Wed, Oct 28
|Webinar
Where Enforcement Lands: What the 2026 National Health Care Fraud Takedown Signals for Health Plans
Who was charged, what the schemes had in common, and questions worth raising at your next leadership meeting.
Webinar Details
Oct 28, 2026, 12:00 PM – 1:00 PM EDT
Webinar
About the Event
In June 2026, the OIG and Justice Department announced the results of the National Health Care Fraud takedown that charged 455 defendants in schemes involving more than $6.5 billion, with a record number of Medicaid cases and data analytics driving much of the detection. Drawing on experience handling federal fraud cases from the government side, this session examines who was charged, the patterns the schemes shared, and how those patterns can show up in a plan's own claims and data.
What you will take away:
Understanding of the scope and priorities of the 2026 National Health Care Fraud Takedown, including its emphasis on Medicaid, data analytics, and individual accountability.
Understanding of the patterns that recurred across cases including kickbacks and medically unnecessary services.
Understanding of what a record enforcement year signals about the scrutiny plans can expect going forward.
Presenter
S. Jnatel Sims, J.D. is the President and Principal Consultant of Catapult Healthcare Consulting, LLC. She is a licensed attorney and compliance professional with more than 26 years of experience in business, legal, and government settings. Ms. Sims offers a distinctive perspective shaped by her experience on both sides of healthcare regulation as a government regulator and as a compliance leader within regulated entities. Before founding Catapult Healthcare Consulting, LLC, Ms. Sims served as a Senior Attorney in the Office of Inspector General for the U.S. Department of Health and Human Services. There, she negotiated and monitored Corporate Integrity Agreements, conducted OIG site visits, evaluated compliance programs, and handled cases involving federal healthcare fraud, waste, and abuse authorities. For her role in significant healthcare fraud matters, she earned the Inspector General’s Exceptional Achievement Award. Ms. Sims also has held executive-level roles within managed care companies and healthcare systems, where she developed and oversaw comprehensive compliance programs and provided strategic guidance to leadership and Boards on regulatory compliance and program performance.