Policy & Compliance

  • June 01, 2026

    DOJ Says Ohio Health System Can't Duck Antitrust Case

    The U.S. Department of Justice defended its antitrust case accusing OhioHealth Corp. of blocking competition through its contracts with insurers, telling an Ohio federal court the health system is depriving consumers of lower-cost health plans.

  • June 01, 2026

    NC Biz Court Bulletin: Referee Tapped, CEO To Be Deposed

    The North Carolina Business Court rounded out May by appointing a discovery referee in a healthcare antitrust class action and ordering the deposition of a top executive in a trade secrets battle, in addition to fielding a new complaint alleging unpaid capital contributions for a captive insurance company.

  • June 01, 2026

    High Court Turns Away Health Workers' Vaccine Mandate Case

    The U.S. Supreme Court declined a bid for review Monday from workers who said a nonprofit healthcare system and Washington state violated their rights by issuing COVID-19 vaccination mandates, leaving in place a Ninth Circuit ruling that said their case didn't pass muster.

  • May 29, 2026

    Illumina Ducks DNA Sequence Rival's Antitrust Suit, For Now

    A DNA sequencing startup will have to rejigger its antitrust lawsuit against Illumina after a California federal judge said it hasn't shown that the industry giant has entered exclusive agreements and hasn't adequately asserted that Illumina priced its offerings below cost, among other failings.

  • May 29, 2026

    Hospital Already Satisfied SEIU Drug Test Award, Judge Says

    An Ohio federal judge tossed a Service Employees International Union affiliate's bid to confirm an arbitration award against a Cleveland hospital Friday, saying the hospital already complied with the award by expunging discipline from a worker's record.

  • May 29, 2026

    Ohio AG Says Cigna Can't Use Sherman Act To Ax State Case

    The Ohio attorney general has urged a federal judge not to dismiss prescription drug price-fixing claims against Express Scripts, its Cigna parent and fellow pharmacy benefit manager Prime Therapeutics, arguing the companies are trying to fight his state law antitrust claims by invoking federal law standards that do not apply.

  • May 29, 2026

    Blood Test Lab Owner Gets 4 Years For $11M Tax Evasion

    The owner of a blood-testing laboratory was sentenced to more than four years in federal prison after evading $11.2 million in taxes by using an accomplice to illegally collect Medicare reimbursements made to the company, California federal prosecutors said.

  • May 29, 2026

    Full 4th Circ. To Rethink W.Va., Md. 340B Drug Discount Laws

    The full Fourth Circuit will revisit two panel decisions that created a circuit split when they temporarily blocked a pair of state laws that barred drugmakers from prohibiting federally funded hospitals from contracting with an unlimited number of pharmacies to dispense discounted drugs in the 340B Drug Pricing Program. 

  • May 29, 2026

    UnitedHealthcare Defrauded Mass. Of $100M, AG Says

    UnitedHealthcare's "growth at all costs strategy" led the insurer's Massachusetts subsidiary to overcharge the state by more than $100 million by exaggerating the medical conditions and needs of seniors, the state's attorney general said in a Friday lawsuit.

  • May 28, 2026

    Wash. Justices Float AI Hypotheticals In Hospital Pixel Case

    As the Washington Supreme Court considered a group of parents' bid to revive their proposed privacy class action over a Seattle hospital's use of the Meta Pixel browser tracking tool on its website, the justices questioned Thursday whether the rise of artificial intelligence-powered chatbots carried implications for the case.

  • May 28, 2026

    Trans Patients Say Stanford Can't Give DOJ Medical Records

    A group of transgender adolescents who received gender-related care at a Stanford Medicine hospital urged a California federal court to order the hospital not to turn over any of their medical records in response to a criminal subpoena issued by a grand jury in Texas.

  • May 28, 2026

    UnitedHealthcare Unit Settles PrEP Coverage Fight

    A UnitedHealthcare subsidiary and two customers who alleged its failure to approve full coverage for PrEP violated the Affordable Care Act have agreed to settle their dispute, parties told a Minnesota federal court.

  • May 28, 2026

    DOJ To Speed Up Review Of Qui Tam Benefits Fraud Claims

    The U.S. Department of Justice announced that it's speeding up the agency's review of whistleblower complaints accusing contractors of defrauding state-administered benefits programs that are funded by the federal government, in violation of the False Claims Act. 

