https://mihealthfreedom.org/community/industry-influence-on-state-health-policy-2/rite-aid-going-bust-again/

Americans' pharmacy options shrank. Medication prices continue to rise. The PBM middlemen that helped cause Rite Aid's financial woes are thriving. 

And now DOJ announces a CVS settlement under the same federal laws. Michigan has 253 CVS store locations spread across 113 cities.

Ultimately, we need to ask ourselves whether sacrificing individual responsibility in purchasing, in exchange for government control and redistribution schemes, is true justice. Are the end results worth the cost?

So, here we go again. 

The DOJ press release re CVS has hotlinks at the original site.

https://www.justice.gov/opa/pr/cvs-agrees-pay-315m-illegally-filling-unlawful-opioid-prescriptions-and-submitting-false

CVS Agrees to Pay $315M for Illegally Filling Unlawful Opioid Prescriptions and for Submitting False Claims to the Federal Government

Tuesday, October 13, 2026

For Immediate Release

Office of Public Affairs

CVS Pharmacy Inc., a Rhode Island-based pharmacy chain, and its related corporate entities (collectively, CVS) have agreed to pay $315 million to resolve allegations that, from October 17, 2013 through December 2, 2025, CVS illegally filled prescriptions for opioids and other controlled substances in violation of the Controlled Substances Act (CSA), and then sought payment for many of those invalid prescriptions from Medicare and other federal healthcare programs in violation of the False Claims Act (FCA).

“Not only does this settlement hold bad actors accountable for their fraudulent activities, but Americans are safer because of it,” said Associate Attorney General Stanley E. Woodward Jr. “Today’s settlement is a significant milestone in the Justice Department’s efforts to combat the opioid epidemic by cracking down on pharmacies who unlawfully fulfill prescriptions for controlled substances.”

“Today’s settlement requires CVS to implement additional safeguards to ensure that prescriptions for opioids and other controlled substances are dispensed only when medically appropriate,” said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division. “The remedial measures in this agreement — including proactive monitoring of opioid prescribing patterns — will provide critical protections for patients and federal healthcare programs. The Department of Justice will continue to take steps to prevent the unlawful dispensing of opioids.”

“The opioid epidemic has affected families and communities across Rhode Island and throughout the nation,” said First Assistant U.S. Attorney Charles C. Calenda for the District of Rhode Island. “Pharmacies that dispense controlled substances must maintain effective compliance systems to identify and respond to warning signs that prescriptions may be unlawful or medically unnecessary. This settlement demonstrates the importance of those obligations and the consequences of failing to implement safeguards designed to prevent the improper dispensing of controlled substances.”

The settlement resolves allegations in the government’s complaint, which the United States filed on Dec. 13, 2024, in the U.S. District Court for the District of Rhode Island, that CVS knowingly filled prescriptions for controlled substances that lacked a legitimate medical purpose, were not valid, and/or were not issued in the usual course of professional practice. The United States alleged that CVS dispensed prescriptions for dangerous and excessive quantities of opioids, opioid prescriptions filled too early, and “trinity” prescriptions, a dangerous and abused combination of an opioid, a benzodiazepine, and a muscle relaxant. CVS also allegedly filled prescriptions for controlled substances from “pill mill” prescribers who issued large numbers of controlled substance prescriptions without any medical purpose. Further, the United States alleged that CVS pharmacists filled these prescriptions despite clear red flags indicating that there was a high likelihood that the prescriptions lacked a legitimate medical purpose, were not valid, or were not issued in the course of professional practice. Many of these prescriptions were ultimately billed to and reimbursed by federal healthcare programs.

The complaint further alleged that CVS’s violations stemmed from corporate-imposed performance metrics, incentive compensation, and staffing policies that prioritized corporate profits over patient safety. CVS failed to employ enough pharmacists to serve patients, comply with CVS’s legal obligations, and meet corporate performance metrics. In addition, CVS’s policies allegedly prevented pharmacists from warning one another about certain problematic prescribers.

In addition to the monetary payment announced today, CVS has entered into a memorandum of agreement with DEA to address its future obligations in dispensing controlled substances. This agreement requires CVS to establish a hotline for both employees and the public to report suspected illegal dispensing of controlled substances, proactively monitor the dispensing patterns of its pharmacies to identify and address potentially illegal dispensing, and establish a process to evaluate prescribers suspected of illegal prescribing.

“This settlement agreement highlights DEA’s commitment to protecting the health and safety of Americans while holding CVS accountable for dispensing unlawful prescriptions and endangering the public,” said DEA Assistant Administrator Cheri Oz. “DEA is unwavering in its commitment to protect public health and ensuring pharmacies adhere to the highest standards of responsible dispensing. We will continue to work closely with law enforcement, regulatory agencies, and the healthcare community to prevent the misuse of controlled substances, and we will hold those who jeopardize the safety of our citizens accountable.”

