Policy & Compliance

  • April 15, 2025

    Minn. Couple Accused Of $15M Healthcare Fraud Scheme

    A Minnesota couple whose company was hit with a default civil judgment last year now face an indictment alleging they carried out a $15 million scheme to defraud Medicare, Medicaid and insurance companies by overbilling for neurofeedback therapy and other medical services.

  • April 15, 2025

    Legislation Roundup: States Consider Slew Of Abortion Bills

    Nearly three years after the U.S. Supreme Court's Dobbs decision upended federal abortion access protection, dozens of abortion-related bills are moving through state legislatures this year.

  • April 15, 2025

    Ga. Woman Says Baby 'Ripped Away' After Embryo Mix-Up

    A South Carolina fertility clinic has been hit with a lawsuit from a former patient alleging that its doctors placed the wrong embryo inside her — a fact she discovered only when she, a white woman, gave birth to a Black boy — only to have the baby "ripped away from her" by his biological parents after months of raising him as her own.

  • April 15, 2025

    McGuireWoods Immune From Defamation Case, NC Panel Told

    McGuireWoods LLP and a former partner have told a North Carolina state appeals court that they have absolute privilege over allegedly defamatory statements made in connection with an investigation into the former CEO of a managed care organization, arguing that the trial court should have granted them a pretrial win.

  • April 15, 2025

    Pa. Man To Plead Guilty In Harvard Body Parts Theft Case

    A Pennsylvania man will plead guilty to a federal charge for transporting body parts that were allegedly stolen from cadavers by the manager of Harvard Medical School's morgue, according to a Tuesday filing.

  • April 15, 2025

    Medicare Advantage 'Upcoding' In Federal Crosshairs

    Dr. Mehmet Oz and others have called for a crackdown on fraud and waste in privately run Medicare plans. But addressing "upcoding" won't be easy, and healthcare attorneys are watching to see whether the increased attention translates into actual enforcement.

  • April 15, 2025

    Abortion Bans At Wyo. High Court: 3 Things To Know

    Wyoming’s highest court is set to hear arguments over whether two near-total abortion bans violate the state Constitution and its guarantee of personal choice in healthcare.

  • April 14, 2025

    9th Circ. Says $24M Punitive Damages In Jail Death Too Steep

    A jury correctly determined that a healthcare contractor was liable for the death of a woman in custody in a Washington jail, a split Ninth Circuit panel ruled Monday, but its $24 million award for punitive damages was excessive.

  • April 14, 2025

    Ark. PBM Regulation Violates ERISA, Teamsters Fund Says

    An Arkansas insurance regulation forcing health plans to turn over information about reimbursement rates negotiated by pharmacy benefit managers, or PBMs, conflicts with federal benefits law, a Teamsters healthcare fund claimed, urging an Illinois federal court to block the state from enforcing the rule.

  • April 14, 2025

    Judge Threatens Penalties Over Late Report In Fla. Fee Suit

    A Florida federal judge threatened parties in a federal proposed class action over excessive fees charged to maintain retirement savings plans, warning there will be sanctions if they do not respond to an order to show why they failed to timely file a case management report.

  • April 14, 2025

    Quinn Emanuel, King & Spalding Rep Harvard In Trump Letter

    Harvard University on Monday turned to a pair of high-powered lawyers from Quinn Emanuel Urquhart & Sullivan LLP and King & Spalding LLP as the school pushed back on the Trump administration's policy demands linked to nearly $9 billion in federal funding — a move that prompted the government to freeze more than $2 billion in grants for the school.

  • April 14, 2025

    FTC Joins DOJ In Targeting Anticompetitive Regulations

    The Federal Trade Commission launched a public inquiry Monday to look into reducing regulations that are hindering competition, following a similar move by the U.S. Department of Justice last month.

  • April 14, 2025

    Takeda Gets Actos Case Paused For Class Cert. Review

    A New York federal court has paused a lawsuit accusing Takeda Pharmaceuticals of inflating the price of its diabetes treatment, Actos, by delaying the entry of generic alternatives, and took a scheduled July trial off the calendar, as the company appeals a class certification ruling.

  • April 14, 2025

    Healthcare Duo Joins Carlton Fields From Mass. Boutique

    Carlton Fields announced Monday that a pair of experienced healthcare attorneys joined the firm's Los Angeles and Tampa, Florida, offices after a stint with Massachusetts boutique Kajko Weisman & Colasanti LLP.

