Policy & Compliance
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February 13, 2026
RFK Jr. Taps Ex-Jones Day Atty For FDA Senior Counselor
U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. has named a former Jones Day partner as one of the U.S. Food and Drug Administration's senior counselors, according to an announcement.
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February 13, 2026
States' Generic Drugs Antitrust Case Headed Toward Trial
A Connecticut federal judge has mostly refused to side with pharmaceutical companies facing states' generic drug price-fixing litigation against them, ruling that there are genuine disputes of material fact as to drug distribution chains and the states' antitrust standing and teeing up the case for trial.
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February 13, 2026
Docs Urge Judge To Block CDC's Childhood Vaccine Changes
Doctors organizations Friday urged a Massachusetts federal judge to stop the government from implementing its new, shorter list of recommended vaccines for children and prevent the next meeting of a committee they say has been tainted by anti-vaccine influence.
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February 13, 2026
Iowa AG Urges 8th Circ. To Unblock Parts Of State PBM Law
The state of Iowa urged the Eighth Circuit on Friday to lift a preliminary block on parts of a law limiting pharmacy benefit managers' power to set drug prices in the Hawkeye State, arguing a lower court judge erred in holding that parts of the policy were federally preempted.
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February 13, 2026
Breast Surgery Patients Want ERISA Class Cert. Rethink
A United Healthcare plan member asked a New Jersey federal judge to rethink her decision denying class certification in a suit alleging the insurer systematically refused to cover postmastectomy breast reconstruction claims, arguing the court overlooked evidence showing that common issues could be resolved on a classwide basis.
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February 13, 2026
FDA Removes Boxed Warnings From HRT Products
Six menopause hormone therapies will no longer have warnings on their label about heart disease, breast cancer and dementia, after the U.S. Food and Drug Administration said it removed them so that women can make decisions "free from exaggeration or fear."
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February 12, 2026
Trump Admin. Blocked From Cutting $600M In Health Funding
An Illinois federal judge on Thursday temporarily blocked the Trump administration from terminating more than $600 million in public health funding to four Democratic-led states, saying the states will likely succeed in showing they are unconstitutionally being targeted due to political or policy objectives.
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February 12, 2026
Feds Charge 2 Foreign Nationals Over $10M Healthcare Fraud
Federal officials in Chicago announced healthcare fraud charges Thursday against two natives of Pakistan who allegedly made $10 million by using fake medical companies to submit Medicare and other health benefit claims for items and services they never provided.
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February 12, 2026
DC Circ. Judge Rips Into Insurer In CMS Rating Case
A Louisiana insurer found a tough critic in one D.C. Circuit judge Thursday as it argued that the Centers for Medicare & Medicaid Services used an unfair method to assess its "star ratings" for insurance plans, with the jurist saying the company seemed like it "just wanted whatever interpretation will give you a higher score."
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February 12, 2026
Ex-Pharma Exec Fights AGs' Quick Win Bid In Antitrust Case
A former pharmaceutical marketing executive urged a Connecticut federal court to reject summary judgment sought against him by state attorneys general pursuing wider price-fixing litigation against most of the generic drug industry, arguing key cooperating witnesses' questionable credibility makes a trial necessary.
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February 12, 2026
Goodwin Expands Healthcare Team With Ex-Reed Smith Atty
A healthcare attorney specializing in guiding clients through regulatory and transactional matters has moved her practice to Goodwin Procter LLP's Philadelphia office after more than 11 years with Reed Smith LLP.
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February 11, 2026
AbbVie Sues Medicaid, HHS Over Botox Fair Price Controls
AbbVie Inc. on Wednesday asked a D.C. federal court to block the Centers for Medicare and Medicaid Services from controlling the price of Botox under the Inflation Reduction Act, arguing the cosmetic drug and migraine treatment should be excluded from the controls because it's a "plasma-derived" product.
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February 11, 2026
Ex-Lt. Col. Sues Hegseth Over Son's Benefits Denial
A former U.S. Army lieutenant colonel sued Defense Secretary Pete Hegseth and the Defense Health Agency on Wednesday, alleging his son was wrongfully denied health care coverage for continued inpatient mental health treatment, leaving in limbo more than $270,000 in costs.
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February 11, 2026
Anesthesia Group Looks To End FTC Rollup Suit
U.S. Anesthesia Partners has urged a Texas federal court to end the Federal Trade Commission's case accusing the group of buying competing practices through a so-called rollup strategy, asserting that enforcers have no evidence of any harm to competition.