“Behind every unlawful prescription is a patient who could be put in harm’s way,” said Acting Deputy Inspector General for Investigations Miranda L. Bennett of the U.S. Department of Health and Human Services, Office of Inspector General (HHS OIG). “The allegations in this case point to warning signs that should never be overlooked. HHS OIG will not tolerate conduct that jeopardizes lives, and we will continue to pursue those who betray the trust placed in them.”

The civil settlement resolves a civil lawsuit filed by Hillary Estright, a former CVS employee, under the whistleblower provision of the FCA, which authorizes private parties to sue on behalf of the United States and receive a share of any recovery. It also permits the United States to intervene and take over such lawsuits, as it did here. The amount to be recovered by the private whistleblower has not yet been determined. The qui tam case is captioned United States ex rel. Hillary Estright v. CVS Health Corporation, et al., No. 22-cv-00222 (D.R.I.).

This year the Administration launched the Task Force to Eliminate Fraud and the National Fraud Enforcement Division to enhance the Administration’s war on fraud, waste, and abuse in federal programs. When unscrupulous actors exploit these programs for their own financial gain, they defraud the government, harm the people these programs are designed to aid and protect, and undermine American businesses that play by the rules. The Civil Division’s FCA enforcement plays a critical role in combatting such fraudulent schemes, recovering billions of dollars for the American taxpayers, and holding wrongdoers accountable. FCA matters will continue to be on the forefront of the battle against fraud, and the Civil Division’s FCA work will support and advance the mission of the Task Force to Eliminate Fraud and the National Fraud Enforcement Division.

The resolution obtained in this matter was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section, and the Enforcement & Affirmative Litigation Branch, along with the U.S. Attorneys’ Offices for the District of Rhode Island, Eastern District of Virginia, Eastern District of Texas, and District of Hawaii. The DEA’s Office of Diversion Control, Los Angeles Field Division, Richmond District Office, and Office of Chief Counsel led this case with substantial assistance from Health and Human Services Office of Inspector General, Defense Criminal Investigative Service, Defense Health Agency (DHA), Office of Personnel Management (OPM), Department of Labor (DOL) Office of Inspector General, and the Department of Veterans Affairs (VA).

The investigation and resolution of this matter illustrate the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

The United States is represented in this matter by attorneys from the Justice Department’s Civil Division Commercial Litigation Branch, Fraud Section (Assistant Director Natalie Waites and Trial Attorneys Claire Norsetter and Megan Engel) and Enforcement & Affirmative Litigation Branch (Deputy Director Lisa Hsiao and Trial Attorneys Kathleen Brunson and Katherine Ho), as well as from the U.S. Attorneys’ Offices for the District of Rhode Island (Assistant U.S. Attorney Rachna Vyas), Eastern District of Virginia (Assistant U.S. Attorney John Beerbower), Eastern District of Texas (Assistant U.S. Attorney James Gillingham), and District of Hawaii (Assistant U.S. Attorney Tracy J. Weinstein).

The claims resolved by the settlement are allegations only and there has been no determination of liability.

Note: Find the CSA agreement here and the FCA agreement here.

Note: This press release has been updated from a previous version.

Updated October 14, 2026

AMAC sounds off on Medicare for All in this week's opinion piece.

https://amac.us/newsline/medicare-for-nobody

Medicare for Nobody

Medicare for All could bankrupt Medicare in just 2-3 years, putting seniors' hard-earned health coverage at risk. Here's what retirees need to know.

Stephen Moore     |    October 13, 2026

Political pros will remember that a dozen or so years ago, the Democrats produced a famous (or infamous) TV ad showing a man wheeling an elderly lady in a wheelchair up a path to an overlook on a mountain. At the end of the ad, the man pushes the woman out of her chair and off the cliff.

The person pushing the wheelchair was a lookalike of Paul Ryan, the then-Republican speaker of the House. The idea of the ad was that congressional Republicans had a secret plan to take away Medicare from elderly Americans dependent on the program.

There was never any such doomsday plan, just a series of common-sense steps to control program costs.

But ironically enough, now there really is a plan to bankrupt Medicare and put millions of American senior citizens at risk of losing their health coverage.

It's called Medicare for All, and the idea of the scheme is to offer free health care for everyone in the country.

The bill to create Medicare for All has a multitrillion-dollar price tag. Medicare is already scheduled to run out of funds in about seven years; this Medicare for All plan ensures the program runs out of money in two to three years. Wonderful news.

Vermont Sen. Bernie Sanders is the lead sponsor of the Medicare for All bill, and he already has 18 cosponsors.

