The case is entitled FTC v.
NNOVATIVE PARTNERS, LP, d/b/a
INNOVATIVE HEALTH PLAN or
HEALTHCARE PLAN; AMERICAN
COLLECTIVE, LP, d/b/a
ACLP HEALTH PLAN; HEALTH PLAN
ADMINISTRATORS, LLC; PAPYRUS
GREEN INVESTMENTS LLC; AHMED
IBRAHIM SHOKRY; AMERICAN
COLLECTIVE, LP; PAPYRUS
GREEN INVESTMENTS LLC; and
AMANI IBRAHIM SHOKRY; Defendants.

Telemarketers like these are hated for good reason.

https://www.ftc.gov/news-events/news/press-releases/2026/04/ftc-sues-stop-deceptive-health-care-scheme

FTC Sues to Stop Deceptive Health Care Scheme

FTC alleges scheme has generated millions of dollars by deceiving consumers seeking comprehensive health plans or those who already have coverage

April 22, 2026

At the Federal Trade Commission’s request, a U.S. district court in Florida has temporarily halted a nationwide operation that allegedly impersonates the government and large insurance carriers to deceive consumers seeking health insurance into buying supposedly comprehensive PPO plans that do not offer the coverage they seek.

According to the Commission’s complaint, the scheme—which operates under several names including Innovative Partners and American Collective—also targets already-insured consumers by claiming they need to pay to maintain or renew coverage. The FTC alleges that consumers paid the defendants millions in “premiums” for products they did not want or need, and which expose them to potentially significant and unexpected medical costs.

This action follows FTC Chairman Andrew N. Ferguson’s creation of a Healthcare Task Force in March, as well as the FTC’s prior enforcement efforts against related healthcare schemes.

“Targeting unlawful conduct that drives up Americans’ costs, especially healthcare costs, is one of my top priorities,” said Chairman Andrew N. Ferguson. “The Healthcare Task Force launched last month underscores my commitment to bringing the full strength of the agency to bear on the challenges facing American patients, providers, and communities. The Commission’s work here is essential: When companies engage in practices that inflate prices, limit patient access to medical care, or undermine the integrity of the healthcare system, consumers suffer. Under my leadership, the Commission will continue to pursue fraudsters who deceive or disadvantage people seeking medical treatment, and we will do so with every enforcement tool at my disposal.”

The FTC alleges that since at least early 2023, the six defendants named in the complaint have jointly operated a fraudulent telemarketing scheme that takes advantage of consumers seeking comprehensive health insurance coverage. In making their pitch, the defendants often falsely tell consumers they are buying “state issued” PPO insurance policies that have no deductible and provide full coverage with low or no co-payments, according to the complaint.

The complaint further alleges that when dealing with consumers who already have health insurance, the company’s telemarketers deceptively tell them they are calling from real insurance carriers or the government, and that without immediate payment their policies will be canceled.

The products the defendants sell are not PPO plans or comprehensive health insurance policies, and they cannot be sold on any state or federal government health insurance marketplace, according to the complaint. Instead, the defendants’ plans typically include an assortment of medical discounts, ancillary products, and capped payouts for certain medical events such as emergency room visits—while some plans exclude hospital care entirely.

While at least one defendant has claimed they do not market or sell insurance, the defendants lead consumers to believe the products they offer—which can cost hundreds of dollars a month and thousands of dollars a year—will provide comprehensive coverage, according to the complaint.

The complaint further alleges that when consumers who enroll in the defendants’ supposed PPO policies attempt to use them, they discover that the products do not provide the comprehensive coverage they were promised. As a result, some are forced to postpone care until they can get insurance coverage, while others are faced with substantial medical debt. When frustrated consumers try to cancel their purchase of the products, the defendants often ignore them and the monthly payments continue.