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February 11, 2026
Judge Won't Review Tossed ERISA Claim In Benefits Dispute
An Ohio federal court refused Wednesday to reconsider a recent decision dismissing a woman's Employee Retirement Income Security Act claims against her husband's employer and several UnitedHealth Group Inc. companies that administered the couple's employee health benefits.
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February 11, 2026
HHS Says RFK Jr. Trans Care Policy View Not Legally Binding
Health and Human Services Secretary Robert F. Kennedy Jr.'s declaration supporting the Trump administration's move to cut funding to hospitals that provide gender-affirming care is a nonbinding policy view, his agency told an Oregon federal court, and doesn't trigger provider exclusions from federal health programs.
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February 11, 2026
Organ Donor Network Must Face Veteran's Waitlist Bias Suit
A Black veteran who alleges his kidney transplant timeline was delayed because the United Network for Organ Sharing artificially inflated his kidney function scores can proceed with his Title VI lawsuit, a Georgia federal judge ruled, denying the network's bid to have the suit tossed.
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February 11, 2026
Trans Health And Pediatric Groups Challenge FTC Subpoenas
A major transgender medical group and a pediatric healthcare organization are seeking to end what they call "unlawful" consumer protection investigations from the Federal Trade Commission that want information pertaining to the medical groups' claims made in their marketing and advertising for gender-affirming care for minors.
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February 11, 2026
Mass. AG Charges Medical Transport Co. With Billing Fraud
A nonemergency medical transportation provider and its former owner are facing criminal charges for allegedly billing Massachusetts' Medicaid program for tens of thousands of fake rides and laundering the proceeds to accounts in Uganda, according to a Wednesday announcement.
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February 11, 2026
Kaiser Will Pay $30M To End DOL Mental Health Investigations
Kaiser Permanente has agreed to fork over at least $30 million and change its practices to end multiple U.S. Department of Labor investigations into the adequacy of the healthcare organization's mental health and substance use disorder treatment networks in California, the DOL said.
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February 10, 2026
US Says Abbott Lied, Must Repay Funds Spent On Formula
Abbott Laboratories must face the federal government's lawsuit over the 2022 infant formula crisis caused by the discovery of potentially deadly bacteria in a facility that made baby formula, prosecutors told a Michigan federal court, saying the company "repeatedly lied" about the cleanliness of its plant.
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February 10, 2026
Ex-DOJ Fraud Prosecutors Launch DC White Collar Boutique
Two former U.S. Department of Justice fraud prosecutors are opening their own Washington, D.C., boutique firm to represent clients in complex fraud and white collar cases, they said Tuesday.
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February 10, 2026
PBMs Enter New Era Of Legal Scrutiny
The recent government funding bill includes extensive reforms for the embattled pharmacy benefit manager industry. It may presage a new wave of agency scrutiny, regulatory action and lawsuits, including from PBMs.
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February 10, 2026
Abortion Rules, Vaccine Recommendations And More In Court
Abortion restrictions in Arizona are facing a new legal challenge, and an interstate clash over abortion pills is heating up. Here, Law360 Healthcare Authority takes a look at the week's top healthcare news.
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February 10, 2026
Wash. Panel Says Healthcare Cost-Share Group Is An Insurer
A Utah-based healthcare cost-sharing nonprofit operates as and must register as an insurer under Washington state law, a state appeals panel ruled, upholding a $50,000 fine from the state's insurance commissioner that found the nonprofit ran afoul of Washington insurance law.
Hospitals Face 'Perfect Storm' Of Fed. Cuts, Revenue Strains
Facing federal budget cuts, soaring labor costs and a rising tide of uninsured patients, U.S. hospitals are approaching a financial cliff that could trigger a wave of closures nationwide.
Record FCA Haul Sends 'Loud' Message On Federal Priorities
Aggressive enforcement by President Donald Trump's administration and the qui tam bar's success prosecuting fraud even without government intervention helped fuel the explosion in recoveries under the False Claims Act last year, experts say.
Blip Or Trend? FDA Guidance Fell Off Steeply In 2025
The U.S. Food and Drug Administration issued far less industry guidance last year after President Donald Trump returned to office. The change has pharmaceutical attorneys bracing for more unpredictability.
Expert Analysis
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How State FCA Activity May Affect Civil Fraud Enforcement
A growing trend of state attorneys general enforcing their False Claims Act analogues independently of the U.S. Department of Justice carries potential repercussions for civil fraud enforcement and qui tam litigation considerations, say Li Yu at Bernstein Litowitz, Ellen London at London & Naor and Gwen Stamper at Vogel Slade.
