Policy & Compliance

  • July 03, 2025

    Mich. Justices Turn Down Challenge To Med Mal Damage Cap

    Michigan's highest court won't weigh in on the constitutionality of the state's caps on medical malpractice awards, rejecting a federal district court's certified question Thursday.

  • July 03, 2025

    The Firms That Won Big At The Supreme Court

    The number of law firms juggling three or more arguments before the U.S. Supreme Court this past term nearly doubled from the number of firms that could make that claim last term.

  • July 03, 2025

    Breaking Down The Vote: The High Court Term In Review

    The U.S. Supreme Court once again waited until the term's closing weeks — and even hours — to issue some of its most anticipated and divided decisions.

  • July 03, 2025

    Supreme Court Takes Up Transgender Sports Bans

    The U.S. Supreme Court agreed Thursday to hear challenges to West Virginia and Idaho laws barring transgender athletes from competing on sports teams consistent with their gender identity, putting yet more anti-trans legislation to the test after upholding Tennessee's ban on gender-affirming care for minors this term. 

  • July 02, 2025

    9th Circ. Upholds Sutter Health's Win In Doc's Kickback Suit

    The Ninth Circuit refused to revive a gastroenterologist's constitutional challenge against Sutter Health alleging the nonprofit paid kickbacks to its physicians to refer low-income patients to other hospitals, ruling Wednesday the appellant lacks evidence of purported kickbacks and doesn't address how the alleged injury to those patients harmed him. 

  • July 02, 2025

    ACA Changes Will Result In Mass Coverage Loss, Suit Claims

    Doctors for America, the Main Street Alliance and a trio of cities urged a Maryland federal court to vacate recently finalized changes to Affordable Care Act regulations, arguing they will cause at least 1.8 million people to lose their healthcare coverage.

  • July 02, 2025

    Veterans Sue Air Force For Disability Review Failures

    Three former service members hit the U.S. Air Force with a proposed class action challenging the lawfulness of a screening process used to determine if people should be retained or referred to a formal disability evaluation process.

  • July 02, 2025

    DOJ, HHS Form New False Claims Act Enforcement Group

    Lead attorneys at the U.S. Department of Health and Human Services and the Justice Department will head a working group focused on enforcement of the False Claims Act, government officials announced Wednesday.

  • July 02, 2025

    Pa. Hospital Co. To Pay $2.75M Over Drug Theft Suit

    Pennsylvania healthcare company Lehigh Valley Hospital Network Inc. has agreed to pay the federal government $2.75 million to settle claims that it ran afoul of controlled substance laws when one of its pharmacy technicians allegedly stole medication on multiple occasions.

  • July 02, 2025

    6th Circ. Backs Cigna's Win In Emergency Room Billing Suit

    The Sixth Circuit has ruled that Cigna did not have to face an unjust enrichment lawsuit brought against it by two Tennessee hospitals alleging the insurer underpaid them for out-of-network emergency services, backing a lower court's dismissal order.

  • July 02, 2025

    Wisconsin High Court Narrowly Blocks 1849 Abortion Ban

    The Wisconsin Supreme Court on Wednesday narrowly struck down an 1849 statute criminalizing abortion, finding that the law has been effectively replaced by more modern legislation regulating the procedure.

  • July 01, 2025

    5 Healthcare Enforcement Actions You Don't Want To Miss

    A healthcare fraud operation announced by the Justice Department targeting $14.6 billion in potential false claims wasn't the only enforcement action making waves in the industry this past week.

  • July 01, 2025

    Texas Goes Big On New Healthcare Laws

    It may be mid-summer, but Texas lawmakers are sending doctors and lawyers back to school for a course on what constitutes a "medical emergency" for the purpose of a legal abortion. Law360 Healthcare Authority looks at that statute and other legislation becoming law in the Lone Star State.

  • July 01, 2025

    State AGs Sue Gov't To Halt Medicaid Data Sharing With ICE

    A California-led coalition of nearly two dozen state attorneys general is pushing a federal court to stop the U.S. Department of Health and Human Services from giving immigration officials "unfettered access" to Medicaid recipients' personal health information, arguing that the sharing flouts decades of policy and practice.