  • April 14, 2025

    Sandoz Sues Amgen Over Enbrel Biosimilar

    Sandoz accused Amgen of illegally blocking biosimilar competition to its blockbuster Enbrel drug for arthritis and other inflammatory diseases, alleging that the company used strategic acquisitions and illegal patent extensions to fend off challengers in the space and inflate U.S. prices for its drug.

  • April 11, 2025

    Amgen Can't Ditch Regeneron's Bundling Antitrust Suit

    A Delaware federal judge on Thursday denied Amgen's bid to toss antitrust litigation brought by Regeneron accusing its rival of using a bundling scheme to increase the sales of its cholesterol drug Repatha and push competitors out of the market.

  • April 11, 2025

    Express Scripts Judge Asks If Khan's FTC Exit Affects Suit

    The Missouri federal judge overseeing Express Scripts' lawsuit accusing the Federal Trade Commission of defaming it with a report excoriating the pharmacy benefits manager for allegedly inflating drug costs asked the parties Friday if new leadership at the commission affects the case that significantly targets former Chair Lina Khan.

  • April 11, 2025

    Telehealth Co. Sued Over 2024 Data Breach

    A company that helps healthcare providers manage after-hours patient calls was hit with a proposed class action in New York federal court Friday alleging that it failed to secure user data prior to a 2024 breach that exposed the sensitive information of nearly 1 million people.

  • April 11, 2025

    Fla. Pharmacy Pleads Guilty To Fraud Over Opioid OD Drug

    A Florida-based pharmacy has agreed to plead guilty to healthcare fraud and to pay more than $1 million to settle civil claims it submitted false authorizations for an expensive opioid overdose treatment to federal insurers.

  • April 10, 2025

    AbbVie Wants ND, SD Drug Pricing Laws Blocked

    Drugmaker AbbVie Inc. on Thursday asked federal courts to block new drug-pricing laws in both North Dakota and South Dakota, alleging that the measures requiring the company to transfer products to certain pharmacies at discounted prices are unconstitutional.

  • April 10, 2025

    Vanda Sues FDA To Block Off-Label Use Drug Promo Regs

    A pharmaceutical company, a Texas physician and an often-jet lagged traveler sued the U.S. Food and Drug Administration in Texas federal court Wednesday seeking to block marketing restrictions on the off-label uses of FDA-approved drugs, arguing that long-standing rules and Biden-era guidance runs afoul of the First Amendment.

  • April 10, 2025

    Calif. Centers Used 'Body Brokers' In $10M Scam, BCBS Says

    Blue Cross Blue Shield of Oklahoma slammed two California recovery centers and their owners with a lawsuit Thursday, alleging they spearheaded a $10 million kickback scheme to employ "body brokers" to find Indigenous patients for substance treatment facilities where they went to appalling lengths to stop them from leaving.

  • April 10, 2025

    Holmes Seeks Full 9th Circ. Review Of Theranos Fraud Appeal

    Convicted Theranos Inc. founder Elizabeth Holmes has asked the Ninth Circuit for en banc review of a panel's decision to affirm her criminal fraud conviction and 11-year prison sentence, saying problems with the opinion included a "time-warping relevance theory."

  • April 10, 2025

    Man Admits To $12.5M PPE Investment Fraud

    A California man pled guilty Thursday to defrauding investors of $12.5 million by telling them he had a business opportunity to manufacture personal protective equipment and to create an aerosol product that would kill the coronavirus, Texas federal prosecutors said.

  • April 10, 2025

    Mich. Justices Mull Hospital's Liability For Contract Doc's Acts

    The Michigan Supreme Court on Thursday weighed a Corewell Health hospital's possible vicarious liability for independent physicians practicing within the hospital, with one justice pushing back on the idea that liability would be limited to emergency rooms.

Expert Analysis

  • 2 Regulatory Approaches To Psychedelic Clinical Trials

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    Comparing the U.S. and Canada's regulatory frameworks for clinical trials of psychedelic drugs can be useful for designing trial protocols that meet both countries' requirements, which can in turn help diversify patient populations, bolster data robustness and expedite market access, say Kimberly Chew at Husch Blackwell and Sabrina Ramkellawan at AxialBridge.

