Policy & Compliance
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April 08, 2025
Medicare Drug Price Plan Tramples Constitution, 3rd Circ. Told
New Jersey federal court rulings preserving the Centers for Medicare & Medicaid Services' ability to negotiate prices with drug companies should be overturned on constitutional grounds, pharmaceutical giants Novo Nordisk and Novartis told the Third Circuit during oral arguments Tuesday.
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April 08, 2025
UnitedHealth Puts Anesthesiologists' Antitrust Suit To Sleep
A New York federal judge tossed an antitrust lawsuit accusing a United Healthcare unit of using its market power in the New York metropolitan area to cut reimbursement rates to anesthesia providers by 80% in its public-sector employee health plan, while enlisting MultiPlan to pressure providers into accepting the rates.
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April 08, 2025
Md. Board Enacts Expungement Rule For Physician Records
Maryland doctors who have faced administrative action for failing to pay taxes or attend continuing education classes can have their public records wiped clean under a new rule from the state Board of Physicians.
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April 08, 2025
2nd Circ. Rejects Biden Diary Thief's Appeal Over Medical Info
The Second Circuit denied an appeal on Tuesday from a woman who pled guilty to stealing a diary belonging to former President Joe Biden's daughter, rejecting her arguments that a judge was wrong to allow a probation officer to disclose her presentencing report and prior medical records to mental health providers without first obtaining consent.
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April 07, 2025
CMS' Nursing Home Staffing Requirements Struck Down
A Texas federal judge on Monday struck down new staffing standards for nursing homes participating in Medicare or Medicaid, ruling that federal health officials overstepped their authority by establishing a one-size-fits-all requirement.
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April 07, 2025
Policy Group Tells 4th Circ. Drug Discount Law Needs Reform
The Fourth Circuit on Monday allowed a Boston-based think tank to file an amicus brief supporting a district court's injunction against a West Virginia law that pharmaceutical companies and lobbyists claim unconstitutionally expands a federal drug discount program.
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April 07, 2025
Drug Buyers, Generics Cos. Fight Over Bellwether Litigation
Generic drug buyers vied Friday with the pharmaceutical companies they've accused of price-fixing over how to shape the first rounds of long-gestating Pennsylvania federal court litigation that the plaintiffs want heard in separate consecutive trials and that the drugmakers want combined.
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April 07, 2025
AGs Announce $335M Opioid Deal With Mylan
New York Attorney General Letitia James on Monday said her office and those of other states reached a $335 million deal with Mylan to help combat the opioid crisis.
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April 07, 2025
Ex-Conn. Budget Official Plans To Testify In Corruption Cases
Twice-indicted former Connecticut budget official Konstantinos Diamantis plans to testify in two upcoming federal corruption trials, his attorney revealed Monday during a scheduling call that snapped into focus the timeline for both cases.
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April 07, 2025
Conn. Judge Pauses 'Staggering' Hospital Data Subpoena
A Connecticut judge temporarily paused a subpoena seeking what a health nonprofit called "a staggering amount" of confidential patient data by a proposed class of Constitution State residents accusing Hartford HealthCare Corp. of monopolizing the state's healthcare industry, stating that the court must review the subpoena first.
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April 07, 2025
11 States Tell 6th Circ. To Ax Mich. Conversion Therapy Ban
Eleven U.S. states led by Iowa and South Carolina urged the Sixth Circuit to strike down Michigan's ban on conversion therapy for minors, saying the law censors therapists' speech.
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April 07, 2025
Feds Say Fla. Doctor Fleeced Medicare With Bogus Charges
A doctor and his Florida-based business, Vohra Wound Physicians Management LLC, deliberately overbilled Medicare for years, charging it for wound care procedures that were unnecessary or not performed, according to federal prosecutors.
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April 04, 2025
Split DC Circ. Denies Calif. Subsidies For Border Hospitals
A split D.C. Circuit panel on Friday found it was not unconstitutional for California to exclude hospitals bordering the state from a program distributing supplemental payments to providers that serve Medi-Cal beneficiaries.