  • May 28, 2026

    9th Circ. Won't Revisit FCA Ruling Over Drug Price Program

    The Ninth Circuit has said it will not disturb its March ruling allowing a hospital chain to pursue a False Claims Act lawsuit against various pharmaceutical companies for allegedly causing the government to overpay for drugs under a discount program.

  • May 27, 2026

    Pharmacies Beat Fla. Hospitals' Opioids Suit

    A Florida state judge has handed Walmart, Walgreens and CVS a win in a fight with hospitals over treatment of opioid-addicted patients, finding the hospitals cannot recover damages under state racketeering law because their injuries are indirect.

  • May 27, 2026

    ProPublica Denied Access To Ranbaxy Antitrust MDL Docs

    A Massachusetts federal court denied ProPublica's bid to unseal court filings in settled multidistrict litigation alleging a subsidiary of Indian drugmaker Sun Pharmaceuticals illegally delayed market entry of generic drugs, ruling the nonprofit news organization's request came too late in the case.

  • May 27, 2026

    Judge Doubts Prison Bureau Claim Trans Care Isn't Banned

    A D.C. federal judge repeatedly challenged a Trump administration attorney's claims that a looming ban on gender-affirming care in federal prisons wouldn't amount to a categorical ban on hormone treatments for inmates as he weighed extending an injunction already stopping the policy from taking effect.

  • May 27, 2026

    NY-Presbyterian Says DOJ's Antitrust Case Is Misguided

    New York-Presbyterian Hospital is pushing back against claims that it blocks cheaper insurance plans through its contracts with insurers, telling a federal court that enforcers are challenging industry-standard contract terms that lower prices and guarantee patient access.

  • May 27, 2026

    US Tells Justices To Hold 'Lightning Rod' Health Ministry Case

    The U.S. Supreme Court should hold out on deciding whether a New Mexico insurance law violates the religious rights of nonprofit healthcare-sharing ministries that provide cheap, Christian-focused health insurance options while the justices decide a similar case, the U.S. solicitor general told the court. 

  • May 26, 2026

    9th Circ. Won't Revive Wash. City Workers' Vax Mandate Suit

    A Ninth Circuit panel Tuesday put an end to city workers' lawsuit challenging Bellingham, Washington's COVID-19 vaccine mandate, ruling that a lower court appropriately dismissed the action and barred the workers from amending their claims.

  • May 26, 2026

    Seattle Hospital Loses Appeal Of Dr.'s $21M Race Bias Verdict

    A Washington Court of Appeals panel Tuesday upheld a $21 million verdict against Seattle Children's Hospital in a Black ex-medical director's lawsuit claiming he faced racism in the workplace and retaliation for complaining about systemic inequities, ruling "substantial evidence" justified the jury's findings and damages award.

  • May 26, 2026

    New Suits Target DOJ Release, Loan Rule And More

    Law360 Healthcare Authority looks at new suits filed over the past week, including a $50 million suit over the U.S. Justice Department's handling of a criminal case against Maryland doctors and another challenge over the U.S. Department of Education's rule altering federal student loan eligibility.

  • May 26, 2026

    Meet The Attys For Health Orgs. Fighting Ed. Dept. Loan Caps

    A group of healthcare organizations has tapped a new law firm founded by a former Biden administration attorney to challenge a U.S. Department of Education rule that restricts student loan eligibility for some degree programs. 

  • May 26, 2026

    6th Circ. Rejects Mich. Reproductive Rights Challenge

    Abortion opponents and several parents lack standing to sue top Michigan officials, the Sixth Circuit said Tuesday, affirming dismissal of a suit challenging the state's voter approved reproductive rights amendment.

  • May 26, 2026

    9th Circ. Backs Reinstating DEI Grants Nixed By Trump

    The Ninth Circuit on Tuesday partially upheld a lower court's preliminary injunction and class certification orders in litigation from University of California researchers against President Donald Trump, backing the reinstatement of grants terminated due to presidential orders against diversity, equity and inclusion initiatives while reversing the injunction for those grants that were rescinded without explanation.

Expert Analysis

  • A Rapidly Evolving Landscape For Noncompetes In Healthcare

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    A wave of new state laws regulating noncompete agreements in the healthcare sector, varying in scope, approach and enforceability, are shaped by several factors unique to the industry and are likely to distort the market, say attorneys at Seyfarth.