In addition, the complaint alleges that the defendants:

• unfairly charge consumers without their express, informed consent and fail to disclose material terms and conditions of their negative option feature, specifically the steps consumers must take to cancel the monthly recurring payments;
• make misrepresentations while telemarketing and fail to disclose material information in telemarketing before the consumer consents to pay for the goods or services provided;
• engage in unlawful telemarketing acts and practices by charging consumers for products or services for which they have not provided their express, informed consent;
• deceptively pose as businesses and government officials or misrepresent their affiliation with, or endorsement or sponsorship by, a government entity; and
• use false, fictitious, or fraudulent statements or representations to obtain customer information of a financial institution, such as credit or debit card numbers.

The complaint alleges that the defendants violated the FTC Act, the Telemarketing Sales Rule, the Impersonation Rule, and the Gramm-Leach-Bliley Act and seeks refunds for affected consumers. The court entered a temporary restraining order against the defendants based on their alleged law violations.

The Commission vote authorizing the staff to file the complaint against the six defendants was 2-0. The complaint was filed under seal in the U.S. District Court for the Southern District of Florida, and the seal has now been lifted.

The defendants include Innovative Partners, LP, which does business as Innovative Health Plan or Healthcare Plan, and its Chief Technology Officer Amani Ibrahim Shokry; American Collective, LP, which does business as ACLP Health Plan; Papyrus Green Investments LLC; and their owner Ahmed Ibrihim Shokry, as well as Health Plan Administrators, LLC.

NOTE: The Commission files a complaint when it has “reason to believe” that the named defendants are violating or are about to violate the law and it appears to the Commission that a proceeding is in the public interest. The case will be decided by the court.

Staff attorneys on this matter are Matthew Schiltz, William Hodor, and D’Laney Gielow of the FTC’s Midwest Region.

The Federal Trade Commission works to promote competition and protect and educate consumers. The FTC will never demand money, make threats, tell you to transfer money, or promise you a prize. Learn more about consumer topics at consumer.ftc.gov, or report fraud, scams, and bad business practices at ReportFraud.ftc.gov. Follow the FTC on social media, read consumer alerts and the business blog, and sign up to get the latest FTC news and alerts.

Secretary Kennedy is the first U.S. Cabinet level official to go on record as opposing assisted suicide:

https://modernity.news/2026/04/24/rfk-jr-blasts-abhorrent-assisted-suicide-we-cant-be-a-moral-society-if-america-follows/

RFK Jr. Blasts “Abhorrent” Assisted Suicide: ‘We Can’t Be a Moral Society If America Follows’
By Steve Watson - April 24, 2026

HHS Secretary warns Canada’s MAiD program now drives more deaths than any other cause as euthanasia explodes across the West

Health and Human Services Secretary Robert F. Kennedy Jr. delivered a blunt warning to lawmakers this week: Canada’s rush to expand assisted suicide is turning a once-free nation into a cautionary tale the United States must reject outright.

Testifying before the Senate Finance Committee and Senate HELP Committee, Kennedy forcefully condemned the program known as Medical Assistance in Dying (MAiD). “I think those laws are abhorrent,” he said. Pointing directly to the results north of the border, he added, “And we just see in Canada today, I think the number one cause of death is assisted suicide.”

Kennedy made clear the policy doesn’t stop at personal choice. “And as you say, it targets people with disabilities and people who are struggling in their lives,” he stated. He tied the issue to America’s broader standing in the world: “I don’t think we can be a moral society; we can’t be a moral authority around the globe if that becomes institutionalized throughout our society.”

The comments come as Canada’s experiment spirals. The country is on track to surpass 100,000 assisted deaths before MAID’s 10th anniversary this summer, as noted in a recent New York Post report.

As of 2024, the total already stood at 76,475 — more Canadians killed through the program than died in World War II.

Government-assisted suicide is also spreading like wildfire across the West, often sold as compassion but delivering cost-cutting convenience for cash-strapped socialist healthcare systems.

In the Netherlands, euthanasia now accounts for 6 percent of all deaths and the share is rising every year.

In 2025 alone, 10,341 people died by euthanasia. While most were over 70 with physical illnesses like cancer or heart disease, the cases included 499 dementia patients and 278 listed under vague “other reasons.” One case involved a patient aged between 12-18. Dutch experts are now urging caution for anyone under 25, warning that young brains are still developing and highly susceptible to external pressure and online influence.

