Policy & Compliance

  • May 13, 2026

    Provider Says NY Is On The Hook For $3.3M Medicaid Shortfall

    The New York State Department of Health's refusal to enforce payment obligations by Medicaid managed care organizations has cost a Queens-based safety net provider at least $3.3 million in underpayments for behavioral health services, according to a suit filed in New York federal court.

  • May 12, 2026

    Trans Care In Court: Gov't Probes, Forum Concerns And More

    Law360 Healthcare Authority looks at developments over the past week in legal challenges to probes by the Justice Department and Federal Trade Commission concerning the provision of gender-affirming care for transgender minors.

  • May 12, 2026

    Cigna Says HIPAA Doesn't Save Website Privacy Suit

    A proposed group of Cigna health plan participants can't cite HIPAA to keep up their claims that the insurer improperly tracked their private information through its websites, since the privacy law doesn't cover the kind of information the company collected, the insurer told a Pennsylvania federal court.

  • May 12, 2026

    DOJ Playing 'Dirty Pool' With Hospital In Trans Care Subpoena

    A Rhode Island federal judge indicated Tuesday she's likely to quash a subpoena from the U.S. Department of Justice seeking to obtain gender-affirming care medical records from Rhode Island Hospital, saying the DOJ was playing "dirty pool" by filing a motion to enforce the subpoena in another jurisdiction.

  • May 12, 2026

    A Battle Bigger Than Abortion Pills On Deck At High Court

    The outcome of the latest abortion clash at the high court could reach well beyond mifepristone access and make other federal policy changes on hot-button or divisive issues more vulnerable to state challenges.

  • May 12, 2026

    Texas AG Targets CVS DEI Program, Threatens Fraud Probe

    Texas Attorney General Ken Paxton on Tuesday warned CVS Health its diversity, equity and inclusion program for suppliers may violate state and federal antidiscrimination laws and gave the company 14 days to respond or risk a Medicaid fraud investigation.

  • May 12, 2026

    A Look At 'Most Favored Nation' Drug Pricing One Year Later

    A year ago, President Donald Trump signed a wide-ranging executive order to deliver on a longtime goal of his: making drugs cheaper for Americans. Here is where his "Most Favored Nation" drug-pricing program stands now.

  • May 12, 2026

    Makary Out As FDA Commissioner, Trump Says

    U.S. Food and Drug Administration Commissioner Marty Makary is departing the agency, President Donald Trump confirmed on Tuesday, bringing to an end a tumultuous, one-year run as one of the nation's top health officials.

  • May 11, 2026

    Wash. Says Novartis Isn't Harmed By 340B Drug Pricing Law

    Washington is objecting to Novartis' attempt to block a state law that expands the discounts the drugmaker must provide under the federal 340B Drug Pricing Program, telling a federal court that worry about losing money doesn't constitute irreparable harm.

  • May 11, 2026

    Transgender Minor Patients Seek To Block DOJ Subpoenas

    A group of families asked a Maryland federal judge over the weekend to block the U.S. Department of Justice from obtaining private medical records of thousands of transgender minors across the country, saying subpoenas sent to medical providers violate their privacy.

  • May 11, 2026

    NYC Sanctioned For Sluggish Discovery In IVF Sex Bias Suit

    A federal judge sanctioned New York City on Monday for its lethargic discovery responses in a proposed class action claiming a municipal health plan unlawfully blocked gay men from receiving in vitro fertilization coverage, ordering the city to reimburse the couple leading the suit for their efforts to obtain documents.

  • May 11, 2026

    Justices Extend Stay On 5th Circ. Mifepristone Decision

    The U.S. Supreme Court on Monday extended a stay that preserved, for now, telehealth access to the abortion medication mifepristone.

  • May 11, 2026

    Plaintiffs' Attys Sanctioned In Tylenol MDL, Sparking Appeal

    A New York federal court sanctioned a plaintiffs' firm and its co-founder in federal multidistrict litigation by families alleging that prenatal exposure to acetaminophen can cause autism, saying they improperly shared confidential information from the case in related state court actions.

