Policy & Compliance
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August 12, 2025
Antitrust Actions, Drug Pricing And More
A federal appeals court revived an antitrust suit against drugmakers, the Federal Trade Commission challenged a heart valve company acquisition, a patient's privacy lawsuit against an urgent care clinic was allowed to proceed, and a Texas federal court upheld Medicare's drug price negotiation program. Here, Law360 Healthcare Authority looks at those and other healthcare litigation developments you may have missed over the past week.
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August 12, 2025
NJ Is Key Battleground In Fight Over Newborn Blood Tests
Newborn blood screening, a cornerstone of modern public health, is the focus of a debate over patient privacy, parental consent and what happens to the samples after initial tests are complete. A New Jersey court recently weighed in.
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August 12, 2025
340B Rebate Plan Sparks Questions On Enforcement, Appeals
The drug industry, long critical of the 340B discount program, appeared to score a win when the Trump administration announced a post-sale rebate model. Hospitals and other buyers have some notes on a potentially deficient appeal process and other uncertainties.
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August 12, 2025
Religious Liberty Claims Spread In Abortion Ban Challenges
With the U.S. Supreme Court expanding religious protections, a groundswell of lawsuits challenging state abortion bans on free-exercise grounds has emerged.
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August 11, 2025
Aetna, CVS Want Lab's $21M Payment Suit Tossed For Good
Aetna and its parent company, CVS Health Corp., said a medical laboratory can't stand in the shoes of patients who were allegedly denied coverage by the insurer for lab tests, and they have asked a Connecticut federal judge to toss the lab's lawsuit for good.
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August 11, 2025
Rural Health Providers Say FCC Subsidy Rules Unclear
Rural healthcare providers still don't know what is and isn't covered by the Universal Service Fund and could use some clarification and guidance from the Federal Communications Commission, a group has told the agency.
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August 11, 2025
Proskauer Hires Epstein Becker Lawyer For DC, LA Practices
A healthcare litigator with experience in-house, at the U.S. government and in private practice, has joined Proskauer Rose LLP as a partner to continue working on healthcare, white collar defense and investigation, the firm announced Monday.
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August 08, 2025
Trump EO Requires Appointee Oversight Of US Grantmaking
President Donald Trump has issued an executive order requiring that all funding opportunity announcements and grant awards be reviewed by his political appointees and allowing for grants to be terminated that fall outside the administration's priorities.
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August 08, 2025
DC Medicaid Recipients Win Class Cert. For Notice Row
A D.C. federal judge granted a class certification motion lodged by a group of Medicaid beneficiaries who allege the district has violated their due process rights by failing to provide individualized written notices explaining prescription coverage denials and appeal rights.
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August 08, 2025
Administration Says States Can't Second-Guess ACA Changes
The Trump administration urged a Massachusetts federal court to reject a request by a group of states seeking to stay implementation of new rules that will reduce Affordable Care Act healthcare marketplace subsidies and enforce certain enrollment restrictions.
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August 08, 2025
Iowa PBM Law Challengers Seek Wider Block At 8th Circ.
Employers and benefit plans challenging an Iowa law aiming to limit pharmacy benefit managers' power to set drug prices will seek Eighth Circuit review of a district court judge's decision from July that temporarily blocked parts of the new policy as preempted by federal benefits law.
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August 08, 2025
Attys Seek Final OK Of $100M Walgreens Rx Cost Settlement
An Illinois federal judge should greenlight a $100 million settlement to claims that Walgreens overcharged insured customers for generic prescription drugs, the plaintiffs' attorneys said, asking the judge to wrap up the 8-year-old consumer protection litigation.
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August 07, 2025
Health Insurance Telemarketers Cough Up $145M In FTC Suits
Two telemarketing companies will pay $145 million to settle Federal Trade Commission claims that they misled millions of consumers into buying phony health insurance plans, the FTC said in a Thursday announcement accusing the telemarketers of making false promises that didn't provide what they offered.
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August 07, 2025
HHS Wins Another Round In Medicare Drug Negotiation Battle
A Texas federal court dealt another blow to the pharmaceutical industry Thursday when it ruled in favor of Medicare's Drug Price Negotiation Program, turning away arguments that the program is unconstitutional — the third such decision in two days.
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August 07, 2025
BioPharma Co.'s $15M Deal Over Ruined J&J Vaccines OK'd
A Maryland federal judge on Thursday granted final approval to a $15 million settlement to close out a stockholder derivative suit claiming Emergent BioSolutions Inc. and its top brass made a mint selling stock before their allegedly lax oversight led to the contamination of over 15 million Johnson & Johnson COVID-19 vaccine doses.
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August 07, 2025
Michigan AG Fights Bid To Pause PBM Price-Fixing Suit
Michigan's attorney general has said there is no reason to pause her price-fixing suit against pharmacy benefit managers Express Scripts and Prime Therapeutics for a pending dismissal motion, urging a federal judge not to put discovery on ice.
