Policy & Compliance

  • June 25, 2025

    Trans Worker Says Metal Co.'s Health Plan Discriminatory

    A subsidiary of Kaiser Aluminum discriminated against transgender employees by including an exclusion in its health plan barring coverage for medical treatments related to gender-affirming care, according to a new suit filed in Washington federal court.

  • June 25, 2025

    CVS PBM Hit With $95M Judgment For Overbilling Medicare

    A Pennsylvania federal judge on Wednesday ruled that CVS's pharmacy benefits manager owes the government $95 million for overbilling Medicare Part D-sponsored drugs, leaving the door open for the amount to be tripled later.

  • June 24, 2025

    Arkansas Insurance Dept. Fights Teamsters Plan's ERISA Suit

    The Arkansas Insurance Department is looking to sink a challenge to a state insurance regulation filed by a Teamsters healthcare plan, telling an Illinois federal judge that the regulation isn't preempted by the Employee Retirement Income Security Act and, besides, the plan can't sue the department.

  • June 24, 2025

    Health Data Co. Must Face Revised Investor Fraud Suit

    A Connecticut federal judge won't toss an amended class action claiming a healthcare technology company misled investors about a data platform it claimed to operate that didn't actually exist, ruling that statements about the platform's capabilities are not inactionable, forward-looking statements.

  • June 24, 2025

    4th Circ. Tosses Trans Man's Appeal Over Canceled Surgery

    The Fourth Circuit declined to revive a transgender man's constitutional claims against a religious hospital run by the University of Maryland Medical System over a canceled hysterectomy for gender dysphoria, concluding Tuesday that it couldn't grant further relief, and refused to consider a "late-breaking" argument for emotional distress damages.

  • June 24, 2025

    Calif. AG Asks 9th Circ. To Undo Limits On Pay-For-Delay Ban

    California enforcers on Monday asked the Ninth Circuit to overturn a district court's decision that a state law restricting "reverse payment" settlements between brand-name and generic-drug makers cannot be used to regulate deals that were struck outside the Golden State.

  • June 24, 2025

    Healthcare In Court: 5 Rulings You May Have Missed

    A D.C. federal judge rejected a challenge to the federal government's approval of an audit by Johnson & Johnson into five hospitals' compliance with the 340B drug discount program. In Texas, a state appellate court has blocked San Antonio from going forward with a program that could fund travel for residents to access abortion care in other states. Here, Law360 Healthcare Authority looks at those and other healthcare rulings you may have missed over the last week.

  • June 24, 2025

    Nichols Liu Co-Founder Andy Liu Launches Solo Venture

    Boutique firm Nichols Liu LLP's co-founding partner Andy Liu has launched a solo practice to continue representing government contractors and healthcare industry clients in civil and criminal enforcement matters, telling Law360 Pulse Tuesday he wanted to go out on his own for greater control.

  • June 24, 2025

    Docs Navigate 'Legal Thicket' Of Pregnancy Exclusion Laws

    A first-of-its-kind lawsuit in Kansas challenges a state law that plaintiffs say undermines a woman's right to make critical end-of-life decisions while pregnant and leaves doctors legally vulnerable.

  • June 24, 2025

    Trump Admin Must Release NIH Funds Amid Appeal

    A Massachusetts federal judge on Tuesday denied the Trump administration's request to stay a recent order that it resume processing National Institutes of Health grant applications and releasing funds, warning that even one more day of delay would lead to irreparable harm.

  • June 23, 2025

    Ontrak Founder Gets 3½ Years In Novel Insider Trading Case

    A California federal judge sentenced Ontrak Inc. founder Terren Peizer to 3½ years in prison Monday, following a first-of-its-kind insider trading conviction on accusations that he based a $20 million share sale on material nonpublic information that his health technology company was about to lose its biggest client, Cigna. 

  • June 23, 2025

    9th Circ. Sends Minor's Rehab Claim Back To Premera

    The Ninth Circuit on Monday partially reopened a lawsuit accusing Premera Blue Cross of unlawfully refusing to cover a minor's time in a wilderness therapy program and rehabilitation facility, saying the insurer should take another look at one of the claims.

