- 10 state behavioral health policy updates
- Mood disorders during menopause: A call to recognize and respond
- Iowa governor signs law to reform prior authorization, out-of-network penalties
- Why rural is the perfect setting for innovation: Mayo Clinic Health System CEO
- Tens of thousands of U of California healthcare, service workers to strike
- 3,000 Endeavor nurses seek unionization
- CoxHealth changes service lines, leadership structure
- Healthcare’s trillion-dollar private equity conundrum
- CMS taps 30 healthcare organizations for prior authorization initiative
- Hantavirus response spans 2 US biocontainment facilities: 6 updates
- Former Phoenix Children’s CEO publishes leadership book
- Dentistry’s biggest players
- Nurses feel left out of AI adoption: Survey
- White House freezes $1.3B in Medicaid payments to California
- Nebraska dentist to retire after 33 years of service
- 23 behavioral health executive moves to know
- Turnover runs high at 22% for early-career nurses: Press Ganey
- The key to dental practices operating like a 5-star hotel
- 5 CMS updates shaping outpatient care in 2026
- 5 major GI groups to know
- MB2 Dental adds 5 new partners in 2 months
- Arizona spine practice opens ASC
- Oklahoma CRNA charged with misconduct
- Kaiser Permanente plans 11K-square-foot MOB in Nevada
- Dentistry’s AI gold rush
- Only 1 in 5 physicians is independent: 10 new numbers behind the collapse
- California physician group acquired by PRISM
- Utah physician, 2 nurses charged in $29M fraud scheme
- CMS to withhold $1.3B in Medicaid funds from California, puts state officials on notice about fraud
- 1 behavioral health leader’s playbook for staff retention and safety
- Behavioral health ED visits projected to rise by 1 million
- 5 dental AI updates in 1 month
- 3 lawsuit settlements in dentistry
- BeOne's Venclexta challenger Beqalzi nets FDA approval as first BCL-2 for mantle cell lymphoma
- Financial pressures shutter Iowa dental clinics: 4 notes
- Independent autism research committee adds 7 members
- FDA Commissioner Marty Makary Resigns After Trump Pressure
- 10 notes on the widening DSO performance gap
- New payer-backed ad campaign pushes for No Surprises Act IDR reform
- CDC-linked autism researcher arraigned on fraud charges
- Nearly 1 in 3 boys under 14 discussed suicide in crisis conversations: Report
- Docs more burnt out, skeptical of AI than nurses, survey report finds
- As Trump arrives in China, Big Pharma CEOs are notably absent
- Remarks at the MFA Legal & Compliance 2026 Conference
- CMS pauses hospice, home health Medicare enrollments in fraud crackdown
- GLP-1 Drugs May Improve Breast Cancer Outcomes
- NYU Langone Health says it received grand jury subpoena over gender-affirming care
- Merck KGaA looks to M&A to bolster its 'rather slim' pipeline
- Takeda, slimming down for 'new era,' plots 4,500 layoffs in latest restructuring drive
- BeOne Medicines’ Brukinsa TV ad 'Clarity' hit by FDA over 'misleading suggestions'
- Health systems are exploring AI-powered cardiac risk screening. New CMS reimbursement could unlock a business case for it
- Ted Turner's Brain Disease More Common Than Previously Thought, Review Finds
- Most mental health practitioners satisfied with work, financially stable, SimplePractice finds
- Novo, Lilly tout respective early response and weight loss maintenance data as GLP-1 rivalry intensifies
- Haleon tackles sports injuries with latest soccer play
- Perimenopausal Women Face Greater Heart Risk, Study Finds
- Ivermectin Prescriptions Doubled After Mel Gibson Cancer Cure Claim
- Eating Out Linked To Obesity Risk Worldwide
- Low Wages, Empty Plates, Heavy Toll: Rethinking Suicide Prevention
- Trump and Kennedy Seek To Relax Safeguards for AI Healthcare Tools
- RFK Jr. Swaps Vaccine Talk for Healthy Foods and Reading to Tots in Push To Woo Voters
- Valneva to lay off up to 15% of workforce in face of ‘adverse trend’ in travel vaccines
- California to award $111M for behavioral health supportive housing
- 6 new psychiatric residency programs to know
- USOSM adds New York practice
- Mayo Clinic CEO Gianrico Farrugia stepping down at year's end
- BioMarin consolidates staff at Amicus HQ after closing $4.8B deal for rare disease peer
