HHS Cracks Down on Healthcare Fraud While States Brace for Medicaid Changes

Welcome to your weekly HHS update, listeners. This week’s top headline: The Trump Administration announced a major crackdown on Medicare and Medicaid fraud on February 26, according to a CMS press release, deferring $259.5 million in quarterly Medicaid funding to Minnesota, imposing a six-month moratorium on new Medicare enrollments for certain medical supply companies, and launching the CRUSH initiative to uncover suspicious billing—after stopping over $1.5 billion in fraud last year. Key developments include the House Energy and Commerce Committee’s March 3 letters to ten states like California and New York, demanding details on Medicaid fraud in areas like behavioral analysis and non-emergency transport, per Health Management Associates. Pharmacy benefit managers face heat too: The FTC finalized a settlement with Express Scripts requiring business practice overhauls, while the Consolidated Appropriations Act of 2026 mandates transparency in commercial insurance and Medicare Part D. CMS’s proposed 2026 Notice of Benefit and Payment Parameters hikes user fees but adds HIV PrEP to risk models for better access, and a D.C. court struck down HRSA’s child site registration for 340B drug discounts, freeing hospitals from that rule. These hit hard: Everyday Americans gain from fraud crackdowns protecting taxpayer dollars and affordability, but states like Montana launching Medicaid work requirements by July—with a grace period to October—could disenroll non-compliant folks, prompting $4.3 million in new staffing. Businesses, especially PBMs and suppliers, face compliance burdens and moratoriums, while hospitals benefit from 340B relief. States must ramp up integrity efforts or risk funding cuts. HHS Secretary Robert F. Kennedy Jr. emphasized, “We’re protecting patients and taxpayers.” Experts at King & Spalding note this boosts program sustainability. Watch Montana’s July rollout, CRUSH RFI comments due March 30, and FY26 appropriations with $4.6 billion for community health centers and telehealth extensions to 2027. For more, visit HHS.gov or CMS.gov. Submit CRUSH feedback now. Thanks for tuning in, listeners—subscribe for updates. This has been a Quiet Please production, for more check out quietplease.ai. For more http://www.quietplease.ai Get the best deals https://amzn.to/3ODvOta This content was created in partnership and with the help of Artificial Intelligence AI.