  • June 23, 2025

    Justices Skip Pa. Med Mal Fund's Bid To Shield $300M Surplus

    The U.S. Supreme Court said Monday it won't decide if Pennsylvania's medical malpractice insurance fund is a government entity for the purpose of determining if the state is authorized to dip into the money pool's $300 million budget surplus. 

  • June 20, 2025

    Texas Panel Blocks San Antonio's Abortion Travel Funding

    A Texas appellate court blocked the city of San Antonio from going forward with a program that included funding for out-of-state travel for abortions, finding that the state has the right to challenge the program even though the funding has not yet been spent.

  • June 20, 2025

    PE Firm Demands FDA Docs For Defense In Deal Challenge

    Private equity firm GTCR BC Holdings LLC is seeking a court order for the U.S. Food and Drug Administration to produce over a decade's worth of medical device approval applications, arguing the documents are necessary in its defense against a merger challenge by the federal government.

  • June 20, 2025

    Nose Spray Co. Sues FTC Over Substantiation Requirement

    Nasal spray maker Xlear Inc. is suing the Federal Trade Commission in Utah federal court, seeking a declaration that the agency is going beyond its statutory mandate by requiring scientific substantiation in marketing claims, even if the claims are not false and misleading.

  • June 20, 2025

    4 ERISA Cases To Watch In The 2nd Half Of 2025

    The U.S. Department of Labor's challenge to a pair of injunctions blocking Biden-era regulations that broaden who qualifies as an investment advice fiduciary under federal benefits law tops the list of cases benefits attorneys will be watching in the latter half of the year.

  • June 18, 2025

    Texas Judge Vacates Biden-Era HHS Abortion Privacy Rule

    A Texas federal judge on Thursday agreed to vacate a U.S. Department of Health and Human Services rule finalized during the Biden administration that aimed to protect the privacy of patients seeking abortions and gender-affirming care, ruling that the HHS didn't have the authority to "fashion special protections" in areas of "great political significance."

  • June 18, 2025

    NC Panel Rejects HCA Unit's Appeal Over Rival Project Award

    A North Carolina appeals court on Wednesday rejected an HCA Healthcare subsidiary's challenge to an award of a certificate of need allowing a rival to build a new acute care facility, backing a decision in favor of the state health department behind the award.

  • June 18, 2025

    Nurse Staffing Exec Can't Nix Conviction, Sanctions Floated

    A Nevada federal court has refused a nurse staffing executive's bid to undo his conviction on wage-fixing and wire fraud charges, and threatened his attorneys with sanctions for allegedly making repeated misrepresentations to the court.

  • June 18, 2025

    High Court Concurrences Signal Hard Battle For Trans Rights

    U.S. Supreme Court Justice Amy Coney Barrett joined the court's two most conservative members Wednesday to suggest laws that differentiate based on transgender status should be subject to the lowest level of judicial review, providing guidance to lower courts that will likely make it harder for litigants to vindicate trans rights.

  • June 18, 2025

    NY High Court Lifts Block On NYC Shifting Retiree Healthcare

    New York's highest court lifted an injunction Wednesday that had blocked New York City from switching retired city employees' health insurance provider, ruling that the city never promised its retirees that it would keep them on a Medicare supplemental plan.

  • June 18, 2025

    Ex-Drug Exec Must Testify, But Keeps 5th Amendment Rights

    Sandoz, Teva, Actavis and Taro can again subpoena the deposition testimony of a former Actavis and Teva executive, but a Pennsylvania federal judge is still allowing the witness to invoke his Fifth Amendment rights against self-incrimination, even though the Justice Department dropped the criminal charges against him.

  • June 18, 2025

    Age Bias Taints Kansas Health Dept. Promotions, EEOC Says

    The Kansas Department of Health and Environment overlooked an older worker for promotions to more senior lab tech roles solely because of her age, the U.S. Equal Employment Opportunity Commission told a federal court.

  • June 18, 2025

    DC Judge Throws Out Suits Over J&J Drug Discount Audits

    A D.C. federal judge nixed five lawsuits brought by hospitals that accused federal healthcare regulators of illegally authorizing Johnson & Johnson to audit their business records for compliance with the 340B drug discount program.

