Policy & Compliance

  • July 16, 2025

    8th Circ. Sends Part Of OptumRx Pricing Fight To Arbitration

    The Eighth Circuit partially reversed a ruling Wednesday that denied pharmacy benefits manager OptumRx's bid to send a drugstore's proposed class action over generics prescription reimbursements to arbitration, finding that OptumRx waived arbitration as to three claims, but an arbitrator must decide the fate of two recently pleaded claims.

  • July 16, 2025

    Pharmacy Benefit Managers Say Ohio Can't Recast Suit

    The state of Ohio can't "recast its complaint on appeal" in order to convince the Sixth Circuit that its enforcement suit accusing two pharmacy benefit managers of working to raise the cost of prescription drugs belongs in state court, those managers have told the appellate court.

  • July 16, 2025

    Maine Clinics Sue Over Medicaid Ban On Abortion Providers

    A Maine family planning organization sued the U.S. Department of Health and Human Services on Wednesday over abortion-related Medicaid restrictions outlined in President Donald Trump's budget act, saying they violate constitutional equal protection rights.

  • July 16, 2025

    Charity Care Is Not Unconstitutional Taking, NJ Justices Rule

    The New Jersey Supreme Court on Wednesday held that a state requirement to treat patients regardless of the patient's ability to pay does not amount to unconstitutional per se or regulatory taking, backing a lower court's decision that dismissed a group of Garden State hospitals' challenge to the requirement.

  • July 15, 2025

    GTCR Seeks Rival's Sales Data To Counter FTC Challenge

    The private equity firm looking to buy medical device coating company Surmodics is seeking Salesforce data from another competitor in the space, saying the information is crucial to showing that the industry will still be competitive if its acquisition is cleared.

  • July 15, 2025

    Trump Admin Seeks Win In Harvard $2B Funding Freeze Case

    The Trump administration urged a Massachusetts federal judge Monday to grant it summary judgment in Harvard University's lawsuit challenging the government's effort to freeze $2.2 billion in funding, arguing the dispute is a contract fight that belongs in the Federal Claims Court and the allegations fail on the merits.

  • July 15, 2025

    Split 4th Circ. Rejects GenBioPro Abortion Ban Challenge

    A split Fourth Circuit panel on Tuesday rejected GenBioPro's challenge to a West Virginia law banning medication abortion with narrow exceptions, with the majority finding the ban does not conflict with federal regulators' statutory authority to impose safety requirements on drug manufacturers.

  • July 15, 2025

    Medicaid Cuts Pose 'Frontal Assault,' Penn Law Prof Says

    Allison K. Hoffman, a health insurance regulation expert at the University of Pennsylvania Carey Law School, talks about the wide-ranging impacts of the cuts coming to Medicaid funding.

  • July 15, 2025

    Decades After Autism Omnibus, CDC Back In Thimerosal Fight

    An unusual legal proceeding two decades ago tested claims that childhood vaccines caused autism. The "omnibus" proceeding found no such link, cutting off the primary legal path for such claims. Today, a CDC advisory panel reconstituted by HHS Secretary Robert F. Kennedy Jr. is reopening the debate.

  • July 15, 2025

    Wash. Court Doubts Hospitals' Bid To Nix $230M Judgment

    A Washington state appellate judge criticized a hospital system's attempt to undo a $230 million loss in a class wage and hour suit on Tuesday, suggesting the employer's arguments about meal break waivers and timekeeping practices are at odds with its own records.  

  • July 15, 2025

    Workers Seek Class Status In United Pricing Scheme Suit

    A group of workers urged a California federal judge to award them class certification in their suit alleging United Behavioral Health and a billing contractor shorted them on coverage for out-of-network substance use disorder treatments, arguing they put forward new detail that clears class status requirements.

  • July 15, 2025

    Amid Budget Woe, New Hampshire Shutters Drug Price Board

    Bucking a trend of state efforts to rein in prescription drug prices, New Hampshire lawmakers have dissolved a state drug affordability board launched just five years ago.

  • July 15, 2025

    Wisconsin Health Co. Faces Trimmed 403(b) Fee Suit

    A federal judge agreed to trim a federal benefits lawsuit against a Wisconsin health system from a proposed class of employees who said their 403(b) retirement plan was mismanaged, refusing to dismiss recordkeeping fee claims but agreeing to toss allegations of excessive investment management fees.

