The Regulator

First: that is how many federal appeals courts had ever ruled on whether the whistleblower lawsuits behind billions of dollars in Medicare and Medicaid fraud recoveries are unconstitutional, and the answer that came back this week keeps them alive. The U.S. Court of Appeals for the Eleventh Circuit ruled September 1, 2026 in United States ex rel. Zafirov v. Florida Medical Associates, LLC that False Claims Act whistleblowers, known as relators, are not “Officers of the United States” under the Constitution’s Appointments Clause, reversing a 2024 decision by U.S. District Judge Kathryn Kimball Mizelle that had declared the qui tam mechanism unconstitutional and rattled the fraud enforcement bar for two years. The panel held relators lack the continuing position, ongoing compensation, or transferable authority that would make them government officers, since each relator’s role lasts only for a single case, then sent the case back to the district court to weigh separate Take Care Clause and Vesting Clause challenges the defendants also raised. The underlying suit accuses Physician Partners LLC, Freedom Health Inc. and Optimum Healthcare Inc., three related Florida Medicare Advantage entities, of submitting diagnosis codes for conditions patients did not have or were not treated for, inflating the risk-adjustment payments Medicare sent the companies; primary-care physician Dr. Clarissa Zafirov, employed by one of the defendants, filed the case in 2020. Confidence: Medium. This run fetched the court’s own opinion directly, but could not reliably machine-read the PDF text, so the holding and disposition rely on two independent legal-industry summaries of the ruling. Sources: Zafirov v. Florida Medical Associates, LLC, opinion, U.S. Court of Appeals for the Eleventh Circuit, Eleventh Circuit Rejects Appointments Clause Challenge to Qui Tam Mechanism, Sidley FCA Qui Notes, Eleventh Circuit Upholds Constitutionality of the False Claims Act’s Qui Tam Provision and Reverses Lower Court, National Law Review.

377,000: that is how many Coloradans on Medicaid just got a letter, email, or text warning that a new federal work requirement could cost them their coverage on New Year’s Day. The Colorado Department of Health Care Policy and Financing began notifying members of Health First Colorado, the state’s Medicaid program, this week that the work requirement created by this year’s federal budget law takes effect January 1, 2027, and that anyone earning $20,815 or less a year, or $42,760 for a family of four, will need to document at least 80 hours a month of work, school, or volunteering, or qualify for an exemption, to keep coverage. The notifications reach roughly a third of the state’s 1.1 million Medicaid enrollees, and the department is also shortening recertification from once a year to every six months; Executive Director Gretchen Hammer said the agency wants “all potentially impacted Health First Colorado members to know about these significant federal changes well before they take effect,” and the department’s own notice warns that members “will lose their coverage if they are not in compliance or fail to provide information showing they are exempt.” Colorado’s mailing follows the nationwide notification deadline this newsletter covered September 2. Confidence: High. This run reviewed Colorado Sun’s direct reporting, which quotes the department by name; the department’s own notice document returned an access block to direct fetch. Sources: Colorado warns Medicaid enrollees about looming work requirements, Colorado Sun, Work Requirements Notice, Colorado Department of Health Care Policy and Financing.

$58 million: that is the federal check Hawaii just cashed for new ambulances in every county and a push to train more rural doctors. The Centers for Medicare and Medicaid Services (CMS) announced September 1, 2026 that it is sending Hawaii $58 million under the Rural Health Transformation Program, the $50 billion state-grant fund created by this year’s budget reconciliation law, with $45 million going to the University of Hawaii’s John A. Burns School of Medicine for a workforce initiative called HOME RUN and $13 million to the state Department of Health for new ambulances in every county plus emergency communications upgrades. Governor Josh Green said “distance can determine whether someone receives care in time,” while HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz both touted the award as a model for the broader program. Confidence: High. This run reviewed CMS’s own press release directly. Sources: Trump Administration Announces $58 Million to Deliver New Ambulances, Upgrade Emergency Communications, and More in Hawaii, Centers for Medicare and Medicaid Services.

Nine: that is how many states now let a licensed counselor cross state lines without a second license, after Wyoming and Tennessee went live in the Counseling Compact this week. Wyoming became the compact’s eighth operational state on August 31, 2026 and Tennessee became the ninth on September 1, joining Arkansas, Arizona, Georgia, Indiana, Louisiana, Minnesota and Ohio; licensed professional counselors who live in one of the nine states can now apply for a compact privilege to practice, in person or by telehealth, in any of the others without a separate state licensing board application. The Counseling Compact joins a growing family of interstate occupational-licensure compacts, including the Nurse Licensure Compact, the Interstate Medical Licensure Compact and PSYPACT for psychologists, that states are using to ease behavioral health workforce shortages without giving up their own licensing authority. Confidence: High. This run reviewed the Counseling Compact Commission’s own website directly. Sources: Counseling Compact, Counseling Compact Commission.

14 years: that is how long a Danish researcher accused of stealing federal autism-research money ran from the law before pleading guilty this week, in a case that has long fueled vaccine misinformation online. Poul Thorsen, 65, pleaded guilty September 1, 2026 to wire fraud for diverting more than $1 million from an $11 million-plus Centers for Disease Control and Prevention (CDC) grant that funded Danish studies, several of them frequently cited by anti-vaccine activists as debunking a link between vaccines and autism, by submitting invoices bearing a forged CDC signature between February 2004 and June 2008. Thorsen had been on HHS’s Office of Inspector General’s list of most-wanted fugitives since a 2011 warrant and was extradited after his arrest in Germany last year; U.S. Attorney Theodore Hertzberg said Thorsen “ran a multi-year fraud scheme to cheat the CDC, diverting valuable federal grant money to service his greed and inflated lifestyle,” and Thorsen is scheduled to be sentenced December 1, 2026 and ordered to pay full restitution. Confidence: Medium. Justice.gov’s own press release returned an access block to direct fetch this run, a recurring pattern with the Department of Justice; this account relies on two independent local news outlets that reviewed the Justice Department’s statement directly. Sources: Danish researcher pleads guilty after 14 years on the run, stealing more than $1M in CDC grant money, Atlanta News First, Danish researcher pleads guilty to stealing $1M CDC grant money, FOX 5 Atlanta.