Policy & Compliance

  • July 07, 2025

    Atty-Client Shield Null In HIV Drug Fraud Case Docs, Feds Say

    Two alleged distributors of sham HIV drugs can't shield more than 1,000 documents related to legal advice from discovery, U.S. prosecutors told a Florida federal judge Monday, asserting that any attorney-client privilege is invalidated because the advice was used to facilitate a $90 million fraud.

  • July 07, 2025

    Ex-Leerink Banker Can't Get Redo On Unpaid Bonuses Claim

    A Massachusetts federal judge declined on Monday to rethink partially tossing a former Leerink Partners employee's suit alleging she was cheated out of millions of dollars in bonuses, rejecting the worker's argument that new evidence should change the court's mind.

  • July 07, 2025

    J&J Unit Looks To Wipe Out $442M Catheter Antitrust Loss

    Johnson & Johnson health tech unit Biosense Webster has asked a California federal court to throw out Innovative Health's $442 million trial win in a case accusing Biosense of conditioning product support for its cardiac mapping systems on the purchase of cardiac catheters.

  • July 03, 2025

    States Still Oppose Florida's Generic Drug Deal With Sandoz

    States accusing generic-drug makers of fixing prices are continuing to object to a $10 million settlement struck between Florida and Sandoz, arguing that it limits their ability to negotiate deals while letting the Sunshine State benefit without participating in the litigation.

  • July 03, 2025

    Natera Inks $8.25M Deal To End Prenatal Tests Suit

    A proposed class of buyers of Natera Inc.'s noninvasive prenatal tests has asked a California federal court to give preliminary approval to an $8.25 million settlement to resolve claims that the company knew the tests were unreliable but failed to tell buyers.

  • July 03, 2025

    High Court Passes On Mont. Abortion, Parental Consent Case

    The U.S. Supreme Court declined Thursday to hear a case focused on parental consent and abortion in Montana, as two conservative justices said the decision shouldn't be seen as a rejection by the justices of the parental-rights question itself.

  • July 03, 2025

    HHS Ordered To Restore Data Axed Under 'Gender Ideology' EO

    The U.S. Department of Health and Human Services must restore a swath of webpages and datasets it took down following a Trump administration executive order seeking to root out references to so-called gender ideology, a D.C. federal judge ruled.

  • July 03, 2025

    Mich. Justices Turn Down Challenge To Med Mal Damage Cap

    Michigan's highest court won't weigh in on the constitutionality of the state's caps on medical malpractice awards, rejecting a federal district court's certified question Thursday.

  • July 03, 2025

    The Firms That Won Big At The Supreme Court

    The number of law firms juggling three or more arguments before the U.S. Supreme Court this past term nearly doubled from the number of firms that could make that claim last term.

  • July 03, 2025

    Breaking Down The Vote: The High Court Term In Review

    The U.S. Supreme Court once again waited until the term's closing weeks — and even hours — to issue some of its most anticipated and divided decisions.

  • July 03, 2025

    Supreme Court Takes Up Transgender Sports Bans

    The U.S. Supreme Court agreed Thursday to hear challenges to West Virginia and Idaho laws barring transgender athletes from competing on sports teams consistent with their gender identity, putting yet more anti-trans legislation to the test after upholding Tennessee's ban on gender-affirming care for minors this term. 

  • July 02, 2025

    9th Circ. Upholds Sutter Health's Win In Doc's Kickback Suit

    The Ninth Circuit refused to revive a gastroenterologist's constitutional challenge against Sutter Health alleging the nonprofit paid kickbacks to its physicians to refer low-income patients to other hospitals, ruling Wednesday the appellant lacks evidence of purported kickbacks and doesn't address how the alleged injury to those patients harmed him. 

  • July 02, 2025

    ACA Changes Will Result In Mass Coverage Loss, Suit Claims

    Doctors for America, the Main Street Alliance and a trio of cities urged a Maryland federal court to vacate recently finalized changes to Affordable Care Act regulations, arguing they will cause at least 1.8 million people to lose their healthcare coverage.