Canada’s program began in 2016 limited to terminal cases. Within a year, officials were openly discussing how it could save over $130 million annually in medical costs. Expansions followed: mental illness is scheduled to qualify starting in 2027, and discussions continue about “mature minors” as young as 12.

Belgium and the Netherlands already allow child euthanasia. England, Wales, and Scotland are now pushing similar legislation modeled on Canada’s original law.

The results speak for themselves. In Canada, one in every 20 deaths is now government-assisted suicide. Proponents promised rare, tightly controlled cases. Reality delivered a bureaucratic death machine that quietly expanded to the disabled, the depressed, and the financially burdensome.

Kennedy offered lawmakers a clear path forward. “I am happy to work with you in whatever way we can,” he said, signaling openness to bipartisan efforts to protect vulnerable Americans from the same slope.

Another recent case captured the human cost in Spain, where a 25-year-old woman paralyzed after a horrific gang rape was euthanized despite her parents’ desperate legal fight:

Spanish bishops called it what it is: “Euthanasia and assisted suicide are not medical acts, but deliberate interruptions of the bond of care, and represent a social defeat when presented as a response to human suffering.”

They stressed that “the dignity of the human person does not depend on their state of health… but rather is an intrinsic value that must be recognized, protected and helped in all circumstances.”

The message is simple: when life hurts, the answer is not state-sponsored death but real care, real treatment, and real hope.

Canada and Europe are showing the West what happens when governments treat citizens as budget line items rather than sacred individuals.

https://thehill.com/policy/defense/5841096-pentagon-ends-mandatory-flu-vaccines/

Hegseth ends mandatory flu vaccine for service members
By Ellen Mitchell - April 21, 2026

The Pentagon is ending mandatory flu vaccines for service members, phrasing the change as giving troops “medical autonomy” and “freedom to express their religious convictions,” Defense Secretary Pete Hegseth announced Tuesday.

“Our new policy is simple. If you, an American warrior entrusted to defend this nation, believe that the flu vaccine is in your best interest, then you’re free to take it. You should. But we will not force you. Because your body, your faith are not negotiable,” Hegseth said in a video message posted to social media.

He called the flu shot requirement part of “absurd, overreaching mandates that only weaken our warfighting capabilities.”

“Our men and women in uniform were forced to choose between their conscience and their country, even when those decisions posed no threat to our military readiness,” Hegseth said of the previous guidelines. “The notion that a flu vaccine must be mandatory for every service member everywhere in every circumstance at all times is just overly broad and not rational.”

The new rule, laid out in a brief April 20 memo, goes a step further than the Defense Department policy from May 2025 that carved out flu shot exemptions for reservists and proclaimed that the vaccine was only necessary in some circumstances for all service members.

The policy change also comes after the Trump administration offered major changes to other vaccination guidance, spurred on by advice from anti-vaccine figures.

Vaccines have been a key focus in President Trump’s second term, with the Pentagon offering back pay and the chance to rejoin the military for the thousands of veterans discharged from the armed forces for refusing the COVID-19 vaccine during the Biden administration.

More than 8,000 service members were separated from the military for refusing to comply with the Pentagon’s coronavirus vaccine mandate.

Trump, in a January executive order, called for allowing such service members to enlist, but the overwhelming majority have declined to do so, with less than 200 taking the option.

Bill text is pending.

https://greatlakeswire.com/barrett-announces-second-package-of-bills-to-make-health-care-affordable-again/

Barrett announces second package of bills to make health care affordable again

Great Lakes Wire    |    Apr 20, 2026

Congressman Tom Barrett announced on Apr. 20 a new set of legislative proposals aimed at lowering health care costs and increasing transparency for patients. The announcement marks the unveiling of the second package under his Blueprint for a Better America, focusing on making health care more affordable.

The proposed legislation is intended to address ongoing concerns about high medical expenses faced by Michigan residents and others across the country. Barrett said, “Michigan patients are sick and tired of paying too much to see a doctor and get the treatment and medicine they need.” He added that large insurance companies profit while families face rising premiums and unclear pricing structures.