- US Monitors For Hantavirus As WHO Expects More Cases But 'Not Another COVID'
- University of California, union near May 14 strike deadline with no deal in hand
- 1 in 5 marketplace enrollees dropped their coverage in 2026: media report
- Hims & Hers posts $92M loss in Q1 as it shifts to branded GLP-1 medications
- Listen to the Latest ‘KFF Health News Minute’
- FDA Commissioner Marty Makary to resign, capping turbulent tenure
- FDA Commissioner Marty Makary to resign, capping turbulent tenure
- Providence puts years of losses in rearview with its third consecutive quarter of operating gains
- Millions of Women Suffer in Silence From Treatable Pelvic Organ Prolapse
- Eli Lilly pauses Indian obesity awareness campaign after regulatory notices: report
- Optum Rx unveils new transparent PBM model
- Fitness wearable Whoop adds on-demand clinician access, EHR syncing
- Alkermes’ Lumryz hits phase 3 mark in another sleep disorder, fueling momentum from $2.4B Avadel acquisition
- ACA exchanges take spotlight in Q1
- Pfizer, Arvinas win $85M upfront in Rigel licensing pact for new breast cancer med Veppanu
- Bayer's Eylea declines by 24%, bearing the brunt of biosmilar competition
- As public vaccine criticism quiets, RFK Jr. keeps safety inquiries running in background: NYT
- As public vaccine criticism quiets, RFK Jr. keeps safety inquiries running in background: NYT
- What's Fueling The High U.S. Death Rate? It Might Not Be What You Think
- Telemedicine Not Breaking The Bank, Also Not Expanding Patient Access
- After-School Sports An Overall Boon To Children And Teens, Study Shows
- Trump Promised Cheaper Drugs. Some Prices Dropped. Many Others Shot Up
- Why Are Older Adults Taking Edibles? Survey Reveals Some Surprises
- Low Wages, Empty Plates, Heavy Toll: Rethinking Suicide Prevention
- EU advances scheme to bolster manufacturing autonomy, avert drug shortages
- Bicara Therapeutics hires Replimune, Sanofi alum as chief commercial officer
- The broken pipeline of mental healthcare for LGBTQ teenagers
- FDA Launches One-Day Inspectional Assessments to Strengthen and Expand Oversight
- FDA Launches One-Day Inspectional Assessments to Strengthen and Expand Oversight
- Is your hospital ready for a prolonged IT outage? Joint Commission, AHA's new resiliency program will let you know
- FDA Expands AI Capabilities: Launches ELSA and Completes HALO Data Platform Consolidation
- FDA Expands AI Capabilities: Launches ELSA and Completes HALO Data Platform Consolidation
- Roche acquires PathAI to transform AI-driven diagnostics
- Roche acquires PathAI to transform AI-driven diagnostics
- Trump Planning to Fire FDA Commissioner Marty Makary
- Trump Planning to Fire FDA Commissioner Marty Makary
- Included Health launches AI-powered solution to connect members to providers
- FDA Green Lights Bizengri Drug To Treat Rare, Aggressive Bile Duct Cancer
- The Hidden Design Flaw in Medical Device Service Technology
- The Hidden Design Flaw in Medical Device Service Technology
- An Endovascular Approach to Neurological Diseases Can Shift the Treatment Paradigm
- An Endovascular Approach to Neurological Diseases Can Shift the Treatment Paradigm
- 8,500 Steps A Day Could Be Sweet Spot For Preventing Weight Regain
- Why Gen AI is a Win for MedTech: And, How to Unlock its Potential with the Right Policies
- Why Gen AI is a Win for MedTech: And, How to Unlock its Potential with the Right Policies
- Survey: Employers seeking greater transparency from pharmacy benefits
- Kaiser Permanente's investments pick up the slack as Q1 operating margin slims to 2.1%
- AMA unveils policy framework to combat AI deepfake physician impersonation
- The Medical Device Cybersecurity Gap Hiding in Plain Sight
- The Medical Device Cybersecurity Gap Hiding in Plain Sight
- CSL slashes revenue projection and takes $5B impairment as interim CEO flags R&D misses, market erosion
- Healthcare bankruptcies up 33% in Q1 2026: report
- Why Doctors Are Quitting At An Earlier Age
- Sharper Brains May Face Higher Depression Relapse Risk, Study Finds
- Older Adults Have Fewer Regrets, Study Says
- Partner's bispecific Bizengri nabs FDA national priority nod in rare bile duct cancer
- Daiichi Sankyo targets global top 5 oncology rank by 2035, $1.3B efficiency drive in new 5-year plan