  • July 01, 2025

    Iowa Judge Halts Law Targeting Pharmacy Benefit Managers

    A federal judge in Des Moines has temporarily blocked an Iowa law regulating pharmacy benefit managers, delivering a significant victory to a coalition of local businesses that argued the statute overstepped federal authority and infringed on free speech.

  • July 01, 2025

    Lighting Co. Can't Escape 401(k) Forfeiture, Health Fee Suit

    An Illinois federal judge narrowed a proposed federal benefits class action against an automotive lighting company from an ex-worker, but allowed allegations to proceed to discovery alleging the company misspent 401(k) forfeitures and failed to properly notify workers about a health plan tobacco surcharge.

  • July 01, 2025

    High Court Ruling Puts Limits On Medicaid Enforcement

    The U.S. Supreme Court ruling that bars a Medicaid beneficiary from suing over her right to choose a medical provider could make more states comfortable following South Carolina’s lead and cutting off Medicaid funding for disfavored providers.

  • July 01, 2025

    Rural Clinics Win Reprieve For Telehealth Funds At High Court

    Thousands of rural healthcare clinics that rely on federal subsidies to provide telehealth services to millions of patients secured a major win when the U.S. Supreme Court ruled that the funding for a key Federal Communications Commission program is not unconstitutional.

  • July 01, 2025

    Top Personal Injury, Med Mal News: 2025 Midyear Report

    A U.S. Supreme Court ruling over whether personal injury claims can be brought under a RICO statute and a $7.4 billion settlement reached with the Sackler family and Purdue Pharma are among Law360's top personal injury and medical malpractice cases from the first six months of 2025.

  • July 01, 2025

    Dentons Adds Career Arnold & Porter Litigator In DC

    A career Arnold & Porter LLP attorney who spent more than 20 years with his former firm representing clients in False Claims Act litigation and other forms of commercial litigation has joined Dentons' Washington, D.C., office as a partner, the firm announced Tuesday.

  • July 01, 2025

    Anthem Inks $13M Deal To End Mental Health Class Action

    Anthem has agreed to pay about $12.9 million to end a proposed class action alleging the insurer's coverage denials for inpatient mental health and substance use disorder treatments violated federal benefits and mental health parity laws, according to New York federal court filings.

  • July 01, 2025

    RI Judge Orders Halt To HHS Layoffs, Reorganization

    A Rhode Island federal judge on Tuesday blocked the Trump administration from carrying out mass layoffs at the U.S. Department of Health and Human Services, finding the reorganization usurped congressional spending authority and likely violated the Administrative Procedure Act.

  • June 30, 2025

    Texas Panel Says Suit Challenging Abortion Travel Is Unripe

    A split Texas appeals court panel found Monday that several anti-abortion groups lack standing to sue the city of San Antonio for allegedly earmarking money to pay for out-of-state abortion travel, saying the money had not gone out yet and the groups' claims were not ripe.

  • June 30, 2025

    Justices Won't Disturb 10th Circ. Oklahoma PBM Law Ruling

    The U.S. Supreme Court on Monday declined to hear the state of Oklahoma's challenge to a Tenth Circuit decision that found parts of a recently enacted law regulating pharmacy benefit managers were preempted by federal benefits laws and Medicare Part D, cementing an industry group's win in the case.

  • June 30, 2025

    DOJ Says Over 300 Charged In $14.6B Healthcare Fraud Sting

    A healthcare fraud operation conducted by federal and state law enforcement groups netted more than 300 defendants in a slew of schemes amounting to $14.6 billion in potential false claims, the Justice Department announced Monday.

Expert Analysis

  • What To Expect From Calif. Bill Regulating PE In Healthcare

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    A California bill currently awaiting Gov. Gavin Newsom's approval, intended to increase oversight over private equity and hedge fund investments in healthcare, is emblematic of recent increased scrutiny of investments in the space, and may affect transactions and operations in California in a number of ways, say attorneys at Ropes & Gray.