Barrett joined Representative Eric Burlison in introducing the Great American Healthcare Plan (H.R. 8324), which seeks several reforms: expanding access to tax-free Health Savings Accounts (HSAs) by removing restrictions and increasing contribution limits; broadening eligible HSA expenses to include insurance premiums, healthy food, vitamins, and fitness-related costs; strengthening federal price transparency requirements by mandating hospitals and insurers disclose actual prices in clear terms; enabling certain healthcare professionals such as physician assistants or pharmacists to dispense low-risk medicines without physician oversight; creating marketplace pools for small businesses to provide better insurance options for employees; and ensuring fair reimbursement through Medicare Part B for expensive cancer treatments.

Barrett also co-sponsored the Every Dollar Counts Act (H.R. 8270), which would require insurers to count all patient spending on prescription drugs toward deductibles and out-of-pocket maximums regardless of where medications are purchased. This measure aims to help patients shop for more affordable prescriptions rather than being limited by network restrictions.

These two bills follow an earlier six-bill package from Barrett designed to expand HSAs further, prevent insurance fraud, ensure competitive prescription drug pricing compared with other countries, allow working seniors continued HSA contributions, improve insurer spending ratios on health care services, and enhance Medicare customer service.

Barrett’s Blueprint outlines broader goals beyond health care affordability—such as restoring trust in government operations, helping families afford homes in Mid-Michigan, recalibrating foreign policy priorities toward peace initiatives—and positions these legislative efforts within a larger vision for reform.

The State of Texas authorized $50 million to fund clinical trials of ibogaine last year. Texas House Bill 3717 and Senate Bill 2308 passed and were signed by the Governor at the behest of former Governor Rick Perry.  The Trump XO will probably also facilitate the research going on in Texas:

https://www.whitehouse.gov/presidential-actions/2026/04/accelerating-medical-treatments-for-serious-mental-illness/

ACCELERATING MEDICAL TREATMENTS FOR SERIOUS MENTAL ILLNESS
Executive Orders
April 18, 2026

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered:

Section 1. Purpose and Policy. Policymakers and the medical field have long struggled to address the burden of suicide and serious mental illness rates in America. Today, over 14 million American adults have a serious mental illness, defined as having a diagnosable mental, behavioral, or emotional disorder that substantially interferes with a person’s life and ability to function, and about 8 million are on prescription medication for these conditions. Suicide rates tragically increased by 37 percent from 2000 to 2018. During my first term, we made historic progress in helping those struggling with some of the most insidious mental illnesses, and suicide rates decreased by 5 percent from 2018 to 2020. The COVID-19 pandemic and the Biden Administration’s prolonged shutdown stunted this progress and suicide rates rebounded upwards again to their peak rate in 2022. Critically, veterans often suffer in greater measure from this tragedy. For over 20 years, there have been more than 6,000 veteran suicides per year, and the current veteran suicide rate is more than twice as much as the non-veteran adult population.

Individuals suffering from major depressive disorder and substance abuse disorder, among other serious mental illnesses, can relapse or not fully respond to standard medical and psychiatric therapies. Despite massive Federal investment into researching potential advancements in mental health care and treatment, our medical research system has yet to produce approved therapies that promote enduring improvements in the mental health condition of these most complex patients. Innovative methods are needed to find long-term solutions for these Americans beyond existing prescription medications.

Psychedelic drugs, including ibogaine compounds, show potential in clinical studies to address serious mental illnesses for patients whose conditions persist after completing standard therapy. Indeed, the Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to specific psychedelic drugs, and there are numerous products currently in the clinical trial pipeline for review of safety and efficacy. It is the policy of my Administration to accelerate innovative research models and appropriate drug approvals to increase access to psychedelic drugs that could save lives and reverse the crisis of serious mental illness in America.

Sec. 2. FDA Review Prioritization and Right to Try. (a) The Commissioner of Food and Drugs shall provide Commissioner’s National Priority Vouchers to appropriate psychedelic drugs that have received a Breakthrough Therapy designation and are in accordance with the criteria of the National Priority Voucher Program.