Expert Analysis

  • How NY's FAIR Act Mirrors CFPB State Recommendations

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    New York's proposed FAIR Business Practices Act, which targets predatory lending and junk fees, reflects the Rohit Chopra-era Consumer Financial Protection Bureau's recommendations to states in a number of ways, including by defining "abusive" conduct and adding a new right to file class actions, says Christian Hancock at Bradley Arant.

  • A Breakdown Of Trump's Order On Drug Pricing

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    The Trump administration may attempt to effectuate through rulemaking a recently issued executive order on lowering drug prices, which would likely have an adverse effect on stakeholders and trigger litigation, say attorneys at Debevoise.

  • Takeaways From DOJ's 1st Wage-Fixing Jury Conviction

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    U.S. v. Lopez marked the U.S. Department of Justice's first labor market conviction at trial as a Nevada federal jury found a home healthcare staffing executive guilty of wage-fixing and wire fraud, signaling that improper agreements risk facing successful criminal prosecution, say attorneys at McGuireWoods.

  • Deregulation Memo Presents Risks, Opportunities For Cos.

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    A recent Trump administration memo providing direction to agencies tasked with rescinding regulations under an earlier executive order — without undergoing the typical notice-and-review process — will likely create much uncertainty for businesses, though they may be able to engage with agencies to shape the regulatory agenda, say attorneys at Blank Rome.

  • The IRS Shouldn't Go To War Over Harvard's Tax Exemption

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    If the Internal Revenue Service revokes Harvard's tax-exempt status for violating established public policy — a position unsupported by currently available information — the precedent set by surviving the inevitable court challenge could undercut the autonomy and distinctiveness of the charitable sector, says Johnny Rex Buckles at Houston Law Center.

  • New Hospice Regulations Should Enforce Core Principles

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    As the U.S. Department of Health and Human Services' Office of Inspector General prepares to research and expand on oversight of Medicare hospice care, the OIG should keep in mind certain core principles, such as an emphasis on preventing the entry of hospices that raise red flags, says Bill Dombi at Arnall Golden.

  • 7 Considerations For Conducting Drug Clinical Trials Abroad

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    With continuing cuts to U.S. Food and Drug Administration staffing motivating some pharmaceutical companies to consider developing drugs abroad, it's important to understand the additional risks and compliance requirements associated with conducting clinical studies in other countries, say attorneys at Morgan Lewis.

  • Compliance Lessons From Warby Parker's HIPAA Fine

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    The U.S. Department of Health and Human Services' civil money penalty against Warby Parker highlights the emerging challenges that consumer-facing brands encounter when expanding into healthcare-adjacent sectors, with Health Insurance Portability and Accountability Act compliance being a potential focus of regulatory attention, say attorneys at Saul Ewing.

  • 5th Circ. Ruling Is Latest Signal Of Shaky Qui Tam Landscape

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    In his recent concurring opinion in U.S. v. Peripheral Vascular Associates, a Fifth Circuit judge joined a growing list of jurists suggesting that the False Claims Act's whistleblower provisions are unconstitutional, underscoring that acceptance of qui tam relators can no longer be taken for granted, say attorneys at Miller & Chevalier.

  • Medicare Advantage Enforcement Strong Amid Agency Cuts

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    The second Trump administration's actions thus far suggest that Medicare Advantage enforcement remains a bipartisan focus despite challenges presented by evolving trends in federal agency staffing and resources, say attorneys at Ropes & Gray.

  • A New Tool For Assessing Kickback Risks In Health Marketing

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    The Seventh Circuit's recent decision in U.S. v. Sorensen, reversing a conviction after trial of a durable medical equipment distributor, highlights two principle considerations for determining whether payments to marketers in healthcare are unlawful under the Anti-Kickback Statute, says Elisha Kobre at Sheppard Mullin.

  • How Trump Orders Affect Health Orgs.' Care For Trans Minors

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    Two recent executive orders issued by President Donald Trump regarding gender-affirming care for minors have put healthcare organizations in a precarious situation, and these institutions should prepare for various implications and potential scenarios, say attorneys at ArentFox.

  • Reproductive Health Under Trump So Far, And What's Next

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    Based on priorities stated so far, the Trump administration will likely continue to weaken Biden-era policies that protect reproductive health, with abortion, in vitro fertilization and contraception all being issues to watch closely amid a post-Dobbs shift, say attorneys at McDermott.