Policy & Compliance

  • June 23, 2026

    Kaiser Owes LA County Hospital $82M In Out-Of-Network Suit

    Kaiser Permanente's health coverage arm must pay more than $82 million to Pomona Valley Hospital Medical Center to cover unreimbursed emergency medical services, a California state judge ordered Tuesday, after a state appeals court backed a jury's verdict concerning payment for roughly 4,000 disputed medical service claims.

  • June 23, 2026

    Texas Woman Says ERs Violated EMTALA Amid Miscarriage

    A Texas woman urged the U.S. Centers for Medicare & Medicaid Services to investigate two providers over their alleged violations of the Emergency Medical Treatment and Labor Act, or EMTALA, when she sought treatment for a miscarriage, arguing her case "is not an isolated incident."

  • June 23, 2026

    What To Know About State-Level PBM Reform

    Healthcare attorneys are keeping a close eye on new laws focused on the vertical integration of pharmacy benefit managers.

  • June 23, 2026

    FTC Tells 4th Circ. Court Got It Wrong In J&J Stelara Case

    The Federal Trade Commission has told the Fourth Circuit that a Virginia federal court messed up when it ruled in an antitrust suit against Johnson & Johnson that the company bringing the suit needed to show specific intent in order to prop up a monopolization claim over the immunosuppressive drug Stelara.

  • June 23, 2026

    What To Know About The Missouri Abortion Law Ruling

    Nearly two years after Missouri residents enshrined reproductive rights into the state constitution, a judge ruled that more than three dozen state laws conflicted with the 2024 ballot amendment. Law360 Healthcare Authority looks at the case and what it means for abortion law in the Show-Me State.

  • June 23, 2026

    BCLP Health Atty Talks False Claims Act, Move From DOJ

    A former leader of False Claims Act enforcement at the U.S. Department of Justice has joined Bryan Cave Leighton Paisner LLP. Susan Carney Lynch spoke to Law360 Healthcare Authority about the move and trends in FCA enforcement.

  • June 23, 2026

    UnitedHealth Trims But Can't Escape 401(k) Forfeiture Suit

    UnitedHealth Group won dismissal of some claims in a proposed class action alleging the company mismanaged its employee 401(k) and profit sharing plan by misallocating forfeitures, but couldn't escape allegations that the way the company spent the funds breached fiduciary duties and caused transactions prohibited by federal benefits law.

  • June 23, 2026

    Judge Flags Flaws In Rule Capping Health Student Loans

    A D.C. federal judge appeared to agree with health worker organizations challenging new federal student loan caps that there were problems with how the U.S. Department of Education defined "professional degrees" in a recent rulemaking, but suggested that "taking over the job" of the department would be inappropriate.

  • June 23, 2026

    BioNTech Accused Of Firing Nurse Over Drug Trial Concerns

    A former senior clinical trial manager at BioNTech US Inc. told a North Carolina federal court Monday that she was wrongfully fired after complaining to higher-ups about an "epidemic of safety issues and protocol deviations" in clinical trials.

  • June 23, 2026

    Feds Tout AI's Role In $6.5B Healthcare Fraud Crackdown

    Federal authorities said Tuesday that artificial intelligence and sophisticated data analysis helped them detect and prosecute healthcare fraud as part of a national crackdown that resulted in charges against 455 defendants.

  • June 22, 2026

    FTC Requires Fix For Aurobindo's $250M Lannett Deal

    The Federal Trade Commission is allowing Aurobindo Pharma Ltd. to move ahead with its planned $250 million acquisition of Lannett Co. Inc., after the pharmaceutical company agreed to unload four generic drug products to prevent potential overlaps.

  • June 22, 2026

    Sodexo Can't Wipe Out Worker's Nicotine Fee Suit

    A California federal judge refused to toss a Sodexo worker's proposed class action alleging the global food services company wrongly charged nicotine-using employees $1,200 more a year for health insurance, opening discovery on allegations that a wellness program implementing the surcharge didn't meet all federal requirements.

  • June 18, 2026

    RFK Jr. Urges 1st Circ. To Reinstate His Vaccine Advisers

    U.S. Health Secretary Robert F. Kennedy Jr. told the First Circuit a Boston federal judge's decision to freeze his vaccine committee appointments lacks a legal foundation and has left the government paralyzed when it comes to vaccine policy.

  • June 18, 2026

    Gibson Dunn Hires Ropes & Gray Health Regulatory Atty In DC

    Gibson Dunn & Crutcher LLP has hired a former Ropes & Gray LLP partner who works on a myriad of health regulatory and drug pricing matters, advising pharmaceutical manufacturers, investors and other entities on those issues, the firm announced Thursday.