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August 07, 2025
10th Circ. Upholds Okla. Law Banning Trans Care For Minors
The Tenth Circuit declined to block an Oklahoma law banning gender-affirming care for transgender minors, ruling that a recent U.S. Supreme Court opinion backing a similar law from Tennessee undermines state residents' claims that the statute is discriminatory.
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August 07, 2025
2nd Circ. Axes Challenge To Medicare Drug Price Negotiations
In a published opinion Thursday, the Second Circuit turned away Boehringer Ingelheim's constitutional and administrative challenge to the Medicare Drug Price Negotiation Program, finding that the program is voluntary and it was lawfully implemented under the Inflation Reduction Act.
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August 07, 2025
Mich. Agency Can't Shake Suit Over Fights At Psych Hospital
The Michigan claims court has ruled that the state's health department must face a lawsuit over the beating of a child at a state-run psychiatric facility because the complaint adequately alleged hospital staff took intentional steps that "directly and predictably" led to the fight.
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August 06, 2025
6th Circ. Rips 'Stalking Horse' Ploy In Drug Negotiation Suit
The pharmaceutical industry will feel the sting of a Wednesday loss in a wide-ranging war over Medicare's power to negotiate drug prices, as the Sixth Circuit tossed a suit and accused one major company of utilizing a "stalking horse" to sue in a more favorable forum.
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August 06, 2025
States Urge Justices To Back Med Mal Laws In Federal Court
Tennessee and 26 other states on Wednesday urged the U.S. Supreme Court to hold that state statutes requiring an expert affidavit in all medical malpractice suits may be applied in federal court, arguing that overriding these laws under federal procedure rules would undermine state authority.
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August 06, 2025
Compelling ERISA Arbitration No Sure Thing, 9th Circ. Shows
The Ninth Circuit aligned with several other federal appeals courts when it recently struck down a clause in a food service company's employee health plan that barred class or representative actions, marking the latest in a series of setbacks for employers looking to push federal benefits suits into solo arbitration.
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August 06, 2025
Texas Hospital Should Face Retirement Plan Suit, Judge Says
A Houston hospital shouldn't dodge a proposed class action claiming it failed to remove a J.P. Morgan fund from its $2.8 billion employee retirement plan despite the investment option's consistent underperformance, a Texas federal magistrate judge recommended Wednesday, saying the allegations are solid enough to stay in court.
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August 06, 2025
Spinal Implant Co. CEO Avoids Prison After Plea Deal
The founder and CEO of Massachusetts medical device maker SpineFrontier was sentenced Wednesday to a year of supervised release, the first six months on home confinement, for directing employees to mislead the government about the nature of payments to a surgeon who was using the company's products.
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August 06, 2025
State AGs Want Final OK For $39M Apotex Price-Fixing Deal
Nearly every state attorney general in the country has asked a Connecticut federal judge to give final approval to a $39.1 million deal to settle claims that drugmaker Apotex Corp. schemed with others to fix prices and allocate markets for generic drugs, noting that the Florida-based company has already made the payment.
Expert Analysis
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A Look At Key 5th Circ. White Collar Rulings So Far This Year
In the first half of 2025, the Fifth Circuit has decided numerous cases of particular import to white collar practitioners, which collectively underscore the critical importance of meticulous recordbuilding, procedural compliance and strategic litigation choices at every stage of a case, says Joe Magliolo at Jackson Walker.
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What US Medicine Onshoring Means For Indian Life Sciences
Despite the Trump administration's latest moves to onshore essential medicine manufacturing, India will likely remain an indispensable component of the U.S. drug supply chain, but Indian manufacturers should prepare for stricter compliance checks, says Jashaswi Ghosh at Holon Law Partners.
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FCA Working Group Reboot Signals EHR Compliance Risk
The revival of the False Claims Act working group is an aggressive expansion of enforcement efforts by the Justice Department and the U.S. Department of Health and Human Services targeted toward technology-enabled fraud involving electronic health records and other data, say attorneys at ArentFox Schiff.
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FDA's Hasty Policymaking Approach Faces APA Challenges
Though the U.S. Food and Drug Administration has abandoned its usual notice-and-comment process for implementing new regulatory initiatives, two recent district court decisions make clear that these programs are still susceptible to Administrative Procedure Act challenges, says Rachel Turow at Skadden.
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The Metamorphosis Of The Major Questions Doctrine
The so-called major questions doctrine arose as a counterweight to Chevron deference over the past few decades, but invocations of the doctrine have persisted in the year since Chevron was overturned, suggesting it still has a role to play in reining in agency overreach, say attorneys at Crowell & Moring.
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A Rapidly Evolving Landscape For Noncompetes In Healthcare
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.
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Arguing The 8th Amendment For Reduction In FCA Penalties
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.
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$95M Caremark Verdict Should Put PBMs On Notice
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.
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DOJ Actions Signal Rising Enforcement Risk For Health Cos.
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.
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Spotlight On Medicare Marketing Practices Enforcement Trend
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.
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Federal Regs Order May Spell Harsher FDCA Enforcement
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.
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What High Court's Tenn. Trans Care Ruling Means Nationally
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.
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High Court ACA Ruling May Harm Preventative Care
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.