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Wage-Based H-1B Rule Amplifies Lottery Risks For Law Firms
Under the wage-based H-1B lottery rule taking effect Feb. 27, law firms planning to hire noncitizen law graduates awaiting bar admission should consider their options, as the work performed by such candidates may sit at the intersection of multiple occupational classifications with differing chances of success, says Jun Li at Reid & Wise.
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Assessing Compliance Risks Around TrumpRx Participation
As there are novel compliance obligations and potential political opposition related to the new TrumpRx online drug platform, companies intending to participate on the site should consider the pressure points that are likely to draw enforcement scrutiny, say attorneys at Sheppard.
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Predicting Actual Impact From CDC's New Vaccine Guidance
Recent federal changes to the childhood immunization schedule, reducing the number of vaccine recommendations from 18 to 11, do not automatically create enforceable obligations for parents, schools or healthcare providers, but may spur litigation and other downstream effects on school policies and state guidelines, says Mehdi Sinaki at Michelman & Robinson.
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What Rescheduling Means For Cannabis Labels, Marketing
The proposed reclassification of cannabis is expected to bring heightened scrutiny of labeling, advertising and marketing from the U.S. Food and Drug Administration and the Federal Trade Commission, but the brands that tighten evidence, standardize operations and professionalize marketing controls now will see fewer surprises and better outcomes, say attorneys at Wilson Elser.
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What's At Stake In Possible Circuit Split On Medicaid Rule
A recent Eleventh Circuit decision, reviving Florida's lawsuit against a federal rule that reduces Medicaid funding based on agreements between hospitals, sets up a potential circuit split with the Fifth Circuit, with important ramifications for states looking to private administrators to run provider tax programs, say Liz Goodman, Karuna Seshasai and Rebecca Pitt at FTI Consulting.
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Courts' Rare Quash Of DOJ Subpoenas Has Lessons For Cos.
In a rare move, three federal courts recently quashed or partially quashed expansive U.S. Department of Justice administrative subpoenas issued to providers of gender-affirming care, demonstrating that courts will scrutinize purpose, cabin statutory authority and acknowledge the profound privacy burdens of overbroad government demands for sensitive records, say attorneys at ArentFox Schiff.
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Remote Patient Monitoring Is At Regulatory Inflection Point
With remote patient monitoring at the center of new federal pilot programs and a recent report from the U.S. Department of Health and Human Services' Office of Inspector General examining Medicare billing for those services, it is clear that balancing innovation and risk will be a central challenge ahead for digital health stakeholders, say attorneys at Morgan Lewis.
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Utah's AI Prescription Renewal Pilot Could Inform Policy
Utah recently became the first state to approve an artificial intelligence system for autonomously renewing certain prescription medicines, providing a test case for how regulators may be able to draw boundaries between administrative automation and medical judgment, say Jashaswi Ghosh at Holon Law Partners and Bryant Godfrey at Foley Hoag.
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Ramped Up Psychedelic Production Carries Opportunity, Risk
Kimberly Chew at Husch Blackwell discusses the key legal implications of the U.S. Drug Enforcement Administration's recent dramatic increases in the production quotas for a range of psychedelic substances, offering guidance on compliance, risk management and strategic opportunities for practitioners navigating this rapidly evolving landscape.
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New Biotech Nat'l Security Controls May Have Blunted Impact
While the newly enacted federal prohibition against contracting with certain biotechnology providers associated with countries of concern may have consequences on U.S. companies' ability to develop drugs, the restrictions may prove to be less problematic for the industry than the significant publicity around their passage would suggest, say attorneys at Wilson Sonsini.
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Takeaways From The DOJ Fraud Section's 2025 Year In Review
Former acting Principal Deputy Chief Sean Tonolli of the U.S. Department of Justice's Fraud Section, now at Cahill Gordon, analyzes key findings from the section’s annual report — including the changes implemented to adapt to the new administration’s priorities — and lays out what to watch for this year.
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Traditional FCA Enforcement Surges Amid Shifting Priorities
The U.S. Department of Justice’s January report on False Claims Act enforcement in fiscal year 2025 reveals that while the administration signaled its intent to expand FCA enforcement into new areas such as tariffs, for now the greatest exposure remains in traditional areas like healthcare — in which the risk is growing, say attorneys at Debevoise.