(b) The FDA and Drug Enforcement Administration shall facilitate and establish a pathway for eligible patients to access psychedelic drugs, including ibogaine compounds, under the Right to Try Act (21 U.S.C. 360bbb-0a), including any necessary Schedule I handling authorizations for treating physicians and researchers, consistent with 21 U.S.C. 823, and any applicable waiver authority under the Controlled Substances Act.

Sec. 3. Department of Health and Human Services Funding for Federal-State Collaboration. The Secretary of Health and Human Services shall, through the Advanced Research Projects Agency for Health, allocate at least $50 million from existing funds to support and partner with State governments that have enacted or are developing programs to advance psychedelic drugs for serious mental illnesses, including through Federal funding, technical assistance, and data sharing as appropriate and consistent with applicable law.

Sec. 4. Department of Health and Human Services and FDA Collaboration with the Department of Veterans Affairs and the Private Sector. The Department of Health and Human Services (HHS) and FDA shall collaborate with the Department of Veterans Affairs (VA) and, as appropriate and consistent with applicable law, including any privacy restrictions from the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996, with the private sector, to increase clinical trial participation, data sharing, and real-world evidence generation regarding psychedelic drugs, and shall prioritize drugs that have received a Breakthrough Therapy designation. The HHS, FDA, and VA are directed to sign data-sharing memoranda as appropriate to ensure that data from relevant clinical studies conducted by other executive departments and agencies is made available to FDA to facilitate the timely evaluation and approval of drugs that meet standards for approval under section 505 of the Federal Food, Drug, and Cosmetic Act.

Sec. 5. Timely Rescheduling. The Attorney General shall, in consultation with HHS, initiate and complete review of any product containing a Schedule I substance that has successfully completed Phase 3 clinical trials for a serious mental health disorder, so that rescheduling, if appropriate under 21 U.S.C. 811, may proceed as quickly as practicable for such specific products that are ultimately approved under section 505 of the Federal Food, Drug, and Cosmetic Act.

Sec. 6. General Provisions. (a) Nothing in this order shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

(d) The costs for publication of this order shall be borne by the Department of Health and Human Services.

DONALD J. TRUMP

THE WHITE HOUSE,

April 18, 2026.

https://www.reuters.com/business/healthcare-pharmaceuticals/trump-announces-new-leadership-cdc-nominates-erica-schwartz-director-2026-04-16/

Trump nominates former deputy surgeon general as CDC director
By Yasmeen Abutaleb and Julie Steenhuysen - April 16, 2026

Summary

• Position has been open since Susan Monarez was fired last year
• Schwartz has been praised by former public health officials
• Nominated healthcare executive Sean Slovenski as deputy director

WASHINGTON, April 16 (Reuters) - U.S. ​President Donald Trump said on Thursday he would nominate Erica Schwartz, who had served as deputy surgeon general during the ‌COVID-19 pandemic, to become director of the Centers for Disease Control and Prevention following multiple leadership shakeups at the health agency.

Schwartz, who served during Trump's first term, was involved in the federal COVID response, helping to coordinate national preparedness and public health efforts.

The nomination represents a far more traditional pick for the ​embattled health agency, as the White House seeks to focus on more popular issues such as lowering drug prices and ​food safety, rather than Health Secretary Robert F. Kennedy Jr.'s controversial vaccine policies with Republicans bracing for a ⁠difficult November midterm election. At a pair of congressional hearings on Thursday, Kennedy largely avoided questions about vaccines.

Trump, in a post on Truth ​Social, also said he was naming healthcare executive Sean Slovenski as CDC deputy director and chief operating officer, Texas Health Commissioner Jen Shuford ​as CDC deputy director and chief medical officer and FDA official Sara Brenner as senior counselor for public health to Kennedy.

The nominations come after a Massachusetts judge blocked key parts of Kennedy's effort to reshape U.S. vaccine policy, including a move to reduce the number of shots routinely recommended for children, and his overhaul of ​a CDC advisory committee on inoculations.