Meanwhile, most of the democratic socialists who have seemingly taken command of the Democratic Party in the last few months are almost all fully on board this train that is picking up momentum on the campaign trails.

Free health care! Who could be against that?

Well, seniors, for one. The folks on Medicare are dependent on the coverage,

And they paid dutifully for many years into the trust fund via the 3.8% payroll tax when they were working.

We would expect that Democrats would be sprinting away from Medicare for All at full speed. Instead, many are hopping on this train.

It is by far the most expensive feature of the democratic socialist policy agenda. The Trump White House puts the price tag at well over $50 trillion. In other words, Democrats are providing more health benefits and more free stuff to buy votes.

But the financial reality is no secret to seniors. They strongly oppose expanding their gold-plated coverage plan to people who are young or unemployed and haven't paid for any of the benefits.

I call the Democratic scheme the "throw grandma from the train" scenario.

The program will run out of money. Medicare coverage will be severely trimmed. The plan will eventually blow up.

You might even say that now Dem congressional leaders Sen. Chuck Schumer and Rep. Hakeem Jeffries are the ones with plans to parade seniors up that hill only to toss them off.

What's further infuriating is, the Sanders Medicare for All scheme would make even illegal immigrants eligible for free health care. The law as written would apply to any "resident" of the U.S. -- which will only further encourage illegal entries.

Obviously, all these expansions will put Medicare into a financial freefall.

Medicare for All will morph into Medicare for Nobody. Seniors need to make it clear that the plan that Bernie envisions will lead to rationing of heath care along with worsening coverage and medical outcomes.

What a deal.

Kudos to these students, Forest Hills, Ferris State, and the Center for Medical Training for taking hold where it counts!

NOTE: The term "medical certification" is erroneous. CNA stands for Certified Nurse Aide, as defined in Michigan law and registry.

Medicine has its own separate degree structure.

https://www.woodtv.com/news/kent-county/forest-hills-central-students-earn-medical-certification/

Forest Hills Central students earn medical certification

Teresa Weakley    |    Oct 9, 2026

ADA TOWNSHIP, Mich. (WOOD) — On a Friday afternoon at Forest Hills Central High School, students aren’t just reading about patient care. They’re practicing it.

Inside a classroom set up more like a healthcare lab than a typical high school course, students learn hands-on skills they’ll soon use in real healthcare settings.

Through a new partnership involving the Center for Medical Training and Ferris State University, students can earn college credit while working toward certification as a nursing assistant before they graduate.

“It’s like to practice it so that we can then perform it when we go and visit hospitals,” senior Maisey Pell said.

The program debuted at Forest Hills Central this school year. Students complete online coursework connected to Ferris State while spending Fridays in hands-on training sessions at their own school. There, they practice skills under the guidance of healthcare professionals before moving into clinical settings.

“We were doing skills checkoffs,” Ashley Bauer, founder and director of the Center for Medical Training, said. “Each week we learn a new skill. The students come in and then they will perform that skill.”

After completing those checkoffs, students head into nursing homes and healthcare facilities to work with actual patients under supervision.

“After they get done with their clinical check-offs, then we take them into a nursing home or a healthcare facility, where they then perform the skills on actual patients,” Bauer said.

The goal is for students to take Michigan’s nurse aide exam before the semester ends and become certified nursing assistants, or CNAs.

“Hopefully I’ll have the certification to be a nursing assistant at least. Then I can hopefully go into college with that and have the background to pursue nursing,” Pell said.

For her, the program offers something traditional classes can’t.

“We get to come and do some more hands-on learning,” Pell said. “With the professors, it’s lectures and stuff, which is very helpful. But this is a little bit more helpful because then we can actually do stuff.”

The program grew out of Bauer’s 20-year healthcare career. She started as a CNA herself, later becoming a licensed practical nurse and then a registered nurse.

During the COVID-19 pandemic, she watched staffing shortages strain healthcare systems and began looking for ways to build a larger pipeline of future workers.

“I worked in healthcare for 20 years, and through COVID I was like, ‘Man, we really need help. How can we get more help?'” Bauer said. “How can we build more interest in this?”

The Center for Medical Training, based in Grandville, provides state-certified nurse aide training focused on hands-on learning and career preparation. Now entering its third year, the organization works with multiple school districts and customizes programs to meet each school’s needs.

“This was the first year that we stepped out of our own classroom and stepped into somebody else’s building. It’s been so much fun,” Bauer said.

The model appears to be working. During a recent tour of a local healthcare facility, Bauer’s students were greeted by two graduates of the program who are already working in the field.

“It was awesome to see two of our previous students meet us at the door,” she said. “To see them be successful too.”

