Policy & Compliance

  • August 19, 2025

    Panel Weighs Ga. High Court Ruling In Sham Donor Suit

    Customers who accused a sperm bank of selling sperm without disclosing the true medical and criminal histories of donors urged the Georgia Court of Appeals to revive their lawsuits Tuesday, arguing the dismissals were based on a misreading of a 2020 decision from the state's high court.

  • August 19, 2025

    CMS Defeats 'Hair's Breadth' Star Rating Challenge

    Insurance companies challenging the "star" system for rating Medicare Advantage organizations have lost another round in court, with a Texas federal judge saying Elevance Health failed to show federal officials violated the law when rounding down scores.

  • August 19, 2025

    Judge Backs Deal To Overhaul NY Kids' Mental Healthcare

    A New York federal judge has given the green light to allow the state to revamp its Medicaid mental health services for children to expand greater in-home and crisis care to prevent the institutionalization of kids. 

  • August 19, 2025

    Hawaii Abortion Drug Fight: 3 Things To Know

    The drug mifepristone has emerged as a key flash point in legal battles over state abortion restrictions, drug prescribing rules and the legalities of sending abortion medications across state lines. This week, a federal court in Hawaii will hear arguments in a challenge to the FDA's changes to the drug safety review process.

  • August 19, 2025

    Trump's 'Abnormal' Use Of FCA Could Get Tricky In Court

    The Trump administration is wielding the False Claims Act in unusually narrow ways to drive policies on social and cultural issues — including gender-affirming care and diversity, equity and inclusion programs — but the government's potential theories of liability under the federal law remain largely untested and might not hold up in court, experts say.

  • August 18, 2025

    Most Ozempic, Wegovy Claims Survive MDL Dismissal Bid

    Eli Lilly & Co. and Novo Nordisk will have to face most of a multidistrict litigation accusing them of misleading consumers over the risks and benefits of popular weight loss drugs like Ozempic and Trulicity, after a Pennsylvania federal judge only trimmed a few of the dozen claims the drugmakers tried to have tossed.

  • August 18, 2025

    Judge Known For Nixing ACA To Lead Texas' Northern District

    A conservative judge known for declaring Obamacare unconstitutional, among other high-profile rulings, took over as chief judge of the U.S. District Court for the Northern District of Texas on Monday, according to an announcement from the court.

  • August 15, 2025

    DOJ Backs Small Biz In Gender Dysphoria Coverage Dispute

    The U.S. Department of Justice told a New Hampshire federal court Friday that employers are not required under federal anti-discrimination laws to provide medical coverage for gender dysphoria, and that federal religious freedom law protects a turbomachinery company from covering a transgender employee's treatment for the disorder.

  • August 15, 2025

    Microsoft Unit Agrees To Pay $8.5M In MOVEIt Hack MDL

    A Massachusetts federal judge has preliminarily signed off on an $8.5 million settlement reached between Nuance Communications and more than 1 million patients in multidistrict litigation over a 2023 malware attack that exploited a vulnerability in Progress Software's MOVEIt transfer file tool. 

  • August 15, 2025

    Wholesalers Want Final OK For $51M AstraZeneca Settlement

    Drug wholesalers asked a Delaware federal judge Thursday for the final stamp of approval on a combined $51.4 million in settlements AstraZeneca Pharmaceuticals LP and Handa Pharmaceuticals LLC agreed to pay to resolve allegations AstraZeneca paid off generic-drug makers, including Handa, to protect its brand antipsychotic Seroquel XR.

  • August 15, 2025

    AbbVie's Key RICO Claims In Drug Cost Fraud Suit Survive

    An Illinois federal judge on Friday ruled that AbbVie could move ahead with the bulk of its racketeering, tortious interference and fraud claims against a behind-the-scenes healthcare company that the drugmaker alleges colluded with pharmacy benefit managers to fraudulently obtain drugs meant for patients in AbbVie's charitable programs.

  • August 15, 2025

    Home Chain Got OT Math Wrong For 1,000 Nurses, Court Told

    A group of nursing homes operating as one company left shift differentials and bonus pay out of certified nursing assistants' overtime math, a former employee alleged in a suit in Mississippi federal court, saying the violations affected more than 1,000 workers.

  • August 15, 2025

    1st Wrongful Death Suit Filed In Deadly Mass. Rest Home Fire

    The first of what are expected to be multiple wrongful death lawsuits stemming from a July 13 fire that killed 10 elderly and disabled residents of a Fall River, Massachusetts, assisted living facility was filed late Thursday in state court.

  • August 14, 2025

    OptumRx Flags Email Accidentally Sent To Opioid MDL Parties

    UnitedHealth subsidiary OptumRx Inc. is seeking a ban on secret communications with the Ohio federal judge overseeing sprawling national opioid litigation after the court-appointed special master accidentally sent the company an email, intended for the judge, celebrating a "gambit" that prevented objections to his decision.

  • August 14, 2025

    Calif. Justices Say No Arb. For Nursing Home Death Claim

    The California Supreme Court on Thursday reversed a decision sending to arbitration a wrongful death claim by parents who allege their son was neglected at the 24-hour skilled nursing facility he was admitted to.

  • August 14, 2025

    Fired Nurse Accused Of Stealing Drugs Can't Revive Bias Suit

    The Seventh Circuit declined Thursday to reinstate a fired Salvadoran nurse's suit claiming she was accused of stealing and using opioids at work out of bias for her nationality, stating she failed to put forward evidence that her national origin drove concerns rather than her sluggish behavior.

