Policy & Compliance

  • April 08, 2025

    NJ Hospital Can Face Claims In Life Support Malpractice Suit

    A New Jersey appeals court won't let a hospital escape claims that it wrongfully took a patient off life support, saying Tuesday the trial court was too hasty in tossing the suit under the New Jersey Declaration of Death Act.

  • April 08, 2025

    Calif. Bill Aims To Limit Insurer Control Over Addiction Care

    A number of U.S. states have made it illegal for insurance providers to override a physician's judgment concerning the addiction treatments necessary for their patient, be it for inpatient care or other kinds of therapies. A recently introduced bill could make California the latest to join the trend.

  • April 08, 2025

    5th Circ. Orders New Trial In $140M Healthcare Fraud Case

    A Fifth Circuit panel shot down a bid from a suspect in a $140 million healthcare fraud scheme to forestall a second trial after alleged prosecutorial misconduct sank the first, finding the government hadn't intentionally withheld evidence.

  • April 08, 2025

    OIG Finds $1.8M Of Potential 'Overbillings' In VA Contract

    The Department of Veterans Affairs Office of Inspector General said Tuesday that a transportation services contractor may have overbilled the department by about $1.8 million over two years and recommended that VA contracting officials consider whether they could or should try to recover any money.

  • April 08, 2025

    Expert And 'Worthlessness Theory' Ejected In Valsartan MDL

    Patients and insurers who claim they were ripped off when purchasing the contaminated blood pressure medication Valsartan won't be able to argue that the drug was worthless as a matter of law, a New Jersey federal judge overseeing the multidistrict litigation has ruled, casting doubt that the plaintiffs will secure a full refund for their purchase.

  • April 08, 2025

    Medicare Drug Price Plan Tramples Constitution, 3rd Circ. Told

    New Jersey federal court rulings preserving the Centers for Medicare & Medicaid Services' ability to negotiate prices with drug companies should be overturned on constitutional grounds, pharmaceutical giants Novo Nordisk and Novartis told the Third Circuit during oral arguments Tuesday.

  • April 08, 2025

    UnitedHealth Puts Anesthesiologists' Antitrust Suit To Sleep

    A New York federal judge tossed an antitrust lawsuit accusing a United Healthcare unit of using its market power in the New York metropolitan area to cut reimbursement rates to anesthesia providers by 80% in its public-sector employee health plan, while enlisting MultiPlan to pressure providers into accepting the rates.

  • April 08, 2025

    Md. Board Enacts Expungement Rule For Physician Records

    Maryland doctors who have faced administrative action for failing to pay taxes or attend continuing education classes can have their public records wiped clean under a new rule from the state Board of Physicians.

  • April 08, 2025

    2nd Circ. Rejects Biden Diary Thief's Appeal Over Medical Info

    The Second Circuit denied an appeal on Tuesday from a woman who pled guilty to stealing a diary belonging to former President Joe Biden's daughter, rejecting her arguments that a judge was wrong to allow a probation officer to disclose her presentencing report and prior medical records to mental health providers without first obtaining consent.

  • April 07, 2025

    CMS' Nursing Home Staffing Requirements Struck Down

    A Texas federal judge on Monday struck down new staffing standards for nursing homes participating in Medicare or Medicaid, ruling that federal health officials overstepped their authority by establishing a one-size-fits-all requirement.

  • April 07, 2025

    Policy Group Tells 4th Circ. Drug Discount Law Needs Reform

    The Fourth Circuit on Monday allowed a Boston-based think tank to file an amicus brief supporting a district court's injunction against a West Virginia law that pharmaceutical companies and lobbyists claim unconstitutionally expands a federal drug discount program.

  • April 07, 2025

    Drug Buyers, Generics Cos. Fight Over Bellwether Litigation

    Generic drug buyers vied Friday with the pharmaceutical companies they've accused of price-fixing over how to shape the first rounds of long-gestating Pennsylvania federal court litigation that the plaintiffs want heard in separate consecutive trials and that the drugmakers want combined.

