Overview

Don't make leadership, AI, or compliance decisions in healthcare without understanding how DOJ and whistleblowers are evaluating your data in 2026.In The 2026 DOJ & FCA Healthcare AI Risk Map, healthcare compliance and AI governance expert Salimah Muhammad explains how federal enforcement actually evaluates leadership oversight, AI-driven workflows, and False Claims Act risk in 2026-and how healthcare organizations can protect themselves before audits begin. Built in alignment with Gibson Dunn's 2025-2026 DOJ and FCA updates, this book breaks down how the Department of Justice, whistleblowers, and regulators identify enforcement targets using data patterns, automation signals, and documentation gaps-long before an audit letter arrives. Whether you are a healthcare executive, board member, compliance leader, administrator, or private equity sponsor, this guide provides clarity on where AI, automation, and vendor tools quietly create liability-and how to convert assumed compliance into court-safe oversight. Drawing on over 15 years of experience supporting CMS, NCQA, and HEDIS audits, Muhammad translates complex enforcement logic into practical, actionable guidance. Readers learn how to recognize high-value enforcement zones, implement Human-in-the-Loop (HITL) accountability, and document leadership decisions in ways that withstand DOJ scrutiny. This book is essential for healthcare organizations using AI in clinical, coding, utilization, or administrative workflows-and for leaders who remain fully accountable for outcomes, even when decisions are automated.

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