The experience also gives students a chance to test-drive a career before investing years and thousands of dollars in college.

“This is also experience to see if we really want to go into nursing. I think it’s totally helpful since we’re still in high school,” Pell explained.

For students who discover healthcare isn’t the right fit, Bauer considers that a success too.

“Some students recognize through this, like, ‘Maybe healthcare is not my thing,'” she said.

As for Pell, she’s still committed to nursing, even if she’s a little nervous about the next step.

“I would say I’m a little nervous to go and do it on an actual resident and perform the skills,” she said. “But with all the training and practice that we have here, hopefully I’ll be able to do that and be successful.”

Bauer hopes more schools will eventually join the program.

“We would love to see this expand to several different schools. We’re really getting these students ready,” she said.

This trenchant quote sets the stage for MDHHS's Oct 13 Maternal Infant Health Update, below.

The receipts and more from Delano Squires discussing his recent book The Vanishing Black Family in Thursday's Hillsdale Podcast. https://podcast.hillsdale.edu/the-vanishing-black-family/

When The System Becomes the Barrier: Transforming a Patient’s Experience into Healthcare System Change

“If the patient encountered the same problem at multiple points within the healthcare system, we must examine the system—not only the individual.”
—Mary Dixon‑Woods

Patient experience is an important indicator of healthcare quality, yet experiences of stigma, discrimination, disrespect, and poor communication are often addressed as isolated interpersonal events rather than potential indicators of system level problems. This article examines how a patients experience involving a young, Black, pregnant woman living with HIV can serve as a catalyst for healthcare-system improvement. When concerns occur at multiple points across a patient’s healthcare journey, healthcare leaders and clinicians should examine organizational processes, communication, care coordination, policies, culture and accountability in addition to individual behavior.

The Patient Experience: A Case That Reveals System Failure
Background Summary: J.S. is a 32-year-old HIV positive pregnant woman who moved to the US from Somalia 5 years ago. When J.S. arrived in the U.S she was about 7 months pregnant and had not received any prenatal care. J.S. had a spontaneous delivery on December 25, 2023. The infant was born with severe medical complications. It was later determined the infant was HIV positive with advanced AIDS.

Fast forward two years later, J.S. is in and out of HIV care, returns to the Ryan White agency pregnant, and seeks assistance for medical care and resources. The Ryan White agency re-engages the client in medical care and helps her navigate her OB, ID, and other medical needs while addressing her social needs. Ultimately, the patient maintains viral load suppression and a plan in place to deliver her baby vaginally

Through complex social determinants and life circumstances. J.S. pushed through to maintain viral load suppression and have a non-complicated vaginal delivery and an HIV-negative infant. After delivery, the following events occurred throughout her postpartum stay on a labor and delivery unit.

The following account is not simply a report of poor bedside manners—its details signal broad structural issues:

Delayed discharge four days after a vaginal delivery
No nutritious meal offered after labor and delivery
No welcome/gift bag or infant discharge teaching
No infant medication administration education
A nurse questioning the authenticity of a new, in‑box car seat
Missed long‑acting ART dose due to poor coordination during the hospital stay
These failures highlight critical gaps in:

Care coordination between obstetrics and HIV providers
Respect, dignity, and equitable treatment
Maternal and infant discharge processes
Communication and patient education
Organizational culture and accountability
Why This Case Matters: Maternal Health and HIV Care Are Intertwined
This is more than a patient complaint—it is a structural failure that directly implicates maternal and infant health. Stigma, inequitable treatment, inadequate discharge processes, and fragmented care coordination erode trust and create downstream consequences:

Avoidance of care
Missed appointments
Reduced engagement in HIV treatment
Delayed symptom reporting
Compromised maternal and infant outcomes
Her experience illustrates how disrespect, disorganization, and bias can silently undermine both maternal and HIV care.

In a state where dozens of maternal deaths occur annually- and where maternal mortality review committees consistently find preventable causes—experiences like hers must be treated as critical data points showing us where change is urgently needed.

From Patients Story to Systems Change: A Call to Action
A call to action for Ryan White Providers, Obstetricians, Infectious Disease Specialists, and Healthcare Leaders

We cannot allow this experience to be dismissed as unfortunate or uncommon. It is symptomatic of larger failures identified in statewide maternal mortality reviews. Addressing this case is not optional—it is part of our responsibility to ensure equitable, safe, patient -centered care for pregnant women and women living with HIV.

The United States Department of Health and Human Services and The Centers of Medicaid have outlined evidence-based strategies to reduce morbidities in healthcare systems, hospitals and birthing facilities to transform the maternal health model. One health system at a time, one pillar at a time and the time is now. Small changes create meaningful differences. But systemic accountability creates lasting transformation. If your health system is interested in learning more about stigma women with HIV face during prenatal care, delivery, infant feeding, and post-partum, please contact Sabrina Sanders.

