Policy & Compliance

  • September 19, 2025

    Ga. Providers Seek Exit From 'Conspiratorial' BCBS Fraud Suit

    Healthcare consulting firm HaloMD and several providers urged a federal judge Friday to toss a lawsuit from Blue Cross Blue Shield of Georgia accusing them of abusing a federal dispute resolution process for surprise medical bills, arguing the insurer's suit offers little more than "inflammatory, conspiratorial rhetoric."

  • September 19, 2025

    CDC Panel Urges Caution On COVID Vax, Punts On Hep B

    A panel of advisers at the Centers for Disease Control and Prevention on Friday voted unanimously to recommend that people receiving the COVID-19 vaccine this season do so only after discussing it with their health providers.

  • September 18, 2025

    Brothers Blame Associate For $90M HIV Drug Fraud Scheme

    Two Maryland brothers accused of selling $90 million worth of mislabeled HIV drugs told a Florida federal jury on Thursday that their charges stem from an associate hired for his pharmaceutical industry connections, but who instead lied about the medication's black market origins and told them it was purchased legitimately.

  • September 18, 2025

    Mich. Top Court To Weigh Medicare's Role In No-Fault Cases

    Michigan's highest court will weigh whether an injured driver who opted out of personal injury protection due to his Medicare coverage must offset his damages by billing the insurance program for accident-related medical expenses in a no-fault dispute. 

  • September 18, 2025

    HHS Shutters Miami Organ Donor Org. For 'Unsafe' Practices

    Federal health officials have decertified a Miami-based organ procurement organization that arranges organ donations after an investigation found a pattern of "unsafe" practices, marking the first time the federal government has revoked the certification of such a group, according to an announcement Thursday from Health Secretary Robert F. Kennedy Jr. 

  • September 18, 2025

    Elevance Won't Cover Zepbound To Treat Apnea, Patient Says

    Elevance Health, formerly known as Anthem Inc., arbitrarily excludes coverage of FDA-approved Zepbound to treat moderate to severe obstructive sleep apnea and refuses to consider requests for exceptions by maintaining that the medication is for weight loss, alleges a proposed class action filed by an enrollee in Indiana federal court Tuesday.

  • September 18, 2025

    Senate Confirms Trump's Pick To Lead DOL Benefits Arm

    The Senate confirmed fiduciary liability insurance expert Daniel Aronowitz on Thursday to lead the U.S. Department of Labor's employee benefits division, which oversees regulation and enforcement of employer-provided health and retirement plans.

  • September 18, 2025

    Couple Slam NC Defense Attys In Hospital Negligence Appeal

    A couple pursuing negligence claims against a local hospital scoffed at the idea that they were lurking on the sidelines waiting to cash in on a favorable outcome in a similar case, telling the North Carolina appeals court to ignore an amicus brief by defense attorneys arguing as much.

  • September 18, 2025

    1st Circ. Won't Lift Block On HHS Job, Program Cuts

    The First Circuit on Wednesday rejected a bid by the Trump administration to let it move ahead with cutting 10,000 jobs and end a number of programs at the U.S. Department of Health and Human Services while it appeals a Rhode Island federal judge's order temporarily barring the plan.

  • September 18, 2025

    Withheld Email Not Enough To Revive Doc's Retaliation Suit

    A psychiatrist failed to convince the Second Circuit to reinstate his suit claiming a New York City-area hospital system forced him out because he raised patient safety concerns, with the appeals court saying he couldn't show the hospital's omission of an email during discovery was purposeful.

  • September 17, 2025

    J&J Whistleblowers Defend $1.6B False Claims Act Win

    Whistleblowers filed a brief Wednesday in the Third Circuit in a closely watched False Claims Act appeal involving a $1.6 billion judgment against Johnson & Johnson unit Janssen as well as the constitutionality of the FCA's "qui tam" whistleblower provisions, arguing that the act's lawfulness has been settled by its "unbroken 162-year history."

  • September 17, 2025

    FDA Says Vape Manufacturer Lying About Marketing Approval

    The U.S. Food and Drug Administration on Tuesday sued manufacturers of flavored vapes in New Jersey federal court to seek an end to their sales, saying that they are falsely representing that their products had received marketing approval.

