July 22, 2026 This week The Texas Supreme Court ruled that omissions claims under the Texas Health Care Program Fraud Prevention Act must prove materiality even though the statute never uses that word, holding that a defendant who disclosed its conduct and kept getting paid without objection had effectively negated any claim that the omitted pricing information mattered to the government’s payment decision. Express Scripts is suing Texas Attorney General Ken Paxton to block the full release...
8 days ago • 8 min read
July 22, 2026 This week HHS Secretary Robert F. Kennedy Jr. has stacked the FDA’s Pharmacy Compounding Advisory Committee with nine new members largely favorable to peptide use, just ahead of July meetings on whether compounding pharmacies can produce unproven peptides like BPC-157 that FDA scientists say lack sufficient evidence of safety and efficacy. OIG Advisory Opinion No. 26-15 concludes that a home health agency’s payment of per-hospital subscription fees for online referral management...
15 days ago • 11 min read
July 22, 2026 This week The Justice Department’s 2026 National Health Care Fraud Takedown charged 455 defendants, including 90 medical professionals, across 56 federal districts in schemes totaling more than $6.5 billion in false claims, with authorities seizing over $182 million in assets and securing arrests abroad in massive catheter and telemedicine fraud cases. Thirteen defendants in the Northern District of Texas have been charged across seven cases tied to more than $365 million in...
22 days ago • 9 min read
July 22, 2026 This week Medical spas that handle protected health information must train every single worker—full-time, part-time, temporary, or volunteer—on HIPAA rules and keep those records for at least six years, because skipping this step is its own violation that can trigger steep federal penalties, even before you factor in the tougher privacy laws in states like Texas and California. AI is transforming drug discovery faster than the law can keep up, leaving intellectual property...
29 days ago • 12 min read
July 22, 2026 This week Healthcare’s vendor compliance certifications like SOC 2, HITRUST, and Business Associate Agreements only prove what vendors claim rather than whether security controls actually work, so health systems should base vendor risk decisions on direct, verifiable evidence instead of trusting documentation that can be fabricated, as the $300 million startup Delve allegedly did with 494 nearly identical SOC 2 reports. Texas has become one of the nation’s hottest ASC markets,...
about 1 month ago • 14 min read
July 22, 2026 This week Smart glasses from Meta, Google, and other tech companies pose significant legal risks across wiretap laws, healthcare privacy rules, workplace regulations, and disability rights because they record audio and video without any visible indication to people around the wearer, creating potential violations in everything from patient confidentiality to employee consent requirements. Privacy and data security have become make-or-break issues in M&A deals because buyers now...
about 1 month ago • 13 min read
July 22, 2026 This week Healthcare providers are routinely using deceptive design tactics in their privacy forms that trap patients into agreeing to share their medical data by offering only an “I accept” button while claiming patients have the right to opt out, essentially making it impossible for people to actually exercise the privacy rights they’re supposedly being given. The OIG has given the green light to an orthopedic surgery provider’s innovative warranty program that refunds...
about 2 months ago • 9 min read
July 22, 2026 This week Starting July 1, 2026, Medicare Part D beneficiaries will be able to access GLP-1 weight-loss medications for just $50 per month through the new Medicare GLP-1 Bridge program, which will run through the end of 2027. Texas Children's Hospital agreed to pay over $10 million and fire five doctors after federal authorities accused the hospital of using fake diagnosis codes to hide gender-affirming treatments for minors in violation of state law, marking the first major...
about 2 months ago • 11 min read
July 22, 2026 Fraud, Abuse & Enforcement CMS has imposed six-month, nationwide moratoria on new Medicare enrollment for hospices and home health agencies (HHAs), blocking initial enrollment applications and certain changes in majority ownership. The moratoria, coordinated with Vice President JD Vance’s Anti-Fraud Task Force, do not affect existing providers, who may continue serving Medicare beneficiaries. CMS has already suspended payments to 773 hospices and 23 HHAs suspected of fraud in...
2 months ago • 11 min read