- That Discount At The Pharmacy Counter May Pack Hidden Costs
- Nighttime Heat Waves Increase Asthma Risk
- As Ranks of Uninsured Grow, Minnesota’s Hospitals Are Among Least Charitable in Nation
- Watch: 8 Health Insurance Terms You Should Know
- OVID Health hires Edelman alum Davide Scalenghe to boost its international footprint
- Maintaining trust in medical AI: Monitoring and managing model lifecycle
- Maintaining trust in medical AI: Monitoring and managing model lifecycle
- Eli Lilly shoots for health in new Caitlin Clark ad campaign
- Journalists Shed Light on Deadly Hantavirus Outbreak and a Crisis in the Nation’s ERs
- The Make America Healthy Again Movement Comes for Hospital Food
- Remarks at the Conference on Financial Market Regulation
- Dad Jokes: Remarks at the 13th Annual Conference on Financial Markets Regulation
- RFK Jr. Launches Plan To Curb Antidepressant 'Overprescription'
- Skil-Care launches specialized healthcare product innovation program
- Remarks at the Special Competitive Studies Project AI+ Expo
- Plant-Based Foods May Help Lower Risk of High Blood Pressure
- Targeted Protein Degradation and Novel Modalities: Getting on the Frontline
- Super Shoes Might Increase Risk Of Running Injuries, Study Says
- TV, Movies Offer Flawed Depictions Of Autism, Add To Delayed Diagnosis, Study Says
- Opioid OD Survivors Have Triple Rate Of Repeat Overdoses Than Previously Estimated
- A New Medicare Option For Weight Loss Drugs: What Older Americans Should Know
- Exposure Therapy Can Successfully Ease Peanut Allergies
- Listen: A Federal Agency Is After Workers’ Health Data, and Critics Are Alarmed
- In California Governor Race, Single-Payer Is a Litmus Test. There’s Still No Way To Pay for It.
- Cruise Ship Hantavirus Outbreak Kills 3 as WHO Says Risk Is Low
- Remarks at the 13th Annual Conference on Financial Market Regulation
Medicaid reference emphasized in bold by me.
EXCLUSIVE: Calls Come for Fraud Investigations Into Ohio Day Cares
Rebecca Downs | December 30, 2025
FIRST ON THE DAILY SIGNAL—Suspicion of fraud in Minnesota appears to be just the tip of the iceberg. With fraud suspected in Ohio as well, state legislators are on the move. State Rep. Josh Williams, a Republican, is calling for immediate investigations into day care centers, specifically in the Columbus area.
On Tuesday, Williams sent a letter signed by dozens of other lawmakers to the Ohio Department of Children and Youth. The legislators are calling for “unannounced inspections” of daycare facilities that may be suspected of fraud in the Columbus area.
The letter, shared with The Daily Signal, emphasizes the “unannounced” nature, with such inspections described as “an essential tool to identify violations, deter fraudulent practices, and reinforce confidence in the oversight of publicly funded programs.”
“There have been widespread public reports alleging that certain childcare facilities participating in publicly funded childcare programs are fraudulently billing the State of Ohio for children who are not actually in attendance. These allegations raise serious concerns regarding program integrity, the responsible use of taxpayer dollars, and the overall credibility of Ohio’s publicly funded childcare system,” the letter shares.
The lawmakers speak of a further step as well.
“Taxpayer dollars must be protected, and entities found abusing publicly funded programs must be swiftly held accountable. Continuing to direct state funding to facilities suspected of fraudulent conduct is unacceptable, and the Ohio House of Representatives will act accordingly based on the findings and seriousness of this investigation,” the letter reads.
Williams also spoke to The Daily Signal about his aim in sending out such a letter, which is to get the executive branch to further use its authority. “It’s the legislative branch trying to put the onus on the executive branch to do your job and enforce the laws and regulations, which we think is lacking currently,” he said.
Getting to the bottom of such fraud, Williams stressed, requires “robust efforts” when looking into “suspicious” childcare facilities, with a focus on metropolitan areas. Better screening processes are also key.
