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October 23, 2026

Takeaways from the most recent news in the technology and policies shaping healthcare.

Government

Feds Launch False Claims Act Self-Disclosure Pilot

HHS and the Department of Justice's Civil Division have launched a six-month pilot program encouraging healthcare companies to report themselves for potential civil violations of the False Claims Act, according to Becker's Hospital Review.

Under the Healthcare False Claims Act Self-Disclosure Pilot Program, companies that meet the requirements can settle disclosed conduct through a coordinated civil release that covers both agencies. In practice, that means a single resolution rather than parallel or overlapping enforcement actions, giving disclosing organizations more certainty about their exposure. The pilot is aimed at firms willing to come forward proactively instead of waiting for the government to find the problem.

For hospitals, medical groups, and other Medicare and Medicaid participants, the move signals a continued federal push to reward transparency while keeping the FCA, one of the government's most powerful fraud-recovery tools, front and center. Compliance teams will need to weigh the benefits of early disclosure against the cost of flagging their own conduct during the limited six-month window.

More in Government

Government

GOP Pushes Fraud Message to Deflect Healthcare Cost Anger

Republicans are elevating healthcare fraud as a midterm message to deflect voter anger over costs, while Democrats say the push targets blue states to justify Medicaid and ACA cuts.

Why it matters: Fraud-focused enforcement could reshape Medicaid and ACA funding, audits, and eligibility for the tens of millions who depend on those programs.

Government

CMS Targets PBM Fees and MA Directory Accuracy in New Rule

CMS proposed a rule on Oct. 16 that would publicly score Medicare Advantage provider directories and mandate flat-fee payment structures for PBMs, with comments due Dec. 15.

Why it matters: Public directory scores and flat PBM fees would reshape how Medicare Advantage plans and drug middlemen operate and get paid.

Government

Pennsylvania Sues Insulin Makers and PBMs Over Pricing

Pennsylvania's attorney general sued three insulin makers and several PBMs, alleging they colluded to manipulate insulin prices and raise patient costs.

Why it matters: The case adds to mounting legal pressure on insulin pricing and PBM rebate practices that determine what diabetic patients pay at the pharmacy.