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April 04, 2025
HHS Drops 11th Circ. Fight Over ACA Trans Rule Freeze
The U.S. Department of Health and Human Services agreed to drop its bid to overturn an order blocking it from enforcing regulations that extend the Affordable Care Act's anti-discrimination provisions to transgender individuals against Florida organizations, according to filings with the Eleventh Circuit.
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April 04, 2025
Ohio AG Takes Trans Care Limits Bid To State Justices
Ohio Attorney General Dave Yost has taken his bid to reinstate limits on gender-affirming care for transgender youths to the state's highest court and wants the law's enforcement to continue throughout his appeal.
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April 04, 2025
Seattle Children's Faces Class Action Over Nurse Meal Breaks
A Washington nurse has filed a proposed class action alleging Seattle Children's Hospital broke state law by failing to schedule or provide mandatory rest and meal breaks, in a state court complaint that said the problem was made worse by understaffing during the COVID-19 pandemic.
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April 04, 2025
AGs Sue To Halt Disruptions To NIH Grant Funding
A coalition of 16 states on Friday sued the National Institutes of Health over delays and cancellations of grant programs linked to vaccines, transgender issues and other areas they say are currently "disfavored" by the Trump administration.
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April 03, 2025
Optum, Express Scripts Want Judge Ousted From Opioid MDL
Pharmacy benefit managers Optum and Express Scripts say the Ohio federal judge overseeing multidistrict opioid litigation should recuse himself because he "regularly communicates" with plaintiffs' attorneys in the litigation and is biased in favor of plaintiffs, according to a motion filed Wednesday.
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April 03, 2025
TV Star Dr. Oz Confirmed As New Medicare, Medicaid Leader
The U.S. Senate on Thursday voted 53 to 43, along party lines, to confirm former talk show host and surgeon Dr. Mehmet Oz to be the next administrator of the Centers for Medicare & Medicaid Services.
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April 03, 2025
Swedish Health Services Found Liable For Wage Violations
A Washington state judge has put Seattle-area hospital system Swedish Health Services on the hook for state wage law violations in an employee class action, finding workers were shortchanged by its timekeeping practices and failure to provide a second meal break on longer shifts.
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April 03, 2025
Senate Panel Advances Bills Tackling Drug Patents, Pricing
A U.S. Senate panel on Thursday approved a group of bills tackling pharmaceutical patents and drug pricing, including measures that claim to address so-called patent thickets and an industry practice called "product hopping."
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April 03, 2025
2nd Circ. Judge Thinks Drug Price Fight Sounds Like Antitrust
A Second Circuit judge on Thursday suggested that the federal government may be insulated from claims over its demand for lower prices for Medicare and Medicaid recipients, musing that Boehringer Ingelheim Pharmaceuticals Inc.'s constitutional challenge to an Inflation Reduction Act provision sounds more like an antitrust allegation.
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April 03, 2025
RI Judge Hits Pause On Billions In Health Grant Funding Cuts
A Rhode Island federal judge on Thursday barred the Trump administration from moving forward, for now, with the termination of billions of dollars in grants supporting state public health programs.
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April 03, 2025
Baker Donelson Elevates Health Law And Public Policy Heads
Three Baker Donelson Bearman Caldwell & Berkowitz PC shareholders have been tapped for leadership roles within the firm's national health law and public policy department.
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April 02, 2025
NIH Sued By Researchers Over 'Ideological Purge' On Grants
The American Public Health Association and others sued the federal government in Massachusetts federal court on Wednesday over the cancellations of billions of dollars worth of National Institutes of Health research grants on such issues as gender identity, diversity, vaccine hesitancy and climate change, claiming the "ideological purge" is illegal.
Expert Analysis
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Defense Attys Must Prep For Imminent AI Crime Enforcement
Given recent statements by U.S. Department of Justice officials, white collar practitioners should expect to encounter artificial intelligence in federal criminal enforcement in the near term, even in pending cases, say Jarrod Schaeffer and Scott Glicksman at Abell Eskew.