Concern exists in Ohio because, as Williams put it, the state “is prime for fraud,” especially as it applies to Medicaid. The state representative spoke specifically of expanded programs involving in-house family members acting as aides.
Williams also wished to discuss a bigger picture, including as it applies to the Department of Government Efficiency.
The Ohio version of DOGE, he explained, is the state auditor, though the auditor cannot proactively probe for fraud, and has to do it in response to a call for action. This, Williams explained, is where “Ohio is lacking a little bit.”
DOGE’s aim to go after fraud, waste, and abuse at the state and federal level earned praise from Williams, who specifically cited President Donald Trump and called for such efforts at the state level. He also called out state Democrats who promote funding for a variety of “free” resources, including underperforming schools.
“That’s state tax dollars that could be allocated towards some of those programs to shore up the American dream for actual taxpaying Americans,” Williams added.
The state representative promises to continue following the issue, which also involved a discussion about who is alleged to be engaged in such fraud. Concerns abound about Somali communities in Minnesota.
“I don’t like to demonize any particular group of it, okay? But what we’re seeing is average Americans are not engaged in coordinated cross-level, cross-department type of fraud. It is a consolidated community that essentially has a code of silence and are actively participating in this style of fraud,” Williams offered.
“When it’s within a close-knit community that has a code of silence, that has their own cultural ideologies that are different than the American dream, it makes it prime for fraud, waste, and abuse.”
In addition to unannounced visits, lawmakers are also asking for audits into attendance records and billing submissions; to “immediately suspend or withhold any further state payments” to facilities “where inspections or audits indicate probable fraud”; refer cases to prosecuting authorities; provide the General Assembly with a summary of findings; and continued cooperation with the Ohio Department of Jobs and Family Services’ inspection programs and assets.
On Deck: California !
California likely next step in federal fraud probes after newest revelations in benefit programs
Fake student applications, Medicaid for illegal immigrants, and profligate food programs could make California the next target for federal scrutiny over allegations of benefit fraud.
By Steven Richards - January 2, 2026From fake student applications seeking aid to unapproved Medicaid benefits for illegal immigrants, California is shaping up to be the next battleground for entitlement fraud after mushrooming Minnesota scandals reminded Americans how much of their tax dollars get misused. Even Democrats like California's Rep. Ro Khanna are concerned the Golden State may have provided a golden opportunity for fraudsters.
President Donald Trump says the confirmed and alleged fraud in Minnesota, which was targeted at the state’s food assistance program, daycare facilities, and medical programs is small “peanuts” compared to the fraud in other states.
“California is worse, Illinois is worse and, sadly, New York is worse — a lot of other places,” Trump said during a New Year’s Eve event. “So, we’re going to get to the bottom of this.”
Tackling state-level fraud a bi-partisan matter
The suggestion that there is fraud in California’s social programs seems to have drawn bipartisan agreement. Khanna, who represents the Silicon Valley in the San Francisco Bay Area, has embraced efforts to tackle state-level fraud to build support for a new wealth tax and ensure its revenues are not wasted.
“If you want, as I do, to advocate for Medicare for all, to advocate for higher taxes, you have to have the public trust,” Khanna said in an interview with CNBC. “People need to have a receipt for what their money is going toward. You can’t have corruption in the government and waste in the government and then expect people to support the progressive ideals that I have.”
Khanna’s proposal, which he said would involve a bipartisan partnership with the House Oversight Committee to investigate state-level fraud, came after a recent report from the California State Auditor earlier this month which designated the state’s Department of Social Services a “high risk” to the financial health of the state as a result of its elevated nutrition assistance program’s high payment error rate.
The problem, according to the auditor, is the state’s CalFresh program, which administers federal Supplemental Nutrition Assistance Program (SNAP) funds. Due to changes in the One Big Beautiful Bill that President Donald Trump signed into law earlier this year, the federal government is no longer guaranteed to cover the whole cost of state programs.
States on the hook for excessive payments made in error
Instead, if states have a payment error rate above a certain threshold, the state is required to contribute anywhere from 5% to 15% of the total program cost with its own funding source. The payment error rate is the rate of over or underpayments of benefits. While California’s payment error rate of about 10% is in line with the national average, it lies above the 6% threshold imposed by the OBBB.
