Policy & Compliance

  • 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.

  • June 30, 2025

    High Court Turns Away Fired Christian Workers' Vax Bias Case

    The U.S. Supreme Court on Monday declined to review a Third Circuit ruling that shuttered Christian workers' suits claiming a healthcare system illegally fired them for opposing its COVID-19 vaccine mandate, despite the workers' assertions that the opinion improperly constricted their religious rights.

  • June 30, 2025

    Trump Administration Says Harvard Violated Civil Rights Law

    The Trump administration on Monday informed Harvard University that it had run afoul of federal civil rights law by failing to protect Jewish and Israeli students on campus from harassment, and threatened to cut all funding from the nation's oldest university.

  • June 30, 2025

    Justices Undo Patients' Win In Gender-Affirming Care Fight

    The U.S. Supreme Court on Monday struck down a Fourth Circuit decision that preserved access to gender-affirming care under two state-run health plans, telling the lower court to consider a recent decision by the justices that upheld a Tennessee law limiting treatments for young transgender people.

  • June 27, 2025

    Feds Prevail Over J&J In Another 340B Rebate Dispute

    A D.C. federal judge granted a summary judgment win Friday to the U.S. Health Resources and Services Administration over Johnson & Johnson, finding the agency acted within its discretion when it rejected the company's program to offer rebates instead of discounts in a decades-old drug pricing program.

  • June 27, 2025

    Patient Monitoring Co. To Pay Feds $1.3M To Settle FCA Suit

    A Georgia healthcare patient monitoring company has agreed to pay nearly $1.3 million to resolve a False Claims Act suit alleging it gave referral kickbacks to doctors' offices in half a dozen states, ripping off Medicare and Medicaid in the process.

  • June 27, 2025

    Judge Lets DOGE Access Go On But Cites 'Grave' Concerns

    A D.C. federal judge Friday voiced his "grave" concerns about the White House's Department of Government Efficiency obtaining personal information, but the district court declined to stop the U.S. Department of Labor and U.S. Department of Health and Human Services from giving this access.

Expert Analysis

  • When Banks Unknowingly Become HIPAA Biz Associates

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    There appears to be significant confusion regarding the application of the Health Insurance Portability and Accountability Act to financial institutions when serving healthcare-related clients, so these institutions should consider undertaking several steps as a starting point in the effort to achieve compliance, say attorneys at Vorys.

  • The Regulatory Headwinds Facing Lab-Developed Tests

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    Though the U.S. Food and Drug Administration's final rule regarding regulation of laboratory-developed tests outlines a four-year plan for ending enforcement discretion, and though this rule is currently being challenged in courts, manufacturers should heed compliance opportunities immediately as enforcement actions are already on the horizon, say attorneys at Kirkland & Ellis.

  • 3 High Court Rulings May Shape Health Org. Litigation Tactics

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    Three separate decisions from the U.S. Supreme Court's most recent term — Loper Bright, Corner Post and Jarkesy — will likely strengthen healthcare organizations' ability to affirmatively sue executive agencies to challenge regulations governing operations and enforcement actions, say attorneys at McDermott.

  • A New Way Forward For COVID Vaccine Lawsuit Immunity

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    As Public Readiness and Emergency Preparedness Act protections for COVID-19 vaccines wane, adding those vaccines to coverage by the National Vaccine Injury Compensation Program would bolster defenses for administrators and manufacturers while also providing stronger remedies for those injured by vaccines, says Altom Maglio at MCT Law.

  • Why DOJ's Whistleblower Program May Have Limited Impact

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    The U.S. Department of Justice’s new whistleblower pilot program aims to incentivize individuals to report corporate misconduct, but the program's effectiveness may be undercut by its differences from other federal agencies’ whistleblower programs and its interplay with other DOJ policies, say attorneys at Milbank.

  • How Cos. With Chinese Suppliers Should Prep For Biotech Bill

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    A proposed bill to prohibit government-affiliated life sciences companies from contracting with Chinese biotech companies of concern may necessitate switching to other sources for research and supplies, meaning they should begin evaluating supply chains now due to the long lead times of drug development, say John O'Loughlin and Christina Carone at Weil Gotshal.

  • FTC's Drug Middlemen Probe Highlights Ongoing Scrutiny

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    The Federal Trade Commission's interim staff report on its inquiry into pharmacy benefit managers suggests that the industry will remain under an enforcement microscope for the foreseeable future due to concerns about how PBMs affect drug costs and accessibility, say attorneys at Arnold & Porter.

  • What Cos. Should Note In DOJ's New Whistleblower Pilot

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    After the U.S. Department of Justice unveiled a new whistleblower pilot program last week — continuing its efforts to incentivize individual reporting of misconduct — companies should review the eligibility criteria, update their compliance programs and consider the risks and benefits of making their own self-disclosures, say attorneys at Skadden.

  • Motion To Transfer Venue Considerations For FCA Cases

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    Several recent decisions highlight the importance for practitioners of analyzing as early as possible whether a False Claims Act case warrants a change of venue, and understanding how courts weigh certain factors for defendants versus whistleblowers, say Ellen London at London & Stout, and Li Yu and Corey Lipton at DiCello Levitt.

  • A Primer On EU's Updated Human Substance Regulations

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    The European Union's updated standards regarding quality and safety of substances of human origin meant for human application carry significant implications for companies that work with cells and tissues, and U.S. companies active in the EU market should pay particular attention to the import and export rules, say Geneviève Michaux and Georgios Symeonidis at King & Spalding.

  • CFPB's Medical Debt Proposal May Have Side Effects

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    The Consumer Financial Protection Bureau’s recent proposal to prevent medical debt information from appearing on consumer reports and creditors from basing lending decisions on such information may have initial benefits for some consumers, but there are potential negative consequences that should also be considered, say attorneys at Cooley.

  • 15 Areas That Would Change Under Health Data Rule Proposal

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    If finalized, the Office of the National Coordinator for Health Information Technology's proposed rule will significantly progress its efforts to advance interoperability, respond to stakeholder concerns and clarify compliance with the health IT certification program, say attorneys at Ropes & Gray.

  • 3 Healthcare FCA Deals Provide Self-Disclosure Takeaways

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    Several civil False Claims Act settlements of alleged healthcare fraud violations over the past year demonstrate that healthcare providers may benefit substantially from voluntarily disclosing potential misconduct to both the U.S. Department of Justice and the U.S. Department of Health and Human Services, say Brian Albritton and Raquel Ramirez Jefferson at Phelps Dunbar.