Sabrina Sanders MSN,BSN,RN
HIV Clinical Nurse Consultant
Michigan Department of Health and Human Services
Cell: 517-275-2017
SandersS13@michigan.gov

Sabrina would be happy to provide opportunities for educational information.

Mother Infant Health Collaborative Meetings
Graphic that looks like triangle people in many different shades of blue
All meetings are virtual and scheduled from 1-3 p.m.

2026 MIHC meetings:

Nov.12.
2027 MIHC meetings:

Feb.11.
May 13.
Aug.12.
Nov. 4.
Registration is available on the Division of Maternal and Infant Health website.

Triangle People Graphic
For more information on maternal and infant health in Michigan visit:
Michigan.gov/MIH
Contact the Division of Maternal & Infant Health at MDHHS

Delano Squires is Director of the Center for Human Flourishing at The Heritage Foundation, focusing on the impact of marriage and family structure on social outcomes. He has written extensively on topics related to faith, family, and culture.

He earned a Bachelor of Science in Computer Engineering from the University of Pittsburgh, and his Master of Public Policy from George Washington University. He worked for over a decade in the District of Columbia government, and founded Civitas Consulting Group to assist organizations in creating opportunities for community prosperity.

How Welfare and Feminism Made Marriage Optional and Children Vulnerable comes from Penguin Press and wherever books are sold.

https://www.penguinrandomhouse.com/books/763688/the-vanishing-black-family-by-delano-squires/

Previous works are published in The Root, Newsweek, National Review, The American Conservative, The Federalist, Blaze Media, and The Institute for Family Studies. 

Crain's Grand Rapids has gone behind paywall, so this initial post is a bit of a tease. Background next.

https://www.crainsgrandrapids.com/health-care/cgr-blue-cross-michigan-lawsuit-20261013/

Michigan's anti-trust lawsuit against Blue Cross echoes a different costly national case

Dustin Walsh    |    October 15, 2026

Michigan Attorney General Dana Nessel is striking at healthcare affordability with a lawsuit against Blue Cross Blue Shield of Michigan.

The 116-page complaint, brought in U.S. District Court in Detroit last week, alleges Detroit-based Blue Cross conspired with affiliated insurers nationwide to divide geographic markets and restrict competition for major customers, including the state of Michigan. It claims other Blues plans refused to bid whenever the state sought proposals to administer the employee health plan, leading the state to overpay for years through duplicate and defective claims payments, undisclosed “savings” fees, and withheld rebates.

Nessel’s case follows a similar strategy to a decade-old national lawsuit against the Blue Cross Blue Shield Association, which resulted in multi-billion-dollar settlements. The association and its subordinate organizations maintained no wrongdoing despite the settlements and stated that it is common practice for licensees not to compete in the national lawsuit....

No one will be surprised to hear that this cost taxpayers millions. Or that some of those millions were inappropriate. Or that some of the projects are overtly "Woke."

The astounding thing is the original act making this legal in Michigan. In what universe of limited government is it constitutional for a department of state to create a nonprofit?

CapCon reports details of the performance audit.

https://www.michigancapitolconfidential.com/news/state-paid-health-policy-nonprofit-108-million-before-reviewing-work-plans-audit-finds

State paid health policy nonprofit $108 million before reviewing work plans, audit finds

Rep. criticizes failures in $435 million deal: ‘Major weaknesses exist in the department’s oversight practices’

Scott McClallen   |   October 1, 2026

Michigan’s Department of Health and Human Services awarded a $21 million contract without getting legally required approval, according to a new state audit.

That is one of several problems discovered by the Michigan Office of the Auditor General in an examination of the state health department’s relationship with a nonprofit that received nine high-level agreements and 857 project agreements totaling $435 million over a two-year period.

The department gave the Michigan Public Health Institute $21 million for services without getting approval from the Department of Technology, Management, and Budget, as required by law.

The auditor flagged these payments as a material condition – the most serious category of concern. The payments were for two out of 20 agreements auditors looked at in a probe of whether the health department took the necessary steps to follow state laws that govern contracts with the nonprofit.

Another objective of the audit was to discover whether the health department properly monitored the grants and contracts it gave to the health institute. Auditors concluded that the state health department must better document and monitor its agreements with the quasi-govermental health institute, which Michigan established by law in 1989.

The state health department paid $108 million, the audit said, for financial status reports before receiving or reviewing quarterly work plans needed to validate the work performed. That was flagged as another material condition.

Nearly 70% of the financial status reports auditors reviewed contained no supporting documents.