  • July 02, 2025

    Veterans Sue Air Force For Disability Review Failures

    Three former service members hit the U.S. Air Force with a proposed class action challenging the lawfulness of a screening process used to determine if people should be retained or referred to a formal disability evaluation process.

  • July 02, 2025

    DOJ, HHS Form New False Claims Act Enforcement Group

    Lead attorneys at the U.S. Department of Health and Human Services and the Justice Department will head a working group focused on enforcement of the False Claims Act, government officials announced Wednesday.

  • July 02, 2025

    Pa. Hospital Co. To Pay $2.75M Over Drug Theft Suit

    Pennsylvania healthcare company Lehigh Valley Hospital Network Inc. has agreed to pay the federal government $2.75 million to settle claims that it ran afoul of controlled substance laws when one of its pharmacy technicians allegedly stole medication on multiple occasions.

  • July 02, 2025

    6th Circ. Backs Cigna's Win In Emergency Room Billing Suit

    The Sixth Circuit has ruled that Cigna did not have to face an unjust enrichment lawsuit brought against it by two Tennessee hospitals alleging the insurer underpaid them for out-of-network emergency services, backing a lower court's dismissal order.

  • July 02, 2025

    Wisconsin High Court Narrowly Blocks 1849 Abortion Ban

    The Wisconsin Supreme Court on Wednesday narrowly struck down an 1849 statute criminalizing abortion, finding that the law has been effectively replaced by more modern legislation regulating the procedure.

  • July 01, 2025

    5 Healthcare Enforcement Actions You Don't Want To Miss

    A healthcare fraud operation announced by the Justice Department targeting $14.6 billion in potential false claims wasn't the only enforcement action making waves in the industry this past week.

  • July 01, 2025

    Texas Goes Big On New Healthcare Laws

    It may be mid-summer, but Texas lawmakers are sending doctors and lawyers back to school for a course on what constitutes a "medical emergency" for the purpose of a legal abortion. Law360 Healthcare Authority looks at that statute and other legislation becoming law in the Lone Star State.

  • July 01, 2025

    State AGs Sue Gov't To Halt Medicaid Data Sharing With ICE

    A California-led coalition of nearly two dozen state attorneys general is pushing a federal court to stop the U.S. Department of Health and Human Services from giving immigration officials "unfettered access" to Medicaid recipients' personal health information, arguing that the sharing flouts decades of policy and practice.

  • July 01, 2025

    Iowa Judge Halts Law Targeting Pharmacy Benefit Managers

    A federal judge in Des Moines has temporarily blocked an Iowa law regulating pharmacy benefit managers, delivering a significant victory to a coalition of local businesses that argued the statute overstepped federal authority and infringed on free speech.

  • July 01, 2025

    Lighting Co. Can't Escape 401(k) Forfeiture, Health Fee Suit

    An Illinois federal judge narrowed a proposed federal benefits class action against an automotive lighting company from an ex-worker, but allowed allegations to proceed to discovery alleging the company misspent 401(k) forfeitures and failed to properly notify workers about a health plan tobacco surcharge.

  • July 01, 2025

    High Court Ruling Puts Limits On Medicaid Enforcement

    The U.S. Supreme Court ruling that bars a Medicaid beneficiary from suing over her right to choose a medical provider could make more states comfortable following South Carolina’s lead and cutting off Medicaid funding for disfavored providers.

  • July 01, 2025

    Rural Clinics Win Reprieve For Telehealth Funds At High Court

    Thousands of rural healthcare clinics that rely on federal subsidies to provide telehealth services to millions of patients secured a major win when the U.S. Supreme Court ruled that the funding for a key Federal Communications Commission program is not unconstitutional.

Expert Analysis

  • First 10b5-1 Insider Trading Case Raises Compliance Issues

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    The ongoing case against former Ontrak CEO Terren Peizer is the U.S. Department of Justice's first insider trading prosecution based primarily on the filing of 10b5-1 plans, and has important takeaways for attorneys reviewing corporate policies on the possession of material nonpublic information, say attorneys at Cadwalader.