If approved, Schwartz would lead the Atlanta-based agency, which tracks and responds to domestic and foreign threats ​to public health. The CDC director traditionally has the final say on U.S. vaccine policy.

She would report to Kennedy, who has long questioned the safety of vaccines, ‌contrary ⁠to established science.

Trump fired CDC Director Susan Monarez last August over her objections to vaccine policy changes planned by Kennedy. Her position was filled by two acting directors: Health and Human Services Deputy Secretary Jim O'Neill, who was succeeded in February by Jay Bhattacharya, the director of the U.S. National Institutes of Health.

MORE TRADITIONAL CANDIDATES

Schwartz, who does not have a widely publicized position on vaccines, has been praised by former public health ​officials who have been critical ​of Kennedy's vaccine policies.

Demetre Daskalakis, ⁠former CDC director of the National Center for Immunization and Respiratory Diseases who resigned after Monarez's firing, said Schwartz showed "good leadership" during the COVID response and has a "proven track record... notably with pandemic preparedness."

Polls have ​shown most voters disapprove of Kennedy's moves to overhaul the childhood vaccination schedule.

The White House has ​pushed for more ⁠traditional candidates for top agency roles after Kennedy handpicked a slate of controversial political appointees who have undermined trust in vaccines, according to sources familiar with the discussions.

Close Kennedy ally and vaccine injury lawyer Aaron Siri was critical of the nomination.

"Her long track record of directly issuing rights-crushing civilian ⁠and military ​vaccine mandates, including mandating injection of smallpox, anthrax, and flu vaccines into U.S. ​Forces, and disciplining those that refused, reflects she lacks the basic ethics and morals to lead the CDC," Siri said. "This agency does not need another cheerleader for industry."

https://www.justice.gov/opa/pr/justice-department-reveals-biden-administrations-weaponization-federal-law-against-pro-life

https://www.justice.gov/opa/media/1436006/dl

Justice Department Reveals the Biden Administration’s Weaponization of Federal Law Against Pro-Life Americans
For Immediate Release - Tuesday, April 14, 2026
DoJ Office of Public Affairs

DOJ Weaponization Working Group Report Outlines Corrective Action Taken to Restore the Public’s Confidence in Lawful Treatment of All Americans

• The Biden DOJ closely collaborated with pro-abortion groups to track pro-life activists’ First Amendment activity. Pro-abortion groups—especially the National Abortion Federation, Planned Parenthood, and Feminist Majority Foundation—capitalized on their relationship with the Biden DOJ to gain internal information and push targets for enforcement. These groups compiled evidence and dossiers that ultimately gave rise to search warrants and charges. The Biden DOJ affirmatively asked pro-abortion groups about pro-life individuals’ travel and constitutionally protected advocacy. The Biden DOJ and career attorneys monitored pro-life activists for years before charging them.
• The Biden DOJ’s prosecutors engaged in inappropriate conduct and comments. Prosecutors knowingly withheld evidence that defense counsel requested to prepare an affirmative defense, tried to screen out jurors based on religion, and authorized aggressive arrest tactics instead of allowing pro-life defendants to self-surrender.
• The Biden DOJ helped a pro-abortion group secure funding. The lead prosecutor on each FACE Act prosecution served as a reference on the National Abortion Federation’s application for a private grant. We found no record of ethics approval for the attorney to take an interest in the financial outcome of a party having business before the Biden DOJ.
• The Biden DOJ pursued significantly harsher sentences for pro-life defendants than violent pro-abortion defendants. The Biden DOJ requested an average sentence of 26.8 months for pro-life defendants, compared to 12.3 months for pro-abortion defendants.
• The Biden DOJ violated the rights of Americans through its biased enforcement of the FACE Act. Though the Act was supposed to protect both pro-choice and pro-life facilities, the Biden DOJ provided extensive support to abortion clinics, while ignoring and downplaying vandalism and attacks against pregnancy resource centers.

