The Regulator

27.7 million dollars: that is how much prosecutors say a Los Angeles hospice operator and his marketer billed Medicare using the stolen identities of dead people, in a trial scheduled to open today. A federal jury trial for Oren David Shachar, 59, of Van Nuys, and marketer Abraham Shin, 66, of Corona, is scheduled to begin August 11, 2026 in the U.S. District Court for the Central District of California in Los Angeles, on a 16-count indictment charging conspiracy to commit health care fraud, health care fraud, aggravated identity theft and Anti-Kickback Statute violations. Prosecutors allege the pair ran a scheme from February 2021 through March 2026 using the stolen identities of deceased people, purchased for $1,000 to $3,000 apiece from a Torrance mortuary worker, to enroll them as hospice patients with falsified dates that predated their actual deaths, across four Los Angeles-area hospices: Gentle Touch Hospice Care, Oxford Hospice Care, Art of Hospice and Holly Trinity Hospice. The indictment puts the scheme at roughly $27.7 million billed to Medicare and $26.9 million actually paid. Confidence: Medium. This run could not independently retrieve the Justice Department’s own release, which returned an access error, nor same-day confirmation that the trial proceeded as scheduled rather than being continued; the charges, defendants and dollar figures are corroborated across multiple independent outlets citing the indictment directly. Sources: Health Care Fraud Takedown Results in 10 SoCal Defendants Federally Charged, U.S. Attorney’s Office, Central District of California, Oren Shachar hospice fraud trial in Los Angeles expected to spotlight Medicare abuse allegations, UTV.

80 hours: that is the monthly work, training or volunteer requirement Indiana Medicaid expansion enrollees must start documenting on January 1, 2027, and the state just launched the tools to sort out who is exempt. The Indiana Family and Social Services Administration rolled out a text-alert system, an online exemption-screening tool and a series of public town halls this week to prepare Healthy Indiana Plan members, the state’s Medicaid expansion population, for the federal work requirements. Affected adults will need to document 80 hours a month of work, job training, education, volunteering or another qualifying activity, with compliance reviewed at least every six months using a three-month lookback; FSSA’s new online screener asks about age, health status and employment to tell enrollees in advance whether they are exempt. The first of two town halls, held with Covering Kids and Families, is set for August 17 in Elkhart, with a second September 1 in Fort Wayne. Confidence: High. FSSA’s own screening tool and multiple Indiana outlets citing the agency’s rollout directly confirm the dates and mechanics. Sources: HIP Work Requirement Screener, Indiana Family and Social Services Administration, State rolls out tools for new Medicaid work requirements, Indiana Capital Chronicle.

Today: that is when Medicare’s fast-track coverage pathway for breakthrough medical devices officially entered the Federal Register, the follow-through this newsletter flagged as coming when CMS detailed the plan August 7. The Centers for Medicare and Medicaid Services’ procedural notice for the Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway, CMS-3487-NC, published in the Federal Register August 11, 2026, formally opening the public comment period. The pathway commits CMS to issuing a proposed national coverage determination the same day an FDA-designated breakthrough device receives market authorization, compressing a process that today can take a year or more into a matter of months, with CMS staff engaging device makers earlier in FDA’s review to flag which clinical outcomes matter for Medicare coverage. Confidence: High on the publication itself, stated directly in the Federal Register filing; Medium on downstream device-maker reaction, since none has been publicly reported yet. Sources: Medicare Program; Regulatory Alignment for Predictable and Immediate Device (RAPID) Coverage Pathway, Federal Register, CMS Releases Fact Sheet on Regulatory Alignment for Predictable and Immediate Device Coverage Pathway, Centers for Medicare and Medicaid Services.

120 days: that is how long food and animal-food makers have to comment on an FDA plan that would end the decades-old practice of companies deciding for themselves, with no government sign-off required, that a new ingredient is safe to sell. The Food and Drug Administration proposed a rule August 11, 2026 that would replace the 30-year-old voluntary Generally Recognized as Safe (GRAS) notification system with a mandatory one, requiring anyone introducing a substance into the food supply under the GRAS exemption to notify FDA of the basis for that safety conclusion, rather than allowing companies to self-affirm safety with no agency review. FDA says nearly three decades of voluntary notifications left it unable to say how many substances are on the market based on companies’ own GRAS determinations, a gap a 2011 estimate put at roughly 1,000 substances; the agency classified the proposal as economically significant, meaning it expects an effect on the economy of at least $100 million a year, and is taking public comment for 120 days, with a final rule taking effect 60 days after publication and an 18-month compliance window after that. Confidence: High. FDA’s own pre-publication Federal Register text and its program page state the mechanics, timeline and economic designation directly. Sources: Substances Generally Recognized as Safe, Food and Drug Administration, Federal Register pre-publication text, Generally Recognized as Safe (GRAS) Notification Program, U.S. Food and Drug Administration.

Six: that is how many federal and international agencies just co-signed a warning that a ransomware gang actively targeting hospitals is breaking into networks through exposed VPNs and firewalls. The Cybersecurity and Infrastructure Security Agency, the FBI, the National Security Agency, the Department of Defense Cyber Crime Center, the U.S. Secret Service and South Korea’s National Police Agency jointly published advisory AA26-222A on August 10, 2026, warning that the Gunra ransomware group, a double-extortion operation built on leaked Conti source code that first appeared in April 2025, is actively targeting the healthcare and public health sector alongside finance, manufacturing, transportation, government, utilities, education, retail and professional services. The advisory says Gunra affiliates are breaking in through exposed VPN gateways, firewall appliances and internet-facing remote desktop systems, then exfiltrating data before encrypting it and threatening to publish or sell it on a dark-web leak site if a victim will not pay; the agencies recommend patching internet-facing systems, keeping offline immutable backups and segmenting networks to limit how far an intruder can move once inside. Confidence: Medium. CISA’s own advisory page returned an access error to this run, but the advisory’s existence, ID and content are corroborated directly by the joint-agency PDF hosted on the Defense Department’s own site. Sources: #StopRansomware: Gunra Ransomware, AA26-222A, Cybersecurity and Infrastructure Security Agency, Joint Cybersecurity Advisory PDF, Department of Defense Cyber Crime Center.

Six: that is how many Washington counties now qualify for relaxed Medicare, Medicaid and CHIP paperwork after the federal government declared a public health emergency over wildfires burning across the state. HHS Secretary Robert F. Kennedy Jr. declared a public health emergency for Washington State on August 7, 2026, covering Spokane, Stevens, Okanogan, Ferry, Chelan and Yakima counties, after President Trump’s own emergency declaration August 4; the Centers for Medicare and Medicaid Services followed August 10 with Section 1135 waivers relaxing Medicare, Medicaid and Children’s Health Insurance Program requirements, including deadline extensions and expanded telehealth and facility flexibilities, retroactive to August 1, 2026 and running through the declared emergency period. The waivers let hospitals, nursing homes and other providers in the affected counties bypass certain normal enrollment, documentation and site-of-care rules without losing Medicare or Medicaid payment eligibility while wildfire response continues. Confidence: Medium. This run could not independently retrieve CMS’s own announcement, which returned an access error, but the declaration and waiver mechanics are corroborated directly by HHS’s own Administration for Strategic Preparedness and Response. Sources: HHS Secretary Declares Public Health Emergency for Washington Wildfires, Administration for Strategic Preparedness and Response, CMS Announces Resources, Flexibilities to Assist with Public Health Emergency in the State of Washington, Centers for Medicare and Medicaid Services.