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# Complete Health Partners pays $14.1M in Medicare Advantage upcoding settlement
- URL: https://members.americanhealthintel.com/2026-08-04-regulator/
- Published: 2026-08-04T09:51:00.000Z
- Updated: 2026-08-04T09:51:00.000Z
- Description: Plus: NY ophthalmology practices pay $2.3M in TCD kickback sweep. The day's rules, money, and enforcement, sourced and tiered below.
- Author: American Health Intel

Plus: NY ophthalmology practices pay $2.3M in TCD kickback sweep. The day's rules, money, and enforcement, sourced and tiered below.

| American Health Intel Rules · Money · Medicine · Decoded daily The Regulator Tuesday, August 4, 2026 Complete Health Partners pays $14.1M in Medicare Advantage upcoding settlement Plus: NY ophthalmology practices pay $2.3M in TCD kickback sweep. The day's rules, money, and enforcement, sourced and tiered below. ![](https://americanhealthintel.com/email/pulse-divider.png) Record A Jacksonville company that manages doctors' offices is paying $14.1 million after prosecutors say it told coders to add fake mental-health and addiction diagnoses just to collect bigger Medicare Advantage checks. The alleged scheme ran 2020-2023, adding unsupported codes for substance dependence and depressive, bipolar or paranoid disorders. The whistleblower, a former insurer risk-adjustment official, collects $2.47M. Record Two New York eye doctors' practices are paying $2.3 million over a scheme billing Medicare and Medicaid for unneeded brain-blood-flow ultrasounds, the same kickback scheme that started with five Florida eye practices in January. The kickback arrangement ran through a third-party testing company. Both NY practices signed cooperation deals with federal prosecutors, meaning more defendants in the multistate sweep are likely. Also today Michigan AG sues nursing home operator over $111M Medicaid fraud [Read](https://americanhealthintel.com/editions/2026-08-04-regulator/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#michigan-pioneer-nursing-home-medicaid-fraud) Baylor Scott & White and FirstCare exit Texas Medicaid managed care [Read](https://americanhealthintel.com/editions/2026-08-04-regulator/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#texas-medicaid-baylor-firstcare-mco-exit) FCC votes on Rural Health Care Program rule rewrite [Read](https://americanhealthintel.com/editions/2026-08-04-regulator/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#fcc-rural-health-care-program-fnprm) Senate Finance hearing on biotech and antibiotic pipeline resilience [Read](https://americanhealthintel.com/editions/2026-08-04-regulator/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#senate-finance-biotech-resilience-hearing) 374Records$31.6BEnforcement17Deadlines110Rules [Read this issue + the trackers](https://americanhealthintel.com/editions/2026-08-04-regulator/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) Pick your field on the site and every story tells you what it means for you. Reply to this email and tell us what you want covered. We read everything. We show our work. We score our own calls. [Track record](https://americanhealthintel.com/ledger/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [Calendar](https://americanhealthintel.com/calendar/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [Enforcement](https://americanhealthintel.com/enforcement/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [X](https://x.com/amhealthintel?ref=members.americanhealthintel.com) · [LinkedIn](https://www.linkedin.com/company/american-health-intel?ref=members.americanhealthintel.com) News and analysis, not legal, medical, coding, or investment advice.You subscribed at americanhealthintel.com · [Unsubscribe](%%{unsubscribe%5Furl}%%) |
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