  • Arguing The 8th Amendment For Reduction In FCA Penalties

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    While False Claims Act decisions lack consistency in how high the judgment-to-damages ratio in such cases can be before it becomes unconstitutional, defense counsel should cite the Eighth Amendment's excessive fines clause in pre-trial settlement negotiations, and seek penalty decreases in post-judgment motions and on appeal, says Scott Grubman at Chilivis Grubman.

  • $95M Caremark Verdict Should Put PBMs On Notice

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    A Pennsylvania federal judge’s recent ruling that pharmacy benefits manager CVS Caremark owes the government $95 million for overbilling Medicare Part D-sponsored drugs highlights the effectiveness of the False Claims Act, as scrutiny of PBMs’ outsized role in setting drug prices continues to increase, say attorneys at Duane Morris.

  • DOJ Actions Signal Rising Enforcement Risk For Health Cos.

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    The U.S. Department of Justice's announcement of a new False Claims Act working group, together with the largest healthcare fraud takedown in history, underscore the importance of sophisticated compliance programs that align with the DOJ's data-driven approach, say attorneys at Debevoise.

  • Spotlight On Medicare Marketing Practices Enforcement Trend

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    Recent U.S. Department of Justice actions, including its recent Medicare kickback allegations in Shea v. eHealth, demonstrate increasing enforcement scrutiny on Medicare Advantage marketing practices, say Ellen London at London & Naor, Li Yu at Bernstein Litowitz and Erica Hitchings at the Whistleblower Law Collaborative.

  • Federal Regs Order May Spell Harsher FDCA Enforcement

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    A recent executive order aimed at reducing criminal prosecutions of those who unknowingly violate complex federal regulations may actually lead to more aggressive felony indictments under the Federal Food, Drug and Cosmetic Act, but companies and executives can mitigate risks by following several key principals, say attorneys at McGuireWoods.

  • What High Court's Tenn. Trans Care Ruling Means Nationally

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    The U.S. Supreme Court's decision in U.S. v. Skrmetti, upholding a Tennessee ban on gender-affirming medical care for minors, is fairly limited in scope and closely tailored to the specific language of Tennessee's law, but it may have implications for challenges to similar laws in other states, say attorneys at Hall Render.

  • High Court ACA Ruling May Harm Preventative Care

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    The U.S. Supreme Court's decision in Kennedy v. Braidwood last week, ruling that the U.S. Department of Health and Human Services secretary has authority over an Affordable Care Act preventive care task force, risks harming the credibility of the task force and could open the door to politicians dictating clinical recommendations, says Michael Kolber at Manatt.

  • Rising Enforcement Stakes For Pharma Telehealth Platforms

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    Two pieces of legislation recently introduced in Congress could transform the structure and promotion of telehealth arrangements as legislators increasingly scrutinize direct-to-consumer advertising platforms, potentially paving the way for a new U.S. Food and Drug Administration policy with bipartisan support, say attorneys at Sheppard Mullin.

  • 3 Judicial Approaches To Applying Loper Bright, 1 Year Later

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    In the year since the U.S. Supreme Court overturned Chevron deference in its Loper Bright Enterprises v. Raimondo decision, a few patterns have emerged in lower courts’ application of the precedent to determine whether agency actions are lawful, say attorneys at Husch Blackwell.

  • How Providers Can Brace For Drug Pricing Policy Changes

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    Though it's uncertain which provisions of the Trump administration's executive order aimed at addressing prescription drug costs will eventually be implemented, stakeholders can reduce potential negative outcomes by understanding pathways that could be used to effectuate the order's directives, say attorneys at McDermott.

  • Debunking 4 Misconceptions Around Texas' IV Therapy Law

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    Despite industry confusion, an IV therapy law enacted in Texas last week may actually be the most business-friendly regulatory development the medical spa industry has seen in recent years, says Keith Lefkowitz at Hendershot Cowart.

  • Legacy Of 3 Justices Should Guide Transgender Rights Ruling

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    Three Republican-appointed U.S. Supreme Court justices — Anthony Kennedy, Sandra Day O'Connor and David Souter — gave rise to a jurisprudence of personal liberty that courts today invoke to protect gender-affirming care, and with the court now poised to decide U.S. v. Skrmetti, it must follow the path that they set, says Greg Fosheim at McDermott.