  • April 07, 2025

    AGs Announce $335M Opioid Deal With Mylan

    New York Attorney General Letitia James on Monday said her office and those of other states reached a $335 million deal with Mylan to help combat the opioid crisis.

  • April 07, 2025

    Ex-Conn. Budget Official Plans To Testify In Corruption Cases

    Twice-indicted former Connecticut budget official Konstantinos Diamantis plans to testify in two upcoming federal corruption trials, his attorney revealed Monday during a scheduling call that snapped into focus the timeline for both cases.

  • April 07, 2025

    Conn. Judge Pauses 'Staggering' Hospital Data Subpoena

    A Connecticut judge temporarily paused a subpoena seeking what a health nonprofit called "a staggering amount" of confidential patient data by a proposed class of Constitution State residents accusing Hartford HealthCare Corp. of monopolizing the state's healthcare industry, stating that the court must review the subpoena first.

  • April 07, 2025

    11 States Tell 6th Circ. To Ax Mich. Conversion Therapy Ban

    Eleven U.S. states led by Iowa and South Carolina urged the Sixth Circuit to strike down Michigan's ban on conversion therapy for minors, saying the law censors therapists' speech.

  • April 07, 2025

    Feds Say Fla. Doctor Fleeced Medicare With Bogus Charges

    A doctor and his Florida-based business, Vohra Wound Physicians Management LLC, deliberately overbilled Medicare for years, charging it for wound care procedures that were unnecessary or not performed, according to federal prosecutors.

  • April 04, 2025

    Split DC Circ. Denies Calif. Subsidies For Border Hospitals

    A split D.C. Circuit panel on Friday found it was not unconstitutional for California to exclude hospitals bordering the state from a program distributing supplemental payments to providers that serve Medi-Cal beneficiaries.

  • April 04, 2025

    HHS Drops 11th Circ. Fight Over ACA Trans Rule Freeze

    The U.S. Department of Health and Human Services agreed to drop its bid to overturn an order blocking it from enforcing regulations that extend the Affordable Care Act's anti-discrimination provisions to transgender individuals against Florida organizations, according to filings with the Eleventh Circuit.

  • April 04, 2025

    Ohio AG Takes Trans Care Limits Bid To State Justices

    Ohio Attorney General Dave Yost has taken his bid to reinstate limits on gender-affirming care for transgender youths to the state's highest court and wants the law's enforcement to continue throughout his appeal.

  • April 04, 2025

    Seattle Children's Faces Class Action Over Nurse Meal Breaks

    A Washington nurse has filed a proposed class action alleging Seattle Children's Hospital broke state law by failing to schedule or provide mandatory rest and meal breaks, in a state court complaint that said the problem was made worse by understaffing during the COVID-19 pandemic.

  • April 04, 2025

    AGs Sue To Halt Disruptions To NIH Grant Funding

    A coalition of 16 states on Friday sued the National Institutes of Health over delays and cancellations of grant programs linked to vaccines, transgender issues and other areas they say are currently "disfavored" by the Trump administration.

  • April 03, 2025

    Optum, Express Scripts Want Judge Ousted From Opioid MDL

    Pharmacy benefit managers Optum and Express Scripts say the Ohio federal judge overseeing multidistrict opioid litigation should recuse himself because he "regularly communicates" with plaintiffs' attorneys in the litigation and is biased in favor of plaintiffs, according to a motion filed Wednesday.

  • April 03, 2025

    TV Star Dr. Oz Confirmed As New Medicare, Medicaid Leader

    The U.S. Senate on Thursday voted 53 to 43, along party lines, to confirm former talk show host and surgeon Dr. Mehmet Oz to be the next administrator of the Centers for Medicare & Medicaid Services.

  • April 03, 2025

    Swedish Health Services Found Liable For Wage Violations

    A Washington state judge has put Seattle-area hospital system Swedish Health Services on the hook for state wage law violations in an employee class action, finding workers were shortchanged by its timekeeping practices and failure to provide a second meal break on longer shifts.