  • May 11, 2026

    Agencies Pitch Employers Offering Voluntary Fertility Benefits

    Federal agencies overseeing employer-provided health coverage proposed new rules aimed at expanding workers' access to coverage for infertility treatments and related health conditions by letting employers offer voluntary fertility health benefit policies for procedures such as in vitro fertilization.

  • May 08, 2026

    FTC's Gender-Care Probe Likely Retaliatory, Judge Says

    The Endocrine Society has convinced a D.C. federal judge that the Federal Trade Commission's motivation for targeting it with a subpoena was likely retaliation for the guidelines the nonprofit produced regarding gender-affirming care.

  • May 08, 2026

    Judge Probes Cert. For Diverse Worker Class In No-Poach Suit

    An Illinois federal judge considering whether to certify a class of former health care employees claiming their wages were suppressed by alleged no-poach agreements between DaVita, UnitedHealth Group's Surgical Care Affiliates and Tenet Healthcare Corp. unit United Surgical Partners International questioned Friday if the group of senior-level workers was too diverse for class treatment.

  • May 08, 2026

    Ohio Health System Looks To Toss DOJ Antitrust Case

    OhioHealth told a federal court Friday the antitrust case from the U.S. Department of Justice and state enforcers over the hospital system's contracts with insurers would limit competition, not restore it.

  • May 08, 2026

    4th Circ. Backs Toss Of Fired Worker's Whistleblower Suit

    The Fourth Circuit upheld the dismissal Friday of a home health salesperson's suit claiming he was fired out of retaliation for complaining about sexual comments made at a company picnic, ruling the lower court used the correct legal standard to throw out his case.

  • May 08, 2026

    Using FCA To Go After DEI Poses Legal Hurdles For DOJ

    The Trump administration's use of the False Claims Act to go after DEI policies diverges from past administrations' use of the civil fraud statute to tackle policy initiatives in key ways that may pose legal challenges to enforcement.

  • May 07, 2026

    NC Panel Rules Prior Verdict Bars Hospital Negligence Case

    A divided North Carolina state appeals court panel pulled the plug on a couple's negligence case against a local hospital, finding their suit is bound by a verdict in a separate, near-identical lawsuit in which a jury cleared the same hospital of wrongdoing.

  • May 07, 2026

    La. Says Mailed Abortion Pills Harm State Budget, Sovereignty

    The state of Louisiana on Thursday defended its standing to challenge telehealth access to the abortion medication mifepristone, telling the U.S. Supreme Court that it has suffered financial and other injuries as mail-order pills flood the state.

  • May 07, 2026

    EEOC Suit Over Blind Worker's Firing Heads To Trial

    A Tennessee federal judge cleared for trial a U.S. Equal Employment Opportunity Commission lawsuit claiming a hospital facilities management company unlawfully fired a blind worker, saying a jury should decide if the company properly evaluated the employee's ability to do his job.

  • May 07, 2026

    AstraZeneca Reps Fight To Keep Opt-Ins In Pay Bias Suit

    Female pharmaceutical sales representatives in an AstraZeneca equal pay suit have urged an Illinois federal court to reject the company's bid to dismiss two dozen opt-in plaintiffs for refusing discovery, saying the women feared retaliation and career consequences.

  • May 07, 2026

    Hospital Suspects DOJ Is Forum Shopping For Trans Records

    Children's Hospital of Philadelphia asked a federal judge this week to reassert control over the U.S. Department of Justice's demand for records of gender-affirming care, fearing the government's withdrawal of its local appeal and a case filed against another hospital in Texas portended "forum shopping" for a friendlier court.

  • May 07, 2026

    Harvard Pilgrim Sued Over 'Ghost' Mental Health Network

    Harvard Pilgrim Health Care and its parent company have lured subscribers with a "ghost network" of mental health providers who are frequently out of network, don't accept the insurance or are not taking new patients, according to a proposed class action filed in Massachusetts state court.