Though the health institute and health department are different entities, the two are intertwined. Nearly half of the financial status reports involved in paying the health institute were reviewed by individuals who were current or former employees of the institute, with a total value of $199 million.

A third objective auditors had was to look at how well the department fulfilled its obligation to give lawmakers information on what the research institute did.

Auditors concluded that health department officials routinely failed to report information on salary and wages associated with health institute projects and reports. Some semiannual reports, the auditors said, omitted project and funding information, and none of the projects they reviewed included all the reports, studies, and publications the Legislature requires from the department.

The audit also found that the health department improperly approved certain indirect costs at a higher reimbursement rate than authorized.

House Appropriations Chair Ann Bollin, R-Brighton, said the audit raised red flags.

“For years, I have raised concerns about the scope of the state’s relationship with MPHI and whether sufficient safeguards exist to ensure transparency and accountability,” Bollin said in a statement “This audit confirms that major weaknesses exist in the department’s oversight practices and raises important questions about how taxpayer dollars are being monitored.”

The Michigan Public Health Institute had $200 million in revenue in 2024, according to its 2025 annual report. It has more than 1,000 employees and its work touched each of Michigan’s 83 counties, according to the report.

The state health department budget encompasses about half of the entire state budget. In fiscal year 2027, its budget was more than $30 billion.

The state health department didn’t respond to a request for comment.

MPHI is a nonprofit that partners with health departments, Kelly Kim Coyle, director of corporate communications, told CapCon in an email.

“The Michigan Public Health Institute (MPHI) is a public-private partnership created under bipartisan support to bring efficiency and innovation to Michigan's public health needs. As one of 51 nonprofit public health institutes operating across the United States today, that structure has meant partnering directly with communities and state agencies to responsibly administer public resources for more than three decades.

MPHI remains committed, as we have been since our founding, to the same responsible stewardship of public resources and transparency and accountability standards, as reflected by our longstanding favorable independent audit history. We welcome continuous process improvement for ourselves and the broader public health system in which we work.”

Doug Ringler is Michigan's Auditor General. The OAG summarizes the history in its MDHHS performance audit - not amenable to copy/paste here, but brief at three pages and well worth the read.

The final OAG report lists MDHHS contracted projects and quantifies the revolving door between MDHHS and MPHI. It also suggests legislative changes to Michigan law.

Check out Daily Signal's hotlinked sources.

https://www.dailysignal.com/2026/10/08/louisiana-medicaid-fraud-islamic-terror-financiers/

Authorities Dismantle Louisiana Medicaid Fraud Web of Islamic Terror Financiers

Pedro Rodriguez    |    October 8, 2026

Federal and Louisiana state authorities dismantled a network of Hamas financiers in late September who were accused of committing fraud against the state’s Medicaid program totaling more than $224,000 between 2021 and 2025.

Louisiana Attorney General Liz Murrill announced the arrests Wednesday of Abdel Adhami, Iman H. D. Srour, Omar Adhami, Amani Abu Zenah, and Mohammad I. Adhami, residents of St. Tammany Parish. The suspects face state felony charges of government benefits fraud and theft for allegedly underreporting their income between 2021 and 2025 to receive taxpayer-funded benefits.

“While terrorist sympathizers were funding the death of American citizens and countless others across the world, the hard-working men and women of Louisiana were funding their medical care. No matter where you are or who you are, if you steal from the people of Louisiana, you will face Louisiana justice,” Murrill said in a statement shared with the Daily Signal.

Abdel Adhami and Omar Adhami also face federal charges for providing more than $100,000 to a terrorist financing network that funneled more than $1.7 million to help fund Hamas.

Prior to the arrests, federal and local authorities uncovered that the Adhami brothers had taken part in a campaign to help fund Hamas, a designated foreign terrorist organization responsible for the slaughter of more than 1,200 Israeli civilians on Oct. 7, 2023.

The Louisiana Bureau of Investigation then worked with the Louisiana Department of Health to uncover possible Medicaid fraud. The charges will be prosecuted by St. Tammany Parish District Attorney J. Collin Sims.

Wednesday’s announcement adds to the total of more than $80 million in government funds recovered from fraudsters by the attorney general’s office.

“Through leadership and collaboration with federal, state, and local partners, we are ending systemic Medicaid fraud, waste, and abuse,” Murrill continued.

Michigan's mandate for all licensed healthcare professionals is a perpetually-recurring one, the first of its kind in our state. This Supreme Court case is one to watch.

