
An October 13 amended accusation and petition asks the Medical Board to revoke Connie S. L. Chein's probation over alleged practice and compliance failures. The pleading builds on earlier stayed discipline; it does not establish that the requested revocation has been imposed.
Medium priority · Oct 18, 2026 editionRead story →
A petition signed October 13 asks the Medical Board to revoke Ryan Matthew Spivak's probation, alleging failures involving required programs, testing and quarterly declarations. The filing seeks further discipline under existing probation terms; it does not establish a new revocation or a positive drug test.
Medium priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Lower priority · Oct 18, 2026 editionRead story →
Watch · Oct 18, 2026 editionRead story →
Watch · Oct 18, 2026 editionRead story →
No matching stories.
Compliance Sweep: complete report →Enforcement Briefing: complete report →Medicare & Medicaid: complete report →