Treasury Targets Fraud Schemes Exploiting Government Health Care Benefits
FinCEN issued an advisory, in coordination with the FBI and HHS-OIG, urging financial institutions to identify and report suspicious transactions potentially related to fraud schemes targeting Medicare, Medicaid, and other federal and state health care benefit programs. FinCEN stated that the advisory outlines common fraud typologies, including the use of straw owners and shell companies to enroll as providers, the submission of false claims for nonexistent or unnecessary care, and the laundering of fraud proceeds through domestic and foreign accounts, digital assets, and layered transactions. The Treasury also announced a proposed rule to establish a whistleblower payment framework for eligible tips involving Bank Secrecy Act violations, sanctions violations, and other covered financial misconduct.
CMS Begins Enforcement of New Hospital Price Transparency Requirements
CMS began enforcing updated hospital price transparency requirements on April 1, 2026, following policy changes that took effect January 1, 2026. The revised requirements focus on hospitals’ machine-readable files and are intended to make posted pricing information more accurate, standardized, and comparable across facilities. Among other changes, CMS replaced the prior “estimated allowed amount” field with new allowed-amount data elements, updated attestation requirements, and required hospitals to include organizational NPIs.