The Regulator

15.2 million dollars: that is what Medicare improperly paid physicians for sacroiliac joint injections nationwide, after federal auditors found nearly three in four sampled sessions violated program rules, in a report where CMS refused to build the fix that would stop the biggest error going forward. The Department of Health and Human Services Office of Inspector General posted Report OAS-25-09-021 on August 5, 2026, finding that of 100 sampled sacroiliac joint injection sessions from October 1, 2023 through September 30, 2024, 72 did not comply with Medicare requirements and a further 25 did not meet Medicare guidance. Extrapolated across the full population, Medicare improperly paid an estimated $15.2 million for 134,526 of 186,842 total sessions, with 46,711 sessions incorrectly billed as therapeutic injections when they should have been billed as diagnostic. OIG made three recommendations; CMS concurred with the two calling for provider education but did not concur with the third, the one aimed at a systemic fix for the diagnostic-versus-therapeutic billing error, meaning the pattern OIG just quantified keeps running uncorrected. Confidence: High. HHS OIG’s own posted report states the sample results, dollar figures and CMS’s recommendation responses directly. Sources: Medicare Improperly Paid Physicians an Estimated $15.2 Million for Sacroiliac Joint Injections, HHS Office of Inspector General.

744 million dollars: that is the annual cap on the federal fund that discounts broadband and phone service for rural health clinics, and the Federal Communications Commission just voted to let providers skip a yearly paperwork requirement while it studies whether the cap itself needs to grow. The FCC’s August 6, 2026 open meeting adopted an order permitting Rural Health Care Program participants to reuse a previously approved rural rate for funding year 2027 instead of redoing a cost-based rate justification, the third consecutive year the agency has granted that waiver, and separately opened a Third Further Notice of Proposed Rulemaking seeking comment on cutting administrative burden for the roughly 14,000 rural providers who use the program. This follows through on the vote this newsletter previewed August 4, when a Federal Register Sunshine Act notice first confirmed the agenda item. Confidence: Medium. This run could not independently retrieve the FCC’s full order text, which returned an access error, but the Commission’s own document title corroborates the item was adopted. Sources: FCC Adopts Further Improvements to Rural Health Care Program, Federal Communications Commission.

4 years: that is the new mandatory floor for prison time facing anyone who steals more than 1 million dollars from Minnesota’s Medicaid program, under a law that took effect this month and already funded a staffing expansion of the state’s fraud-investigation unit. Minnesota’s Medical Assistance Protection Act, effective August 1, 2026, created tiered criminal penalties for Medicaid fraud exceeding $100,000 and $1 million, with the $1 million-plus theft tier classified at Severity Level 8 under the state’s sentencing guidelines, carrying a presumptive 48-month prison commitment for an offender with no criminal history; previously, Minnesota law treated all thefts above $35,000 the same regardless of size. Attorney General Keith Ellison, who announced the law’s effect August 3, said it also added 18 staff to his office’s Medicaid Fraud Control Unit, expanding it from 32 to 50 people, including 11 new investigators. Confidence: High. The Minnesota Attorney General’s own press release states the penalty structure, effective date and staffing figures directly. Sources: New Medicaid fraud offense will now send offenders to prison after Attorney General Ellison’s intervention, Minnesota Attorney General.

2 billion dollars: that is what state Medicaid fraud investigators recovered last year, the return 17 state attorneys general are citing as they press Congress to let them chase fraud by Medicaid recipients, not just providers. Oklahoma Attorney General Gentner Drummond and 16 other state attorneys general, from Alaska, Arkansas, Florida, Idaho, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, New Hampshire, North Dakota, South Carolina, South Dakota and West Virginia, sent a letter August 4, 2026 to the House Energy and Commerce Committee and the Senate Finance Committee backing the STOP FRAUD in Medicaid Act, House Resolution 5364 and Senate Bill 4176, which would expand state Medicaid Fraud Control Units’ authority beyond investigating providers to investigating fraud by Medicaid recipients themselves, a category current federal law places off-limits to those units. The letter cites federal figures showing the units recovered $4.64 for every dollar spent in 2025, nearly $2 billion combined from criminal and civil cases. Confidence: High on the letter’s content and signatories, stated on Oklahoma’s own newsroom page; Medium on the bills’ prospects, since neither committee has scheduled a markup. Sources: Drummond urges Congress to help states fight Medicaid fraud, Oklahoma Attorney General.

Any day now: that is when the DEA can criminalize concentrated 7-OH kratom products nationwide, now that the 30-day window the agency gave itself before acting has expired. The Drug Enforcement Administration published a Notice of Intent in the Federal Register July 6, 2026 to temporarily place 7-hydroxymitragynine, a concentrated kratom-derived compound known as 7-OH, into Schedule I of the Controlled Substances Act, covering products exceeding 0.05 percent by dry weight in botanical material, 0.05 percent by concentration, or 1.00 milligram of 7-OH per article for synthetic or processed products. The notice states the order “will not be issued before August 5, 2026,” a deadline that has now passed, with DEA signaling it intends to act as soon as possible afterward. Natural kratom leaf below the threshold is explicitly excluded, but once the order takes effect, manufacturing, distributing, selling or possessing covered concentrated 7-OH products becomes a federal crime, with the temporary control lasting two years and a possible one-year extension. Confidence: High on the notice’s terms and threshold, stated directly in the Federal Register filing; Medium on exact timing, since DEA retains discretion over the issuance date. Sources: Schedules of Controlled Substance: Temporary Placement of 7-Hydroxymitragynine Above a Specified Threshold in Schedule I, Federal Register.

17 months: that is how long the volunteer panel that decides which preventive care insurers must cover for free has gone without meeting, after HHS postponed its July session again. The U.S. Preventive Services Task Force has not convened since March 2025 and has not released a recommendation update since August 2025; its July 2026 meeting was pushed to late August, with HHS citing the need for more time to review, appoint and onboard new members after an April call for nominations produced no announced appointments by the original June start date. Because a Task Force “A” or “B” rating is what triggers the Affordable Care Act’s requirement that insurers cover a preventive service with no copay or deductible, a task force that cannot meet cannot add new no-cost coverage mandates or update existing ones, even as its existing recommendations remain in effect. Confidence: Medium. HHS has not issued its own detailed public statement on the delay; the meeting history and postponement are corroborated across independent reporting and a health policy advisory’s direct review of the task force’s own schedule. Sources: What Does Another USPSTF Meeting Cancellation Mean for Preventive Care Recommendations?, Avalere Health Advisory, The task force that shapes Americans’ preventive care has not met in a year, CNN.