“Because the recent federal changes to SNAP will require California to shoulder part of the cost of the program’s benefits, CalFresh is now a high‑risk program. If the State does not decrease its [payment error rate], it will likely need to spend about $2 billion annually to maintain CalFresh benefits,” the state auditor warned.
“This is particularly concerning considering that California faces growing multiyear budget deficits, as well as a $20 billion operating deficit for SFY 2026–27. The addition of these significant, new state costs will jeopardize a key program for Californians in need and pose a serious impediment to balancing the State’s budget,” the report concluded.
Some states resisting cooperation to fight fraud
The Trump administration believes there is “massive fraud” within the SNAP and other federal benefits programs. Earlier this year, Agricultural Secretary Brooke Rollins requested that states turn over SNAP program data, but a coalition of states sued the administration to block access. California, the state with the greatest number of SNAP recipients at 5.3 million, led the lawsuit. In the data turned over by cooperating states, Rollins said the administration had already uncovered fraud.
One avenue of potential fraud is the growing number of apparent liquor stores and smoke shops that are approved as retailers under the program, which was designed to improve Americans’ nutrition during the Great Depression. According to the Foundation for Government Accountability, which shared the data with Just the News, nearly half of all the liquor and smoke shops it identified in the USDA database were located in California.
In addition to its food programs, California’s community college system has been the subject of growing financial aid fraud in recent years. According to the Los Angeles Times, more than 1.2 million fake students applied to community colleges across the state in 2024 alone.
Because every student that applies to the state schools is admitted, and there are more options for remote and hybrid classes since the COVID-19 pandemic, scammers use the fake profiles to cash in on both federal and state financial aid. According to the Times, the scammers–often running multiple student profiles at once–stay enrolled in classes long enough to collect aid for books, housing, food or other needs and use it for other expenses, like vacations and designer items.
Though the California Community Colleges system captures many of the fraudulent student profiles, data from the chancellor’s office show about $8.4 million in federal and $2.7 million in state aid were stolen in 2024, the Times reported.
In June, the Department of Education implemented new identity verification requirements after California Congressman Kevin Kiley sent a letter warning about the fraud in his state. Part of the changes include a new requirement for an applicant to present an unexpired, valid government ID. The department specifically cited the growth in aid fraud at California’s community colleges for its decision.
Inspector General: "California improperly claimed $52.7 million in Federal Medicaid"
Additionally, the federal Health Department has raised concerns about potential fraud in California’s Medicaid system. The Health and Human Services Department Inspector General determined earlier this year that the state improperly claimed $52.7 million in federal Medicaid reimbursement for payments made on behalf of illegal immigrants.
States are generally prohibited from using any federal money to cover care for such individuals and would normally have to pay out of their own state budgets if they provide care to illegal immigrants, the inspector general said in its May report.
“California improperly claimed $52.7 million in Federal Medicaid reimbursement because it continued to use the proxy percentage that was developed in the early 2000s without assessing whether the percentage correctly accounted for the costs of providing nonemergency services to noncitizens with [Unsatisfactory Immigration Status] under managed care. In addition, California did not have any policies and procedures for assessing and periodically reassessing the proxy percentage,” the inspector general wrote.
But this is only a part of the Medicaid story. There are also concerns that California is using a loophole in the law to funnel billions of federal dollars into paying for healthcare for illegal immigrants, according to a report released earlier this year by the Paragon Health Institute and the Economic Policy and Innovation Center.
According to the report, California “taxes Medicaid insurers and then makes higher payments to those same insurers with that tax revenue. The higher payments enable the state to claim additional federal matching dollars.” These surplus funds are then available to the state to use elsewhere, like expanding Medicaid services for illegal immigrants.
"The state of California, colluding with insurance companies who cover Medicaid beneficiaries, has created one of the most outrageous ones yet, a money laundering scheme that results in California obtaining more than $19 billion in federal money without any state contribution over the period from April 2023 through December 2026,” President of EPIC Paul Winfree told Fox News earlier this year.
From PowerLine Blog's TWiP ! 🤣
https://www.powerlineblog.com/archives/2026/01/the-week-in-pictures-the-coup-continues.php
@10x25mm that's excellent! Victor Davis Hanson has been talking about Medi-Cal fraud for years. I can't wait to see what the DOJ finds.
Get MHF Insights
News and tips for your healthcare freedom.
We never spam you. One-step unsubscribe.