  • July 15, 2025

    A Legal 'Green Light' For FDA Abortion Drug Review

    A case brought by Democratic attorneys general led to a "green light" federal court decision for the Trump administration as it considers new regulations on the abortion drug mifepristone.

  • July 14, 2025

    BCBS Defends $2.8B Provider Antitrust Deal Amid Objections

    Blue Cross Blue Shield asked an Alabama federal judge on Friday to approve a $2.8 billion antitrust settlement with hospitals and other healthcare providers over its territorial policies, arguing that recent objections to the deal's release provision are meritless and the settlement preserves "key, procompetitive features" of the insurance system.

  • July 14, 2025

    CFPB Deal To Put Medical Debt Back On Reports OK'd

    A Texas federal court has reversed a Biden-era rule that kept an estimated $49 billion in medical debt from credit reports after the Consumer Financial Protection Bureau and lender trade groups struck a deal to axe the rule.

  • July 14, 2025

    DOJ Drops Vax Card Case Against Plastic Surgeon Mid-Trial

    The Justice Department dismissed charges against a Utah plastic surgeon accused of leading a conspiracy to forge COVID-19 vaccination cards for over 1,500 people, ending the case less than a week after trial began in Salt Lake City federal court.

  • July 14, 2025

    Cigna Denies Responsibility For Alleged Health Data Breach

    Cigna has asked a Pennsylvania federal judge to throw out class claims by health plan members alleging it failed to protect their private data, arguing they didn't show how their sensitive information was intercepted from the insurer's websites.

  • July 14, 2025

    Court Says Insider Trading Rules Unscathed By Loper Bright

    A U.S. Supreme Court ruling that curtailed deference to agency interpretations of law did not undermine the U.S. Securities and Exchange Commission's rules against insider trading, a Pennsylvania federal court ruled Friday.

  • July 14, 2025

    Judge Says Med Device 401(k) Fee Suit Should Get A Trim

    A Massachusetts federal magistrate judge recommended narrowing a proposed class action claiming a medical technology company saddled its retirement plan with excessive fees and abused forfeited funds, ruling the workers failed to show the business violated the plan's terms.

  • July 14, 2025

    UnitedHealth Settling Fraud Case Over Fake Invoice Scheme

    UnitedHealth Group Inc. and a subsidiary are not going to trial in Colorado state court this week after the company reached a settlement with a defunct Colorado investment company that claimed UnitedHealth should have been liable for the "multi-million dollar fraudulent scheme" executed by a former employee, counsel for the plaintiff told Law360.

  • July 14, 2025

    Ga. County Wants 11th Circ. To Nix Trans Deputy's Health Win

    A Georgia county urged the Eleventh Circuit to reverse a transgender sheriff's deputy's trial court win on claims that denying coverage for a vaginoplasty constituted discrimination in violation of Title VII, arguing the U.S. Supreme Court's recent decision upholding a Tennessee state ban on gender-affirming care for minors supported its appeal.

  • July 14, 2025

    Fla. Says High Court Rulings Back Trans Care Medicaid Ban

    Florida told the Eleventh Circuit that recent U.S. Supreme Court rulings affirm the legality of a state law banning Medicaid payments for gender-affirming medical care, arguing its restrictions mirror a similar Tennessee law upheld by the justices because it centers on gender dysphoria diagnoses, not one's sex.

  • July 14, 2025

    Mich. Jury Sides With Red Cross In COVID Vax Refusal Suit

    A Michigan federal jury on Monday found that a former American Red Cross nurse's request for an exemption from the organization's COVID-19 vaccine mandate wasn't based on a sincere religious belief that barred her from getting the injection, rejecting the worker's request for more than $6 million in damages for her firing.

  • July 14, 2025

    Masimo Corp. Settles Investor Suit Over Revenue Disclosures

    Masimo Corp. has settled proposed class claims alleging the health technology firm misrepresented the company's finances and plans to investors, according to a filing in Southern California federal court.