  • Policy Misrepresentations Carry Insurance Rescission Risks

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    The Second Circuit's recent decision in Medical Mutual v. Gnik, finding that material misrepresentation in a clinic's insurance applications warranted policy rescission, is a clear example of the far-reaching effects that misrepresentations can have and provides a reminder that policyholders should employ relatively straightforward steps to decrease risks, say attorneys at Hunton.

  • The Pros And Cons Of NIST's Proposed March-In Framework

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    Recent comments for and against the National Institute of Standards and Technology’s proposed guidance on march-in rights — which permit the government to seize federally funded patents — highlight how the framework may promote competition, but could also pose a risk to contractors and universities, say Nick Lee and Paul Ragusa at Baker Botts.

  • 2 Recent Suits Show Resiliency Of Medicare Drug Price Law

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    Though pharmaceutical companies continue to file lawsuits challenging the Inflation Reduction Act, which enables the federal government to negotiate for lower prescription drug prices, recent decisions suggest that the reduced drug prices are likely here to stay, says Jose Vela Jr. at Clark Hill.

  • Defense Attys Must Prep For Imminent AI Crime Enforcement

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    Given recent statements by U.S. Department of Justice officials, white collar practitioners should expect to encounter artificial intelligence in federal criminal enforcement in the near term, even in pending cases, say Jarrod Schaeffer and Scott Glicksman at Abell Eskew.

  • Lessons For Nursing Facilities From DOJ Fraud Settlement

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    The U.S. Department of Justice's recent settlement with the owner of skilled nursing and assisted living facilities in Florida provides a cautionary tale of potential fraud risks, and lessons on how facilities can mitigate government enforcement actions, say Callan Stein and Rebecca Younker at Troutman Pepper.

  • HHS' Updated Tracking Tech Guidance Offers Little Clarity

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    The U.S. Department of Health and Human Services' Office for Civil Rights' updated guidance on the use of online tracking technologies appears more focused on legal issues raised in ongoing litigation with the American Hospital Association and less on practical guidance for covered entities, say attorneys at Sheppard Mullin.

  • Takeaways From The 2023 DOJ Fraud Section Report

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    Attorneys at Wiley discuss notable trends from the U.S. Department of Justice's recently reported Fraud Section activity last year and highlight areas of enforcement to watch for in the future, including healthcare fraud and Foreign Corrupt Practices Act violations.

  • NIST March-In Framework Is As Problematic As 2021 Proposal

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    While the National Institute of Standards and Technology's proposed march-in framework on when the government can seize patents has been regarded as a radical departure that will support lowering prescription drug costs, the language at the heart of it is identical to a failed 2021 notice of proposed rulemaking, says attorney Kelly Morron.

  • Spartan Arbitration Tactics Against Well-Funded Opponents

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    Like the ancient Spartans who held off a numerically superior Persian army at the Battle of Thermopylae, trial attorneys and clients faced with arbitration against an opponent with a bigger war chest can take a strategic approach to create a pass to victory, say Kostas Katsiris and Benjamin Argyle at Venable.

  • The Road Ahead For Florida's Drug Importation Program

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    Though the U.S. Food and Drug Administration approved Florida's drug importation program in January, a series of hurdles — including requisite buy-in from Canada — and potential legal challenges must be addressed before importation can begin, say attorneys at Ropes & Gray.

  • Assessing CDC's Revised Guideline On Opioid Prescriptions

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    Kenneth Weinstein, Nicholas Van Niel and Kate Uthe at Analysis Group look at newly available data to evaluate the impact that the Centers for Disease Control and Prevention's revised opioid monitoring guideline have had on prescription trends in recent years, highlighting both specific and overall decreases.

  • Valeant Ruling May Pave Way For Patent-Based FCA Suits

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    The Ninth Circuit’s recent ruling in Silbersher v. Valeant marks a significant development in False Claims Act jurisprudence, opens new avenues for litigation and potentially raises the stakes for patent applicants who intend to do business with the government, say Joshua Robbins and Rick Taché at Buchalter.