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Lessons For Nursing Facilities From DOJ Fraud Settlement
The U.S. Department of Justice's recent settlement with the owner of skilled nursing and assisted living facilities in Florida provides a cautionary tale of potential fraud risks, and lessons on how facilities can mitigate government enforcement actions, say Callan Stein and Rebecca Younker at Troutman Pepper.
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HHS' Updated Tracking Tech Guidance Offers Little Clarity
The U.S. Department of Health and Human Services' Office for Civil Rights' updated guidance on the use of online tracking technologies appears more focused on legal issues raised in ongoing litigation with the American Hospital Association and less on practical guidance for covered entities, say attorneys at Sheppard Mullin.
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Takeaways From The 2023 DOJ Fraud Section Report
Attorneys at Wiley discuss notable trends from the U.S. Department of Justice's recently reported Fraud Section activity last year and highlight areas of enforcement to watch for in the future, including healthcare fraud and Foreign Corrupt Practices Act violations.
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NIST March-In Framework Is As Problematic As 2021 Proposal
While the National Institute of Standards and Technology's proposed march-in framework on when the government can seize patents has been regarded as a radical departure that will support lowering prescription drug costs, the language at the heart of it is identical to a failed 2021 notice of proposed rulemaking, says attorney Kelly Morron.
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Spartan Arbitration Tactics Against Well-Funded Opponents
Like the ancient Spartans who held off a numerically superior Persian army at the Battle of Thermopylae, trial attorneys and clients faced with arbitration against an opponent with a bigger war chest can take a strategic approach to create a pass to victory, say Kostas Katsiris and Benjamin Argyle at Venable.
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The Road Ahead For Florida's Drug Importation Program
Though the U.S. Food and Drug Administration approved Florida's drug importation program in January, a series of hurdles — including requisite buy-in from Canada — and potential legal challenges must be addressed before importation can begin, say attorneys at Ropes & Gray.
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Assessing CDC's Revised Guideline On Opioid Prescriptions
Kenneth Weinstein, Nicholas Van Niel and Kate Uthe at Analysis Group look at newly available data to evaluate the impact that the Centers for Disease Control and Prevention's revised opioid monitoring guideline have had on prescription trends in recent years, highlighting both specific and overall decreases.
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Valeant Ruling May Pave Way For Patent-Based FCA Suits
The Ninth Circuit’s recent ruling in Silbersher v. Valeant marks a significant development in False Claims Act jurisprudence, opens new avenues for litigation and potentially raises the stakes for patent applicants who intend to do business with the government, say Joshua Robbins and Rick Taché at Buchalter.
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Suits Against Insulin Pricing Are Driven By Rebate Addiction
A growing wave of lawsuits filed by states, cities and counties against insulin manufacturers and pharmacy benefit managers improperly allocate the blame for rising insulin costs, when in actuality the plaintiffs are partially responsible, says Dan Leonard at Granite Capitol Consulting.
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When Physician Retirement Arrangements May Be Legal
A recent advisory opinion from the Office of Inspector General regarding physician retirement arrangements sheds light on key considerations and mitigating factors that may be useful when attempting to balance healthcare operational needs with statutory conformity, says Magda Rodriguez at Day Pitney.
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ESG Around The World: Gulf Cooperation Council
The Gulf Cooperation Council is in the early stages of ESG policy implementation, but recent commitments by both states and corporations — including increases in sustainable finance transactions, environmental commitments, female representation on boards and human rights enforcement — show continuing progress toward broader ESG goals, say attorneys at Cleary.
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Navigating ACA Reporting Nuances As Deadlines Loom
Stephanie Lowe at Liebert Cassidy walks employers through need-to-know elements of Affordable Care Act reporting, including two quickly approaching deadlines, the updated affordability threshold, strategies for choosing an affordability safe harbor, and common coding pitfalls.