• On January 23, 2025, President Trump issued full and unconditional pardons to many of the pro-life Christians unfairly targeted by the Biden DOJ.
• DOJ has settled civil cases to address the injustices and took personnel action against those responsible.
• DOJ leadership has dismissed, with prejudice, three civil lawsuits against pro-life activists: United States v. Connolly, No. 2:24-cv-04467 (E.D. Penn.); United States v. Zastrow, et al., No. 2:24-cv-00576 (M.D. Fla.); United States v. Citizens for a Pro-Life Society, et al., No. 1:24-cv-00893 (N.D. Ohio).
• The Trump DOJ issued a directive that, moving forward, DOJ prosecutors may only bring abortion-related civil actions and prosecutions under the FACE Act in extraordinary circumstances or in cases presenting significant aggravating factors.
• To prepare this report, DOJ reviewed approximately 700,000 internal records. Acting Attorney General Blanche has approved a limited waiver of privileged information to provide the public the opportunity to review the underlying materials.

https://mfcannon.substack.com/p/cap-health-care-proposal-regulation

https://www.americanprogress.org/article/a-patients-bill-of-rights-to-lower-health-care-costs/

CAP Health Care Proposal: Regulation Hasn’t Delivered Affordability, So Let’s Try Regulation
To make health care more affordable and universal, we need a different approach.
Michael F. Cannon - April 10, 2026

• Tightening price controls on health insurance premiums by lowering the threshold for individual-market premium increases that regulators may reject, and imposing “rate review” regulation on employer plans as well.
• Indirect, Medicare-based price controls on hospitals in highly concentrated markets, that limit prices to three times what Medicare sets.
• Additional indirect price controls on hospitals whose prices exceed the statewide median, that prohibit price increases greater than the rate of general inflation plus one percentage point.
• Tightening indirect regulation of insurer profits, by limiting administrative expenses to a percentage of industry-average premiums (rather a figure that individual insurers can manipulate) for purposes of “medical loss ratio” (MLR) regulation.
• Imposing indirect regulation of insurer profits on self-funded employer plans. (MLR again.)
• Prohibiting integration, specifically banning health insurance companies from owning “providers, pharmacies, and PBMs,” to prevent insurers from maximizing government subsidies by acquiring downstream providers and then overcharging themselves.
• Additional indirect regulation of insurer profits, where regulators determine whether provider-subsidiaries are overcharging parent insurers, and count the excess against administrative expenses rather than claims.
• Prohibiting prior authorization for “routine, emergency, and essential care” and requiring insurers to obtain permission from a government agency before denying any other claim.

https://www.cms.gov/newsroom/press-releases/cms-proposes-major-reforms-speed-up-patient-access-drugs-increase-transparency-reduce-administrative

https://www.cms.gov/newsroom/fact-sheets/2026-cms-interoperability-standards-prior-authorization-drugs-proposed-rule

https://www.federalregister.gov/public-inspection/2026-07205/medicare-and-medicaid-programs-patient-protection-and-affordable-care-act-interoperability-standards

CMS Proposes Major Reforms to Speed Up Patient Access to Drugs, Increase Transparency, and Reduce Administrative Burden
Press Release - April 10, 2026

• CMS Proposes Major Reforms to Speed Up Patient Access to Drugs, Increase Transparency, and Reduce Administrative Burden
• Proposed rule would require faster prior authorization decisions, expand electronic prior authorization to drugs, and increase transparency across federal programs

• Approval and denial rates;
• Appeal outcomes; and
• Decision timeframes.

• Update health IT standards and implementation guides to align with current versions adopted by ONC for HHS use;
• Expand existing interoperability requirements to small group market QHP issuers on the FF-SHOP; and
• Add a regulatory definition for “Failure to Report” to strengthen CMS’ oversight authority under the Open Payments program.