  • August 14, 2025

    20 States Win Injunction Against ICE's Use Of Medicaid Data

    A California federal judge has blocked the federal government from using Medicaid information from 20 states for immigration enforcement purposes, marking a partial victory for the coalition of states challenging a new data-sharing arrangement between the U.S. Department of Health and Human Services and the Department of Homeland Security.   

  • August 14, 2025

    Conn. Lab To Pay $1.25M In False Claims Settlement

    A Connecticut reference laboratory and its operators have struck a deal with federal and state authorities to settle False Claims Act allegations for more than $1.25 million after they allegedly sought payments for medically unnecessary drug tests, federal prosecutors said.

  • August 14, 2025

    AP Says DOJ Can't Turn Info Sharing Into Views Suppression

    The Associated Press, The Washington Post, Reuters and the BBC hit back Wednesday on Justice Department efforts to back a lawsuit from the anti-vaccine group once tied to Secretary of Health and Human Services Robert F. Kennedy Jr., alleging they colluded with social media platforms to censor rivals.

  • August 14, 2025

    AGs' Dermatology Price-Fixing Case Not A Copy, Judge Says

    A nationwide antitrust enforcement action alleging that pharmaceutical companies fixed prices of generic dermatology drugs can proceed despite the defendants' contention that it's virtually the same as two others that were filed first, a Connecticut federal judge has ruled.

  • August 13, 2025

    Trump Axes Biden Competition Order And Eases Rocket Regs

    President Donald Trump on Wednesday evening revoked an expansive Biden-era executive order that aimed to boost competition across the U.S. economy, lower prices for consumers and increase pay for workers, while issuing his own order to ease regulations on the commercial space industry to boost American rocket launches.

  • August 13, 2025

    High Court's Trans Ruling Doesn't Change Insurer's ACA Loss

    A Washington federal judge has reaffirmed his finding that Premera Blue Cross' coverage policy for gender-affirming chest surgery violates the Affordable Care Act, rejecting the insurer's bid for a redo following the Supreme Court's decision in U.S. v. Skrmetti.

  • August 13, 2025

    8th Circ. Revives Ark. Ban On Youth Gender-Affirming Care

    A split Eighth Circuit en banc panel revived an Arkansas state law banning gender-affirming care for minors, finding that a district court erred in blocking the law because it does not discriminate based on sex but instead classifies based only on age and medical procedure.

  • August 13, 2025

    Texas Woman Says Marine Laced Her Drink With Abortion Pills

    A Texas woman has filed a wrongful death lawsuit in federal court alleging a Marine pilot with whom she had an intimate relationship tricked her into taking abortion pills by putting them in her drink, causing her to lose her pregnancy.

  • August 13, 2025

    Wash. Agencies Must Give Up Docs In Medicaid Fraud Case

    A Washington federal judge has ordered the state attorney general's office to hand over certain records to a hospital system accused of overbilling Medicaid in connection to a neurosurgeon's fraud scheme, rejecting the argument that the documents at issue belong to other state agencies that must be subpoenaed.

Expert Analysis

  • CMS Guidance May Complicate Drug Pricing, Trigger Lawsuits

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    Recent draft guidance from the Centers for Medicare & Medicaid Services proposes to expand the scope of what counts as the same qualifying single-source drug, which would significantly alter the timeline for modified drugs facing price controls and would likely draw legal challenges from innovator drug companies, say attorneys at Debevoise.

  • 3 Takeaways From Recent Cyberattacks On Healthcare Cos.

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    For the healthcare industry, the upward trend in styles of cyberattacks, costs, and entities targeted highlights the critical importance of proactive planning to help withstand the operational, legal and reputational turmoil that can follow a data breach, say attorneys at Troutman Pepper.

  • Most-Favored Nation Drug Pricing Could Shake Up US Pharma

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    Recent moves from the executive and legislative branches represent a serious attempt to revive and refine the first Trump administration's most-favored-nations model for drug pricing, though implementation could bring unintended consequences for pharmaceutical manufacturers and will likely draw significant legal opposition, say attorneys at Morgan Lewis.

  • How Focus On Menopause Care Is Fueling Innovation, Access

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    Recent legislative developments concerning the growing field of menopause care are creating opportunities for increased investment and innovation in the space as they increase access to education and coverage, say attorneys at Kirkland.

  • FDA Commissioner Speech Suggests New Vision For Agency

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    In his first public remarks as U.S. Food and Drug Administration commissioner, Marty Makary outlined an ambitious framework for change centered around cultural restoration, scientific integrity, regulatory flexibility and selective modernization, and substantial enforcement shifts for the food and tobacco sectors, say attorneys at Arnall Golden.

  • Customs Fraud Enforcement In The Age Of Tariffs

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    In the wake of the Trump administration’s new approach toward tariffs, two recent Justice Department developments demonstrate aggressive customs fraud enforcement, with the DOJ emphasizing competitive harm to American businesses, and signaling that investigations will likely involve both civil and criminal enforcement tools, say attorneys at Bernstein Litowitz and London & Naor.

  • Legal Risks For Providers Discussing Psychedelic Therapies

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    The emergence of psychedelic therapies as potential treatments for mental health conditions and other ailments continues to garner significant attention, but the legal landscape surrounding discussions and referrals remains fraught with complexity, creating potential risks for healthcare providers and institutions, says Kimberly Chew at Husch Blackwell.

  • 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.