  • Vertex Suit Highlights Issues For Pharma Fertility Support

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    Vertex Pharmaceuticals' recent lawsuit challenging the U.S. Department of Health and Human Services' interpretation of the Anti-Kickback Statute is influenced by a number of reproductive rights and health equity issues that the Office of Inspector General should address more concretely, including in vitro fertilization and fertility preservation programs, says Mary Kohler at Kohler Health Law.

  • CMS' New 'Breakthrough' Device Policy Shows Little Promise

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    The Centers for Medicare & Medicaid Services’ recent procedural notice outlining a new Medicare coverage pathway for breakthrough medical devices will, at best, be a failed experiment and, at worst, result in Medicare beneficiaries denied access to innovative treatments, say attorneys at King & Spalding.

  • A Preview Of AI Priorities Under The Next President

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    For the first time in a presidential election, both of the leading candidates and their parties have been vocal about artificial intelligence policy, offering clues on the future of regulation as AI continues to advance and congressional action continues to stall, say attorneys at Mintz.

  • Managing Community Health Needs Assessments: A Checklist

    Excerpt from Practical Guidance
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    To guide nonprofit hospitals and health systems through their required community health needs assessment every three years, this checklist outlines the steps for 12 phases of the process.

  • Pa. Health Employers Must Prep For Noncompete Restrictions

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    Newly enacted legislation in Pennsylvania prohibits certain noncompete covenants for healthcare practitioners in the state beginning next year, creating compliance challenges that both employers and employees should be aware of, say attorneys at Buchanan Ingersoll.

  • FTC Focus: What Access To Patent Settlements Would Mean

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    Settling parties should adopt a series of practice tips, including specifying rationales to support specific terms, as the Federal Trade Commission seeks to expand its access to settlements before the Patent Trial and Appeal Board, say Shannon McGowan and David Munkittrick at Proskauer.

  • Agencies Should Reward Corporate Cyber Victim Cooperation

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    The increased regulatory scrutiny on corporate victims of cyberattacks — exemplified by the U.S. Securities and Exchange Commission's case against SolarWinds — should be replaced with a new model that provides adequate incentives for companies to come forward proactively and collaborate with law enforcement, say attorneys at McDermott.

  • Strategies To Defend Against Healthcare Nuclear Verdicts

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    The healthcare industry is increasingly the target of megaclaims, particularly those alleging medical malpractice, but attorneys representing providers can use a few tools to push back on flimsy litigation and reduce the likelihood of a nuclear verdict, says LaMar Jost at Wheeler Trigg.

  • What Drug Cos. Must Know About NY Price Transparency Law

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    Drug manufacturers must understand the contours of New York's recently implemented law requiring self-reporting of drug price increases, as well as best practices for compliance and challenges against similar laws in other states, say Elizabeth Bierut and Angie Garcia at Friedman Kaplan.

  • Whistleblowers Must Note 5 Key Differences Of DOJ Program

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    The U.S. Department of Justice’s recently unveiled whistleblower awards program diverges in key ways from similar programs at other agencies, and individuals must weigh these differences and look first to programs with stronger, proven protections before blowing the whistle, say Stephen Kohn and Geoff Schweller at Kohn Kohn.

  • The Licensure Landscape For Psychedelics Manufacturers

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    As the need for bulk manufacturing of psychedelic substances grows, organizations aiming to support clinical trials or become commercial suppliers must navigate a rigorous and multifaceted journey to obtaining a license from the U.S. Drug Enforcement Administration, say Kimberly Chew at Husch Blackwell and Jaime Dwight at Promega Corp.

  • OSHA Workplace Violence Citation Highlights Mitigation Steps

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    The Occupational Safety and Health Administration's recent citation against behavioral health company Circles of Care sheds light on the enforcement risks companies may face for failing to prevent workplace violence, and is a reminder of the concrete steps that can help improve workplace safety, say attorneys at Benesch.