  • September 17, 2025

    3rd Circ. Weighs Limits On NJ Medical Aid In Dying Act

    The Third Circuit on Wednesday considered whether a Delaware woman with terminal cancer can challenge New Jersey's residency requirement for medical aid in dying, even though she has yet to be certified as having six months or less to live.

  • September 17, 2025

    Hospital Agrees To End Retirement Plan Fee, Investment Suit

    A New York hospital system told a federal court Wednesday it will end a proposed class action alleging it failed to remove underperforming investment options from its retirement plan and keep an eye on administrative costs, losing millions of dollars of employees' savings.

  • September 17, 2025

    Ex-CDC Head Says RFK Jr. Urged Vax Schedule Rubber Stamp

    Susan Monarez, the former head of the Centers for Disease Control and Prevention, told federal lawmakers on Wednesday she was abruptly fired just weeks into her tenure for "holding the line on scientific integrity."

  • September 16, 2025

    Dr.'s COVID Falsehoods Are Free Speech, Wash. Panel Says

    A Washington state appeals court unanimously ruled Tuesday that the Washington Medical Commission overstepped its authority by punishing a doctor for COVID-19 falsehoods he published to his blog, but affirmed the commission's decision to discipline him for prescribing ivermectin to COVID-19 patients.

  • September 16, 2025

    Harborview Nurses In Ga. Score Collective Status In OT Suit

    A pair of nurses who worked at Harborview Health Systems' facility in Rome, Georgia, brought enough evidence to show they and other similarly situated nurses were subjected to pay practices that shorted them on overtime wages to proceed as a collective action, a New York magistrate judge said Tuesday.

  • September 16, 2025

    Merck Says Vaccine Case 'Poor Vehicle' For Antitrust Review

    Merck & Co. told the U.S. Supreme Court to reject a bid from physicians looking to revive antitrust claims over submissions the pharmaceutical giant made to federal regulators concerning its mumps vaccine, arguing that the case is "an exceptionally poor vehicle" for review.

  • September 16, 2025

    FTC Ends Director Overlap In Healthcare Space

    The Federal Trade Commission said three members of Sevita Health's board of directors resigned after enforcers flagged an overlap with the board of a competing provider of specialty healthcare for people with intellectual and developmental disabilities.

  • September 16, 2025

    Oregon Joins Expansion Of '5NP' Acupuncture Practice

    Oregon has joined a number of states that have enacted laws that make it easier for people to get a "five needle" therapy with a raft of mental health benefits, including reduced substance withdrawal symptoms.

  • September 16, 2025

    The Limits On Blue States' Push For Vaccine Policy Control

    Democratic-run states are changing vaccine policies as HHS Secretary Robert F. Kennedy Jr. and other Trump health officials move to restrict vaccine access, creating a new policy patchwork. Those state efforts can only go so far, healthcare experts say.

  • September 16, 2025

    Pharma Tests Drug Price Policies In Court: 3 Cases To Know

    Two circuit courts issued notable rulings over the past week upholding laws aimed at lowering prescription drug prices. Elsewhere, insulin makers are seeking a panel rehearing in a proposed class action targeting discount programs. Here, Law360 Healthcare Authority looks at three key drug pricing cases you may have missed.

  • September 16, 2025

    Wash. Justices Scrutinize Minimum Wage 'Live In' Exclusion

    Washington Supreme Court justices on Tuesday pushed counsel for an adult family home on the stance that its "live in" workers are adequately protected by existing laws and regulations, pointing to testimony its employees are always on call and sometimes at risk of physical assault by residents.

  • September 16, 2025

    Ill. Hospital Nonprofit Must Face Tobacco Fee Suit

    An Illinois federal judge refused to toss the bulk of a proposed class action from an Illinois hospital worker who claimed a fee on the employee health plans of tobacco users was discriminatory and breached fiduciary duties under benefits law, finding most allegations sufficiently backed up to survive dismissal.

  • September 16, 2025

    DC Circ. Asked To Look At ADA Injunction In Segregation Case

    Washington, D.C., wants the D.C. Circuit to narrow an injunction commanding the district to help people in Medicaid-funded nursing homes move out of those facilities and into less restrictive forms of care, as the litigation approaches its 15th birthday.

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.