Weekly healthcare intelligenceRegulation · Enforcement · Government payersAll editions →

All articles and reminders · Enforcement Briefing

Published November 8, 2026 · Reporting window November 1–7, 2026, Pacific. Later developments are labelled. Source coverage is incomplete; the complete reports describe the limitations.

All articlesSearch this edition →
Enforcement Briefing: complete report →

16 articles and reminders, grouped by category.

Enforcement Briefing

Higher-priority matters

Billing fraud & false claims 5 articles and reminders

Billing fraud & false claimsEnforcement BriefingConditional reminder

DOJ reports California physician Violetta Mailyan sentenced to 15 years in prison in Medicare Botox billing case

A federal court sentenced California physician Violetta Mailyan to 15 years in prison on October 29, 2026, DOJ announced on October 30. DOJ reports that she used her medical practice to fraudulently bill Medicare more than $45 million for Botox injection services that were medically unnecessary and never provided, and that after a six-day jury trial ending in May 2026 she was convicted of nine counts of wire fraud and three counts of obstruction of a criminal investigation of a health care offense. The court ordered $32,904,049.41 in restitution to Medicare and the immediate forfeiture of over $16,029,742 worth of seized property.

High priority · Nov 8, 2026 editionRead story →

Billing fraud & false claimsEnforcement BriefingConditional reminder

Adult day-care owner pleads guilty in $65 million Medicaid scheme

Ahsan Ijaz, an owner of two social adult day care centers and a home health care fiscal intermediary in Brooklyn, New York, pleaded guilty to conspiracy to commit health care fraud, the Justice Department announced on October 2, 2026. DOJ reports that he pleaded guilty to defrauding New York State Medicaid of approximately $65 million through claims for social adult day care and home health care services that were not provided; according to court documents, the businesses paid cash kickbacks and bribes to Medicaid recipients to induce enrollment and billed for services not provided, including when certain Medicaid recipients were not in the United States at the time of service. Sentencing is scheduled for March 10, 2027.

High priority · Nov 8, 2026 editionRead story →

Billing fraud & false claimsEnforcement BriefingNew in this edition

California lab and its owner agree to pay $1.25 million to resolve allegations of kickbacks to marketers

DOJ's Civil Division and the U.S. Attorney's Office for the Eastern District of California announced on November 6 that Lab Genomics LLC, a Fountain Valley, California clinical laboratory, and its owner Leena Dalal agreed to pay $1,250,000 to resolve False Claims Act allegations. The United States alleged that from January 2020 through September 2022 Lab Genomics and Dalal knowingly and willfully paid value- and volume-based commissions to three independent contractor marketers to induce them to arrange for or recommend that providers order lab tests, and structured invoices so the commissions looked like flat fees. The matter came from a qui tam suit; the relators will receive $225,000. The settlement agreement states $625,000 of the amount is restitution and that the agreement is neither an admission of liability by the laboratory and its owner nor a concession by the United States that its claims are not well founded. DOJ states the claims are allegations only and there has been no determination of liability. No Corporate Integrity Agreement is mentioned.

Medium priority · Nov 8, 2026 editionRead story →

Billing fraud & false claimsEnforcement BriefingNew in this edition

Quest Diagnostics pays $13 million and signs five-year CIA to resolve allegations of free sports entertainment for referral sources

The U.S. Attorney for the District of New Jersey announced on November 6 that Quest Diagnostics, Inc. paid $13,014,576 plus interest to resolve allegations that it submitted false claims to Medicare and to New York and New Jersey Medicaid. The United States alleged that from July 25, 2013 to August 3, 2022 Quest gave referral decisionmakers free entertainment tied to its New York Giants sponsorship, including suite seats, training-camp access and other events, to induce referrals, and that it measured the return on investment from those events for the 2013 through 2016 seasons. Quest also entered a five-year Corporate Integrity Agreement (CIA) with HHS-OIG that requires an independent review organization to evaluate its risk assessments and audits of remuneration exchanged with referral sources. Three relators share $2,472,769. DOJ states the claims are allegations only, and the agreement states it is not an admission of liability.

Medium priority · Nov 8, 2026 editionRead story →

Billing fraud & false claimsEnforcement BriefingNew in this edition

Tennessee physician group agrees to pay $2.8 million to resolve allegations that non-physician services were billed under physicians' NPIs

The U.S. Attorney for the Middle District of Tennessee announced on November 2 that Premier Medical Group, P.C., a multi-physician practice in Clarksville, Tennessee, agreed to pay $2.8 million to resolve False Claims Act allegations. The United States alleged that from November 1, 2018 through May 31, 2023 Premier billed Medicare and TRICARE for services performed by non-physician practitioners using physicians' National Provider Identifier numbers. DOJ states the claims are allegations only and there has been no determination of liability. The release names no relator and no Corporate Integrity Agreement.

Medium priority · Nov 8, 2026 editionRead story →

Consumer & business misconduct 1 articles and reminders

Consumer & business misconductEnforcement BriefingNew in this edition

Four state AGs settle with medical transcription vendor Perry Johnson & Associates over 13.3 million-person breach

New York Attorney General Letitia James, with the attorneys general of Connecticut, Michigan and New Jersey, announced on November 6 a settlement with Perry Johnson & Associates, Inc. (PJ&A) and related companies over a March 2023 breach affecting 13.3 million people, including about 4.2 million New Yorkers. The release says hackers used a coding employee's credentials when the company did not require multi-factor authentication (MFA) for remote access. The companies will pay at least $300,000 in penalties, with an additional $9,700,000 due if they fail to meet the agreement's terms, and any Perry Johnson company that maintains protected health information (PHI) must keep an information security program and incident response protocol, multi-factor authentication, password management, encryption and asset management safeguards, annual HIPAA-consistent risk assessments, and policies on the collection, use, retention and disposal of health information. The New York Assurance of Discontinuance (AOD) makes findings against specific companies in the group, including that named entities acting as HIPAA business associates never conducted a HIPAA risk analysis and did not meet subcontractor requirements; The Assurance names PJ&A, PJ&A Coding and PJ&A Radiology as the business associates that never conducted a HIPAA risk analysis and did not meet the subcontractor requirements. The respondents neither admit nor deny the findings, and the assurance describes four of the companies (PJ&A, PJ&A Coding, PJ&A Radiology and Medical Transcription and Coding, Inc.) as insolvent and inactive as of the assurance's Effective Date.

Medium priority · Nov 8, 2026 editionRead story →

More matters and continuing watch

Billing fraud & false claims 4 articles and reminders

Health plan oversight 1 articles and reminders

Consumer & business misconduct 5 articles and reminders

Privacy preferences

Where enabled for this site, Cloudflare Web Analytics can send page-use and performance measurements to Cloudflare. This panel provides information and does not turn analytics on or off.

This panel stores no tracking choice and does not change your tool saves, screening, resets, reports or exports. Other sites have separate settings.

Read Privacy & Cookies