Expert Analysis

  • 4th Circ. Health Data Ruling Opens Door To State Law Claims

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    In Real Time Medical v. PointClickCare, the Fourth Circuit recently clarified that state law claims can rest in part on violations of a federal law that prohibits electronic health information blocking, expanding legal risks for health IT companies and potentially creating exposure to a range of competitive implications, say attorneys at BCLP.

  • Unpacking Trump Admin Plans For Value-Based Care

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    Recent developments from the Center for Medicare and Medicaid Innovation suggest the Trump administration intends to put its own stamp on value-based care, emphasizing cost savings assessment in particular, with its recent cancellation of several payment models that had supported primary care, says Miranda Franco at Holland & Knight.

  • What To Expect For Stem Cell Regulation Under Trump Admin

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    The new administration's push for deregulation, plus the post-Chevron legal landscape, and momentum from key political and industry players to facilitate stem cell innovation may create an opportune backdrop for a significant reduction in the U.S. Food and Drug Administration's regulatory framework for stem cells, say attorneys at Sheppard Mullin.

  • How Importers Can Minimize FCA Risks Of Tariff Mitigation

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    False Claims Act risks are inherent in many tariff mitigation strategies, making it important for importers to implement best practices to identify and report potential violations of import regulations before they escalate, says Samuel Finkelstein at LMD Trade Law.

  • 10 Practical Takeaways From FDA's Biopharma AI Guidance

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    Recent guidance from the U.S. Food and Drug Administration provides much-needed insight on the usage of artificial intelligence in producing information to support regulatory decision-making regarding drug safety, with implications ranging from life cycle maintenance to AI tool acquisition, say attorneys at Covington.

  • Lawmakers Shouldn't Overlook Rare Disease Therapies' Value

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    As the ORPHAN Cures Act is pending in Congress, policymakers assessing the value of certain drugs for price regulation should consider data beyond what is collected in clinical trials, say Alice Chen at the University of Southern California, and Molly Frean and Yao Lu at Analysis Group.

  • What Trump's Order Means For The Legal Status Of IVF

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    An executive order signed by President Donald Trump last month signals the administration's potential intention to increase protections for in vitro fertilization services, though more concrete actions would be needed to resolve the current uncertainty around IVF access or bring about a binding legal change, says Jeanne Vance at Weintraub Tobin.

  • Mitigating Tariff Risks For Healthcare In US And Canada

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    Healthcare stakeholders should take steps to evaluate the impact of cross-border tariffs, as the historically strong ties between Canada and the U.S. demonstrate the potential for real disruption and harm to the healthcare industry in both countries, say attorneys at Norton Rose.

  • What's At Stake In High Court Transgender Care Suit

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    The outcome of U.S. v. Skrmetti will have critical implications for the rights of transgender youth and their access to gender-affirming care, and will likely affect other areas of law and policy involving transgender individuals, including education, employment, healthcare and civil rights, say attorneys at ArentFox Schiff.

  • 6 Laws Transforming Calif.'s Health Regulatory Framework

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    Attorneys at Hooper Lundy discuss a number of new California laws that raise pressing issues for independent physicians and small practice groups, ranging from the use of artificial intelligence to wage standards for healthcare employees.

  • Anticipating Calif. Oversight Of PE Participation In Healthcare

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    A new bill recently introduced in the California Senate revives last year's attempt to increase oversight of healthcare transactions involving private equity groups and hedge funds, meaning that attorneys may soon need to assess the compliance status of existing management relationships and consider modifying contract terms, says Andrew Demetriou at Husch Blackwell.

  • Considering The Future Of AI Regulation On Health Sector

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    As Texas looks to become the next state to pass a comprehensive law regulating artificial intelligence, the healthcare industry should consider how AI regulation will continue to evolve in the U.S. and how industry members can keep up with compliance considerations, say attorneys at Kirkland & Ellis.

  • What To Expect From 'Make America Healthy Again' Actions

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    The Make America Healthy Again Commission recently established by President Donald Trump and chaired by Robert F. Kennedy Jr. will potentially bring energy and attention to important public health topics, and stakeholders should be aware of pathways for sharing their input and proactively informing proceedings, says Nicholas Manetto at Faegre Drinker.