Daily Signal broke the story.

https://www.dailysignal.com/2026/10/09/exclusive-montana-ag-asks-supreme-court-revive-case-against-dei-training-that-allegedly-declared-all-caucasians-racist/

EXCLUSIVE: Montana AG Asks Supreme Court to Revive Case Against DEI Training That Allegedly Declared ‘All Caucasians’ Racist

Tyler O’Neil    |    October 9, 2026

FIRST ON THE DAILY SIGNAL—Montana Attorney General Austin Knudsen is leading 20 states in urging the Supreme Court to take up the case of Joshua Young, a former Colorado prison guard who sued the Department of Corrections over a diversity, equity, and inclusion training.

“DEI training actively undermines workplace harmony, and it causes hostility, distrust, and division,” the amicus brief, exclusively obtained by the Daily Signal, states.

Young’s “complaint identifies myriad examples of how the training program endorsed treating and viewing Caucasians worse than other races,” the amicus brief notes.

According to Young’s lawsuit, “the training insisted, among other things, that all Caucasians are racist, that they perpetuate white supremacy, that the very notion of race was invented by white people to justify the oppression of people of color, that white supremacy is an ever-present feature of daily life in the United States, and that Caucasians who deny their own racism are merely ‘fragile’ racists who cannot accept their own prejudice.”

However, Young claimed the training’s effects reverberated afterward, shaping how the prison operated and leading him to conclude that he could not advance in the department.

Young’s supervisors told him they would evaluate whether he incorporated its principles into his work. According to his filings, the training increased distrust within the prison, discouraged him from seeking a promotion, and caused him to second-guess otherwise justified use-of-force decisions due to potential race-based implications.

“Given CDOC’s instruction that employees analyze workplace decisions through a racial-equity framework, Young understood that his superiors would be more likely to credit accusations of racism against him—making his assigned job significantly harder,” the filing states.

Lower courts rejected Young’s lawsuit, ruling that his allegations did not establish a sufficiently severe or pervasive hostile work environment under Title VII of the Civil Rights Act of 1964.

The U.S. Court of Appeals for the 10th Circuit found the training “troubling on many levels” and said its race-based rhetoric was “well on the way to arriving at objectively and subjectively harassing messaging,” but concluded that Young fell short of proving a violation, because the training happened only once and was not followed by additional harassment.

Young’s petition argues that the 10th Circuit’s approach conflicts with rulings from other federal appeals courts that have recognized a single sufficiently severe incident may create a hostile work environment. Title VII forbids employers from fostering a hostile work environment through “severe or pervasive” workplace harassment.

Knudsen’s brief accuses the U.S. Court of Appeals for the 10th Circuit of only evaluating the case “under a pervasiveness standard” in noting that the training occurred only once.

“This sort of top-down discrimination is worlds away from most hostile work environment claims, which usually involve employees harassing other employees,” Knudsen’s brief argues. “A training program that instructs employees to treat others differently based solely on race creates a work environment ‘permeated with abuse.’”

“The answer to racism is not more racism,” Knudsen declares.

Young filed an internal discrimination complaint with the Colorado department, but the inspector general declined to investigate because it found insufficient cause. Colorado has argued that the department did not require employees to change their personal beliefs.

Knudsen’s brief asks the Supreme Court to grant Young’s petition, reverse the dismissal of his case, and allow his hostile-work-environment claim to proceed. The justices would not be deciding whether Young ultimately proved discrimination.

The brief goes further than simply urging Supreme Court review. It condemns this form of DEI training in general, suggesting that employers may engage in discrimination by requiring it.

“Employer training sets the tone for the entire workplace,” Knudsen warns. “When an employer officially sanctions racial scapegoating and treating individuals differently depending on their race in the workplace, that employer per se creates a hostile work environment. Even infrequent training can create a pervasive race-based hostility for the races singled out for negativity.”

A Michigan man has been accused of submitting more than $4 million in Medicare claims for psychotherapy services that an adult day care never provided. 

A federal grand jury in the Eastern District of Michigan has indicted Emory Matthews, 62, of Farmington Hills, on fraud charges. From January 2020 through June 2025, Matthews allegedly helped submit more than $4.75 million in false claims.

Prosecutors say Matthews was a managing employee and administrator of New Beginnings Adult Center Inc. in Detroit, which is owned by his wife, Yolanda Matthews. 

The couple allegedly billed for individual and group psychotherapy that was never delivered; claimed services for patients who were hospitalized at the time; billed for services to beneficiaries who were deceased; used former employees' names on false claims; and hid Emory Matthews' exclusion by failing to disclose his managing role. 

Matthews has a record of committing fraud. He has previously been convicted of soliciting and receiving illegal healthcare kickbacks, a conviction that barred him from billing Medicare.

Yolanda Matthews pleaded guilty on July 27 to one count of conspiracy to commit healthcare fraud.