  • 'Food As Health' Serves Up Fresh Legal Considerations

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    The growth of food as medicine presents a significant opportunity for healthcare organizations and nontraditional healthcare players to improve patient outcomes and reduce costs, though these innovative programs also bring compliance considerations that must be carefully navigated, say attorneys at McDermott.

  • DC Circ. Ruling Heightens HHS Contract Pharmacy Challenges

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    The D.C. Circuit's recent ruling that the Section 340B program does not bar manufacturers from restricting deliveries of discounted drugs to contract pharmacies represents a second strike against the U.S. Department of Health and Human Services' current contract pharmacy policy and raises the stakes surrounding an upcoming Seventh Circuit ruling on the same issue, say attorneys at Foley Hoag.

  • FTC Focus: Exploring The Meaning Of Orange Book Letters

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    The Federal Trade Commission recently announced an expansion of its campaign to promote competition by targeting pharmaceutical manufacturers' improper Orange Book patent listings, but there is a question of whether and how this helps generic entrants, say Colin Kass and David Munkittrick at Proskauer.

  • 3rd Circ.'s Geico Ruling May Encourage Healthcare Arbitration

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    The Third Circuit's recent decision in Geico v. Mount Prospect, finding that claims under New Jersey's Insurance Fraud Prevention Act can be arbitrated, strengthens arbitration as a viable alternative to litigation, even though it is not necessarily always a more favorable forum, say Khaled Klele and Jessica Osterlof at McCarter & English.

  • Proposed Cannabis Reschedule Sidesteps State Law Effects

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    The U.S. Department of Justice's recent proposal to move cannabis to Schedule III of the Controlled Substances Act provides certain benefits, but its failure to address how the rescheduling would interact with existing state cannabis laws disappointed industry participants hoping for clarity on this crucial question, says Ian Stewart at Wilson Elser.

  • A Changing Regulatory Landscape For Weight Loss Drugs

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    As drugs originally approved to treat diabetes become increasingly popular for weight loss purposes, federal and state regulators and payors are increasing their focus on how these drugs are prescribed, and industry participants should pay close attention to rapidly evolving compliance requirements, say attorneys at Goodwin.

  • Opioid Suits Offer Case Study In Abatement Expert Testimony

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    Settlements in the opioid multidistrict litigation provide useful insight into leveraging expert discovery on abatement in public nuisance cases, and would not have been successful without testimony on the costs necessary to lessen the harms of the opioid crisis, says David Burnett at DiCello Levitt.

  • How HHS Discrimination Rule Affects Gender-Affirming Care

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    The U.S. Department of Health and Human Services' new final rule, which reinterprets the Affordable Care Act's anti-discrimination provision, greatly clarifies protections for gender-affirming care and will require compliance considerations from sponsors and administrators of most group health plans, say attorneys at McDermott.

  • FTC Noncompete Rule's Impact On Healthcare Nonprofits

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    Healthcare entities that are nonprofit or tax-exempt and thus outside of the pending Federal Trade Commission noncompete rule's reach should evaluate a number of potential risk factors and impacts, starting by assessing their own status, say Ben Shook and Tania Archer at Moore & Van Allen.

  • Key Takeaways From FDA Final Rule On Lab-Developed Tests

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    Michele Buenafe and Dennis Gucciardo at Morgan Lewis discuss potential consequences of the U.S. Food and Drug Administration's recently finalized rule regulating lab-developed tests as medical devices, and explain the rule's phaseout policy for enforcement discretion.

  • Assessing HHS' Stance On Rare Disease Patient Assistance

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    The U.S. Department of Health and Human Services' recent advisory opinion, temporarily blessing manufacturer-supported copay funds for rare disease patients, carves a narrow path for single-donor funds, but charities and their donors may require additional assistance to navigate programs for such patients, says Mary Kohler at Kohler Health Law.

  • Are Concessions In FDA's Lab-Developed Tests Rule Enough?

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    Although the U.S. Food and Drug Administration's new policy for laboratory-developed tests included major strategic concessions to help balance patient safety, access and diagnostic innovation, the new rule may well face significant legal challenges in court, say Dominick DiSabatino and Audrey Mercer at Sheppard Mullin.