The Regulator

A federal accessibility deadline that touches nearly every doctor’s office and hospital in the country came due this week, and enforcement exposure starts now. Under a Department of Health and Human Services final rule updating Section 504 of the Rehabilitation Act, published in the Federal Register on May 9, 2024, every health care provider that receives HHS federal financial assistance, an estimated 92 percent of physicians, 43 percent of dentists, and all hospitals, was required to have at least one accessible examination table and one accessible weight scale in place by July 8, 2026, under 45 CFR 84.92(c). HHS’s Office for Civil Rights can investigate complaints, order corrective action plans, impose penalties, suspend federal funding, or refer violators to the Justice Department for noncompliance, and the rule separately lets patients with disabilities sue providers directly. Confidence: High. Sources: Nondiscrimination on the Basis of Disability final rule, Federal Register, Section 504 detailed fact sheet, HHS Office for Civil Rights.

A Greensboro, North Carolina woman pleaded guilty this week to billing Medicaid 1.7 million dollars for urine drug tests that were never performed, in a case state investigators say they caught by mining claims data rather than working a tip. Gwendolyn Singleton, who operated a substance-abuse counseling business called Joelle’s Center of Hope, pleaded guilty July 9, 2026 in federal court to health care fraud for billing North Carolina Medicaid for urine drug testing between June 2021 and March 2023, listing a nurse practitioner and a doctor as the ordering providers even though both told investigators they never ordered the tests. North Carolina’s Medicaid Investigations Division, which Attorney General Jeff Jackson’s office says reviews claims data for irregular and anomalous billing patterns, flagged the scheme; Singleton is scheduled for sentencing October 22, 2026 and faces up to 10 years in prison. Confidence: High. Sources: Guilford County Woman Pleads Guilty to Health Care Fraud, U.S. Attorney’s Office for the Middle District of North Carolina, Attorney General Jeff Jackson’s MID Data Mining Efforts Lead to $1.7 Million Medicaid Fraud Conviction, North Carolina Department of Justice.

CVS will pay 36.5 million dollars to settle claims that it systematically over-dispensed insulin pens to Medicaid patients for a decade. Connecticut Attorney General William Tong announced the multistate False Claims Act settlement July 6, 2026, joined by 36 other states, the District of Columbia, and the federal government, resolving allegations that from 2010 through 2020 CVS dispensed more insulin pens than patients’ prescriptions called for, refilled prescriptions before they were due, and under-reported how long each supply should last to avoid detection. About 25.1 million dollars of the settlement goes to state and federal Medicaid programs, with individual state recoveries ranging from roughly 400,000 dollars in Minnesota to more than 2.2 million dollars in New York. Confidence: High. Sources: Attorney General Tong Announces CVS Settlement Over Insulin Pens, Connecticut Office of the Attorney General, Attorney General James Secures $36.5 Million from CVS for Defrauding Medicaid, New York Office of the Attorney General.

CMS proposed a net 420 million dollar increase in what Medicare pays home health agencies for 2027, paired with new program-integrity powers the agency says will save 82 million dollars a year by making it easier to claw back money from bad-actor providers. The Centers for Medicare and Medicaid Services’ Calendar Year 2027 Home Health Prospective Payment System proposed rule, published in the Federal Register July 6, 2026, would raise aggregate Medicare payments to home health agencies by 2.4 percent, an increase driven by a 2.1 percent base-rate update plus a temporary 3.0 percent adjustment tied to how agencies responded to an earlier payment-model change, while also recalibrating case-mix weights and outlier payment thresholds. The same rule would let CMS claw back payments retroactive to the date of noncompliance for any Medicare provider-enrollment revocation, not just the limited categories allowed today, and would let CMS deny or revoke enrollment over a misdemeanor conviction for sexual assault or financial misconduct within the past 10 years. Comments are due August 31, 2026. Confidence: High. Sources: Calendar Year 2027 Home Health Prospective Payment System proposed rule, Federal Register, Calendar Year 2027 Home Health Prospective Payment System Proposed Rule Fact Sheet, CMS.

The DEA moved to make concentrated kratom extract a Schedule I controlled substance nationwide, and the industry has until July 31 to comment before a ban likely takes effect. The Drug Enforcement Administration published two notices in the Federal Register on July 6, 2026 declaring its intent to temporarily place 7-hydroxymitragynine, the compound responsible for kratom’s opioid-like effects, into Schedule I alongside heroin and LSD when it is present above 0.050 percent by dry weight in botanical kratom or above 1.0 milligram per manufactured product, along with three related synthetic derivatives. The action targets concentrated “7-OH” extract products sold at gas stations, smoke shops, and online as unregulated opioid-like alternatives; DEA has not set a date for a final scheduling order after the comment period closes. Confidence: High on the Federal Register filings; Medium on timing, since DEA has not said when a final order will follow. Sources: DEA to Temporarily Schedule 7-OH and Related Substances to Protect Public Safety, Schedules of Controlled Substance: Temporary Placement of 7-Hydroxymitragynine Above a Specified Threshold in Schedule I, Federal Register.