Emory Matthews faces one count of conspiracy to commit healthcare fraud and three counts of healthcare fraud. Each count carries a maximum penalty of 10 years in prison.

This alleged fraud stretched over five years, although the exterior of the facility looked very sketchy. 

If you’ve noticed sketchy medical facilities or have documents alleging benefits fraud, tell CapCon @MiCapCon@mackinac.org.

Rx: skepticism,

Scott McClallen
CapCon Reporter and Editor

First an overview, then updates.

Sally C. Pipes is the president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute, a San Francisco–based think tank founded in 1979.

https://benjaminrush1776.substack.com/p/sally-pipes-trump-has-a-subsidy-alternative

Sally Pipes: "Trump Has a Subsidy Alternative, We Should Take it Seriously"

Direct vouchers for patients—not payouts to insurance companies—is a real path to lowering costs and improving coverage.

Nov 21, 2025

The following is an excerpt from an article by Sally Pipes, Founder & Chair of the Benjamin Rush Institute, published in Newsmax. Click here to read the full article in your browser.

In a social media post earlier this month, President Trump laid out his own alternative to the enhanced Obamacare subsidies that fueled the record-breaking 43-day government shutdown.

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“I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent to money sucking Insurance Companies in order to save the bad Healthcare provided by ObamaCare, BE SENT DIRECTLY TO THE PEOPLE SO THAT THEY CAN PURCHASE THEIR OWN, MUCH BETTER, HEALTHCARE, and have money left over.”

Colorful language aside, the idea is worth considering.

Individual Americans deserve more control over how their healthcare dollars are spent. Injecting more consumerism into the health insurance market can help restore efficiency — and sanity — to our healthcare system.

It’s hard to argue with Trump’s basic critique of the generous COVID-19-era Obamacare subsidies. If extended beyond their scheduled expiration at the end of this year, these subsidies will cost taxpayers $350 billion over the next decade, according to the Congressional Budget Office (CBO).

And as the president notes, that money doesn’t go to patients — it goes directly into the pockets of giant insurance companies.

Trump’s proposed solution to this mess is also compelling — at least in principle. If the government is going to spend enormous sums subsidizing health insurance, much better to give those funds to individuals and let them use the money to buy coverage of their choosing — or even pay for care directly.

An army of consumers with control over healthcare dollars is a recipe for healthier competition among insurers — and higher-quality, better-value coverage in the long run.

But why stop at Obamacare?

Why not look at voucherizing other parts of the health insurance system?

Consider Medicare.

The government currently spends over $1 trillion each year on the healthcare entitlement for seniors.

That amounts to nearly $15,000 per Medicare beneficiary.

Yet instead of giving those funds directly to patients — and allowing them to purchase private coverage — the federal government funds a sprawling health insurance bureaucracy that employs thousands of federal workers.

Transitioning the program to a system of vouchers, in which every enrollee is allotted a set amount of money to pay for healthcare each year, could lower costs and improve the quality of coverage for seniors.

Or let’s extend Trump’s idea for the individual market further.

Why not encourage employers to give their employees untaxed dollars to purchase health insurance that suits their unique needs on the individual market, rather than buying a one-size-fits-all plan for everyone in their employee population?

President Trump created a vehicle for voucherizing employer-sponsored coverage — the individual coverage health reimbursement arrangement, or ICHRA — in his first term.

These accounts can give employers more control over their own healthcare costs — and can encourage employees to spend their healthcare dollars more wisely.

The upshot is more competition within the healthcare market — and downward pressure on prices over time.

The Trump administration has yet to build out a legislative vehicle based on the president’s social media post. But Sen. Bill Cassidy, R-La., has already floated one approach.

The Senate HELP Committee chairman has proposed to redirect enhanced subsidy money into individual Flexible Spending Accounts, or FSAs.

Patients would have 15 months to use those funds to purchase health coverage, or else forfeit the money back to the government.

Republicans can do better.

For starters, they should not commit to extending Obamacare’s enhanced subsidies permanently. Second, they must pair any form of federal health insurance voucher with reforms that relax Obamacare’s insurance market regulations.

Or, make lower-cost short-term health plans, which are not subject to those regulations, more widely available.

Indeed, unless the GOP takes steps to deregulate the health insurance market and make a wider array of affordable plan options available to patients, transitioning to direct subsidy payments won’t create a healthy coverage market.

It could even precipitate a “death spiral,” in which patients flee the exchanges, leaving no one but high-cost, high risk patients in the Obamacare risk pools.

Spending less on corporate welfare for insurers, and more helping patients through direct financial assistance, is precisely the right idea — one whose moment may have finally arrived.

Note that her two final recommendations are already in place: the unsustainable, extended ACA subsidies are gone, and short-term plans are more widely available.