Expert Analysis

  • Incoming Admin May Shake Up Life Sciences Regulation

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    Though President-elect Donald Trump has not yet articulated policy priorities regarding the life sciences industry, the sector is positioned to see significant changes that could affect everything from drug exclusivity and generic drug approvals, to the availability of over-the-counter drugs, to laboratory-developed tests and digital health, say attorneys at Morgan Lewis.

  • Navigating DOJ's Patchwork Whistleblower Regime

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    In the past few months, the U.S. Department of Justice and several individual U.S. attorney’s offices have issued different pilot programs aimed at incentivizing individuals to blow the whistle on misconduct, but this piecemeal approach may create confusion and suboptimal outcomes, say attorneys at BakerHostetler.

  • What To Expect Next From Federal Health Tech Regulation

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    Healthcare organizations should pay close attention to federal health information technology regulators' recent guidance concerning barriers to accessing electronic health information, which signals that more enforcement in this area is likely forthcoming, say attorneys at Ropes & Gray.

  • 5 Areas Congress May Investigate After GOP Election Wins

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    With Republicans poised to take control of Congress in addition to the executive branch next year, private companies can expect an unprecedented uptick in congressional investigations focused on five key areas, including cryptocurrency and healthcare, say attorneys at Cahill Gordon.

  • Takeaways From State Votes On Abortion In The 2024 Election

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    Attorneys at Epstein Becker discuss how 10 states voted on ballot initiatives to either protect or restrict access to abortion in the 2024 general election, and analyze overarching trends.

  • Loper Bright Offers New Materiality Defense To FCA Liability

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    The U.S. Supreme Court's decision in Loper Bight Enterprises v. Raimondo, ending Chevron deference, may have created a new defense to False Claims Act liability by providing the opportunity to argue that a given regulation is not material to the government's payment decision, says Tanner Cook at Husch Blackwell.

  • How Expanded Birth Control Coverage May Affect Employers

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    Employers should consider the potential impact of recently proposed regulations that would expand group health plans' required coverage of preventive services and contraceptives, including questions about how the agencies would implement their plans to eliminate the prescription requirement and alter the exceptions process, says Jennifer Rigterink at Proskauer.

  • Legislation Most Likely To Pass In Lame Duck Session

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    As Congress begins its five-week post-election lame duck session, attorneys at Greenberg Traurig break down the legislative priorities and which proposals can be expected to pass.

  • Preserving The FCA Is Crucial In Trump's 2nd Term

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    While the Trump administration may pursue weaker False Claims Act enforcement, it remains an essential tool in safeguarding public funds and maintaining corporate accountability, so now is not the time to undermine ethical behavior, or reduce protections and incentives for whistleblowers, says Adam Pollock at Pollock Cohen.

  • PREVAIL Bill Is Another Misguided Attempt To Restrict PTAB

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    The decade-long campaign against the U.S. Patent and Trademark Office's Patent Trial and Appeal Board — currently focused on the PREVAIL Act that's slated for markup in the Senate — is not really about procedural issues, and it is not aimed at securing more accurate patentability decisions, says Clear IP's Joseph Matal, former acting director at the USPTO.

  • Justices Face Tough Question On HHS Hospital Pay Formula

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    In Advocate Christ Medical Center v. Becerra, the U.S. Supreme Court will determine whether the U.S. Department of Health and Human Services properly applied certain Medicare reimbursement adjustments to hospitals — a decision that could significantly affect hospitals' ability to seek higher Medicare reimbursement for low-income patients, say attorneys at Sheppard Mullin.

  • Key Healthcare Issues That Hinge On The Election Outcome

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    The 2024 presidential race, while not heavily dominated by healthcare issues compared to past elections, holds significant implications for the direction of healthcare policy in a potential Harris or Trump administration, encompassing issues ranging from Medicare to artificial intelligence, says Miranda Franco at Holland & Knight.

  • The Key To Solving High Drug Costs Is Understanding Causes

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    One-sided views on who or what contributes to the high cost of pharmaceuticals render possible solutions much harder to discover and implement, and a better approach would be to examine history and learn why costs have increased and what legislation has and hasn't helped, says Nancy Linck at NJ Linck Consulting.