A federal jury has convicted the founders of Done, one of the fastest-growing telehealth companies in the stimulant-prescribing space, for orchestrating one of the largest Adderall distribution and fraud schemes in U.S. history. More than 40 million stimulant pills, over $100 million in revenue, and a business model engineered around speed, volume, and automated prescribing — all built with no real clinical guardrails.

In this episode, host Alex Yarijanian breaks down not only what happened, but what this case means for the entire digital health ecosystem, especially behavioral health and companies prescribing controlled substances. When a company like Done collapses — and its founders now face up to 20 years in federal prison — it doesn’t just take itself down. It drags trust, access, and payer willingness down with it.

Alex outlines how this case will reshape:

• Payer contracting and credentialing
• Prescribing oversight and compliance expectations
• Trust in telehealth platforms
• The future of value-based behavioral health
• Why incentives — good or bad — always scale

And most importantly, he explains why value-based care is the antidote to the shortcuts and misaligned incentives that fueled this scandal.

If you’re building, funding, regulating, or partnering with telehealth organizations, this is a must-listen.

Takeaways:

• The case of the telehealth startup highlights the critical importance of clinical oversight in health services.
• Payers are likely to impose stricter regulations on telehealth providers following recent fraudulent activities.
• Building a sustainable healthcare model requires prioritizing patient interests over profit maximization strategies.
• The future of digital health will hinge on trust, necessitating alignment between clinical and business models.

Medicare’s 2026 physician fee schedule is packed with change — but change means opportunity. In this episode of the VBCA Podcast, Alex Yarijanian breaks down the five biggest updates every provider and startup should know:

• Shorter, billable windows for remote monitoring
• New behavioral health add-ons to primary care
• Incentives that reward value-based care
• Expanded reimbursement for digital therapeutics & telehealth
• A major shift from inpatient to outpatient procedures

Whether you’re running a clinic or building the next health tech solution, this playbook will help you turn policy into profit and thrive in the future of care.

Welcome back to the Value-Based Care Advisory podcast! In this episode, host Alex Yarijanian delves into the significant updates and strategies for 2026 in the Medicare Advantage space. He covers essential news and policy changes, including a 5% increase in Medicare payment rates, the scaling back of supplemental benefits, and the permanence of telehealth for behavioral health. Alex also discusses updates to the Medicare physician fee schedule, redesigned enrollment forms, new health risk assessment requirements, and the transition to a new risk adjustment model. Learn how these changes will impact care delivery, compliance, and strategy, and discover what it takes to thrive in this evolving landscape. Tune in and prepare for the Medicare Advantage showdown of 2026!

00:00 Welcome to the Value-Based Care Advisory Podcast

00:15 2026 Medicare Advantage Showdown Overview

01:24 Key Policy Updates for 2026

03:11 Telehealth and Virtual Care Innovations

04:39 Enrollment and Form Updates

06:12 Risk Adjustment and Star Ratings

08:52 Strategic Focus Areas for 2026

14:44 Final Thoughts and Conclusion

Takeaways:

• The 2026 Medicare Advantage payments are set to increase by approximately 5%, contributing an excess of $25 billion to the plans.
• Significant changes have been initiated regarding supplemental benefits, particularly affecting non-medical services like transportation and meals.
• Telehealth services for behavioral health will become a permanent fixture, with no geographic restrictions imposed from 2026 onward.
• New billing codes will be introduced for digital therapeutics and remote monitoring, enhancing the infrastructure for virtual care delivery.
• The upcoming risk adjustment model will utilize the full 2024 CMS HCC risk model, significantly impacting financial strategies for Medicare Advantage organizations.
• Plans must prioritize compliance and operational integrity to navigate the complexities of changing regulations and maintain their competitive edge.