• Improving electronic event notifications for care coordination;
• Strengthening health care cybersecurity and system resilience;
• Enhancing oversight of payer APIs;
• Streamlining step therapy processes; and
• Improving prior authorization for laboratory tests and durable medical equipment, prosthetics, orthotics, and supplies.

https://www.aei.org/health-care/the-trump-administrations-anti-waste-in-health-care-campaign/

The Trump Administration’s Anti-Waste in Health Care Campaign
By James C. Capretta - April 8, 2026

The Trump administration is targeting health care fraud and abuse at a pivotal moment. Combined federal spending on Medicare and Medicaid is high and rising rapidly, as reflected in the administration’s just-released 2027 budget. In 2036, the government expects their expenditures to reach 7.3 percent of GDP (not counting Medicare premiums collected from beneficiaries), up from 6.2 percent in 2026. With defense obligations also spiking, there is no room for complacency toward waste wherever it is found, and health care has been a perennial vulnerability. The administration is moving quickly to capitalize on artificial intelligence (AI) to get ahead of the problem.

Program integrity in health care is challenging because the main entitlement programs are sprawling. In 2021, the Centers for Medicare and Medicaid Services (CMS) estimated it processed over 1.1 billion Medicare fee-for-service claims and made payments to 1.5 million institutional providers and clinicians. Medicaid is run by fifty separate state agencies and pays for a broad array of services, including non-medical support for the disabled and elderly. With the federal Treasury footing much of the total bill, it is not surprising that the programs are vulnerable to abusive schemes.

The Trump administration is attacking waste in these programs from multiple angles. To curb abuses in Medicaid, it has announced special investigations into four states (California, Maine, Minnesota, and New York) and then followed that up by initiating a combined Medicare-Medicaid investigation in Florida, which has been the location for multiple fraudulent schemes going back to the 1990s.

In Medicare, CMS has already taken steps to curb abusive billing practices for coverage of skin substitute treatments for wounds, which will eliminate billions of dollars per year in unnecessary expenditures. In 2024, Medicare spent over $10 billion on these treatments after spending just $242 million in 2019. Some clinicians were submitting claims for payments for patients who were unlikely to benefit from the products. Last year, CMS announced it was closing the coding loopholes that allowed some of the abusive bills to get paid.

In 2026, the agency has turned its focus to durable medical equipment, which is notorious for attracting suppliers with dubious credentials. In February, the agency announced a six-month moratorium on the approval of new DME vendors with the intention of providing a window for establishing tighter oversight and new boundaries that will separate the legitimate from illegitimate suppliers. DME companies deliver oxygen equipment, wheelchairs, and other health-related products often directly to the homes of Medicare beneficiaries. A common scheme involves clinicians ordering DME supplies when they are not necessary and then profiting, most likely indirectly, from the Medicare payments.

The most promising recent development is CMS’s announced plan to use AI and other information technology tools to strengthen oversight of FFS payments. With a high volume of annual claims in both Medicare and Medicaid, automated systems are crucial. Emerging AI technology offers the prospect of building anti-fraud and abuse protocols directly into its existing payment approval processes, which means the government might finally be equipped to stop wasteful spending in health care before it occurs.

Two initiatives could make a difference.

First, in June 2025, the agency launched the Wasteful and Inappropriate Service Reduction Model, or WISeR, with the objective of building AI-facilitated prior authorization screens into Medicare FFS payment systems to reduce spending on unnecessary and low-value care. The initial targets would be services that have been flagged in previous reviews as vulnerable to abuse. The hope is that WISeR will help the government build tools resembling those used by some private managed care plans.

Second, in February, CMS posted a request for information (RFI) to solicit from the private sector new ideas for changing federal regulations to combat fraud and abuse in all of the government’s major health programs, with a specific focus on using AI to detect the most costly schemes. The initiative, called the Comprehensive Regulations to Uncover Suspicious Healthcare, or CRUSH, will lead to rule changes affecting Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the premium subsidy program created by the Affordable Care Act (ACA).

WISeR and CRUSH bear watching because they could institutionalize tighter oversight of program spending. The government’s other efforts are important but depend somewhat on continued vigilance among program administrators, which is not guaranteed.

It is possible that today’s emerging tools could have unexpected effects on total expenditures. CMS’s plan is to use AI to screen out unneeded services and abusive claims, but the industry wants to use it to identify underuse of care in Medicare and Medicaid, and also fees that are below their incurred costs. That information will then be used to press Congress to increase health entitlement spending rather than reduce it.

In other words, the battle for program integrity and spending discipline in health care is never fully won or over.