Expert Analysis

  • 10 Issues To Watch In Aerospace And Defense Contracting

    Author Photo

    This year, in addition to evergreen developments driven by national security priorities, disruptive new technologies and competition with rival powers, federal contractors will see significant disruptions driven by the new administration’s efforts to reduce government spending, regulation and the size of the federal workforce, say attorneys at Thompson Hine.

  • Dispelling 10 Myths About Health Provider-Based Compliance

    Author Photo

    Congress appears intent on requiring hospitals to submit provider-based attestations for all off-campus outpatient hospital locations, so now is the time for hospitals to prepare for this change by understanding common misconceptions about provider-based status and proactively correct noncompliance, say attorneys at McDermott.

  • A Look At HHS' New Opinion On Patient Assistance Programs

    Author Photo

    A recent advisory opinion from the U.S. Department of Health and Human Services' Office of Inspector General follows a recent trend of blessing patient assistance program arrangements that implicate the Anti-Kickback Statute, as long as they are structured with appropriate safeguards to minimize the risk of fraud and abuse, say attorneys at Sheppard Mullin.

  • 2 Anti-Kickback Developments Hold Lessons For Biopharma

    Author Photo

    The U.S. Department of Justice's Anti-Kickback Statute settlement with QOL Medical and a favorable advisory opinion from the U.S. Department of Health and Human Services provide a study in contrasts, but there are tips for biopharma manufacturers trying to navigate the vast compliance space between them, says Mary Kohler at Kohler Health Law.

  • Tips For Pharma-Biotech Overlap Reporting In New HSR Form

    Author Photo

    While there’s no secret recipe for reporting overlaps to the Federal Trade Commission in the new Hart-Scott-Rodino Act form, there are several layers of considerations for all pharma-biotech companies and counsel to reflect on internally before reporting on any deal, say attorneys at A&O Shearman.

  • A Look At Drug Price Negotiation Program's Ongoing Impact

    Author Photo

    More than two years after the passage of the Inflation Reduction Act and the rapid implementation of the drug price negotiation program, attorneys at Ropes & Gray discuss how the IRA has influenced licensing strategies, and how maximum fair prices under the law have economically affected certain drugs.

  • Preparing For A Possible End To The Subminimum Wage

    Author Photo

    The U.S. Department of Labor's proposed rule to end the subminimum wage for employees with disabilities may significantly affect the community-based rehabilitation and training programs that employ these workers, so certified programs should be especially vigilant about compliance during this period of evaluation and scrutiny, say attorneys at Jackson Lewis.

  • Drug Pricing Policy Trends To Expect In 2025 And Beyond

    Author Photo

    Though 2025 may bring more of the same in the realm of drug pricing policy, business as usual entails a sustained, high level of legal and policy developments across at least six major areas, say attorneys at Ropes & Gray.

  • Top 10 Healthcare And Life Sciences Issues To Watch In 2025

    Author Photo

    Under the new Trump administration, this coming year may benefit some healthcare and life sciences stakeholders, while creating new challenges for others amid an increasingly complex regulatory environment, say attorneys at Debevoise.

  • 4 Keys To Litigating In An Active Regulatory Environment

    Author Photo

    For companies facing litigation influenced by government regulatory action — a recent trend that a politically charged atmosphere will exacerbate — there are a few principles that can help to align litigation strategy with broader public positioning in the regulatory and oversight context, say attorneys at Jenner & Block.

  • How Views On Healthcare Price Transparency Are Changing

    Author Photo

    Regulators' attitudes toward price transparency regulation have shifted over the past several years in ways that may seem contradictory, and research into detailed rate information published by hospitals and health plans has yielded mixed results, says Matthew List at Charles River Associates.

  • EEOC Wearable Tech Guidance Highlights Monitoring Scrutiny

    Author Photo

    The U.S. Equal Employment Opportunity Commission's recent fact sheet on wearable technologies cautions against potential issues with federal anti-discrimination laws and demonstrates growing concern from regulators and legislators about intrusive technologies in the workplace, say attorneys at Littler.

  • Navigating The Potential End Of GLP-1 Drug Shortages

    Author Photo

    The U.S. Food and Drug Administration's determination of whether GLP-1 products are in shortage may affect how compounders provide these products and spur a range of litigation including patent disputes and unfair competition suits, say attorneys at Goodwin.