  • June 18, 2026

    5 Big ERISA Litigation Developments From 2026's First Half

    The U.S. Supreme Court's acceptance of a petition challenging Intel's 401(k) investment lineup and a Fourth Circuit ruling unraveling a class of Genworth Financial retirement plan participants headlined the court developments that caught benefits attorneys' attention in the first six months of 2026. Here, Law360 looks at those and other noteworthy ERISA decisions.

  • June 18, 2026

    Health System Strikes Deal To End Tobacco Fee Suit

    Nonprofit health system Advocate Aurora Health reached a deal to close a proposed class action claiming it hit workers with an unlawful fee through their health plan if they used tobacco, according to a filing in Illinois federal court.

  • June 18, 2026

    High Court Bars Federal Review Of State Court Appeals

    The U.S. Supreme Court ruled Thursday that a legal doctrine designed to curtail duplicative litigation prevents parties who lose in state court from appealing in federal district court even if the state case is still pending.

  • June 17, 2026

    Mental Health Co. To Face Wage Class Damages Trial

    A North Carolina federal judge ruled Wednesday that the mental healthcare company JMJ Enterprises LLC must face a second-phase damages trial after a jury found in February in favor of a collective of employees claiming that the company willfully broke federal and state wage laws by underpaying workers at group homes.

  • June 17, 2026

    DC Judge Halts Prison Bureau's 'Near Total' Trans Care Ban

    A Washington, D.C., federal judge blocked the Bureau of Prisons from enforcing a "near total ban" on gender-affirming care for trans incarcerated people, ruling Wednesday the policy was "reverse engineered" to fit the Trump administration's directive barring funding of such care in prisons, violating the Administrative Procedure Act. 

  • June 17, 2026

    Sen. Committee Clears Drug Disclosure, Biosimilar Bills

    The U.S. Senate Committee on Health, Education, Labor and Pensions on Wednesday cleared two bills for full Senate review, tackling the gap between health and patent oversight agencies, and the need for more interchangeable biosimilars.

  • June 17, 2026

    FTC Claims Trans Health Org. Lied About Medical Consensus

    The Federal Trade Commission and several Republican-led states sued the World Professional Association for Transgender Health on Wednesday, telling a Texas federal court that the organization falsely touted a "medical consensus" while advocating for transgender healthcare for children.

  • June 17, 2026

    NC Clinic, School District Must Face COVID Vax Challenge

    A North Carolina state appeals panel issued its second opinion in a lawsuit from the mother of a teenager who alleged he was vaccinated for COVID against his will, finding Wednesday that she adequately put forward constitutional claims and can pursue allegations against a school district and medical society clinic in trial court.

  • June 17, 2026

    DOJ Deal Bars OhioHealth From Blocking Patient Steering

    OhioHealth swore off contract language inhibiting the ability of insurers to steer patients to cheaper healthcare providers, in a settlement resolving one of two U.S. Department of Justice antitrust lawsuits targeting alleged hospital network efforts to force insurers to cover their hospitals in all plans.

  • June 17, 2026

    Genova Burns Adds Pharmacy Industry Specialist In NJ

    Genova Burns LLC strengthened its healthcare abilities this week with the hiring of an attorney focusing on representing pharmacy benefit managers and other players in the prescription drug supply chain.

  • June 17, 2026

    Lab Owner Avoids 'Very Long' Prison Term For $89M Fraud

    A Utah businessman who cooperated with prosecutors after admitting his role in a false Medicare claims scheme was sentenced Wednesday in New Jersey federal court to three years of probation and ordered to forfeit $28 million.

Expert Analysis

  • FTC's Clinical Trial Requirement Threatens Food Claim Rules

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    The Federal Trade Commission's general requirement for randomized controlled trials for most health-benefit claims, recently embraced by the National Advertising Review Board, lacks legal basis and endangers the existing statutory framework Congress created for marketing food and dietary supplements versus drugs, say attorneys at Keller & Heckman.

  • HHS Enforcement Restructuring Signals Compliance Risks

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    The U.S. Department of Health and Human Services' recent restructuring of its Office for Civil Rights suggests that, while Health Insurance Portability and Accountability Act enforcement remains central, its priorities have expanded to encompass civil rights, conscience and religious freedom, and data and cybersecurity issues, say attorneys at King & Spalding.

  • AG Watch: Oregon's Strategic Civil Enforcement Approach

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    Oregon Attorney General Dan Rayfield’s recent antitrust litigation activity and proposed staffing increase are the latest in a series of structural and policy changes that signal that the state Department of Justice is taking a more aggressive approach to civil enforcement, says Keturah Taylor at Cozen O'Connor.

  • A Decade Later, Escobar Is Still Shaping FCA Cases

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    The U.S. Supreme Court's decision 10 years ago in Universal Health Services v. U.S. ex rel. Escobar changed the way in which lower courts evaluate False Claims Act cases — and the ruling remains vital in nearly every FCA case filed today, say attorneys at Bradley Arant.

  • How FCA, FCPA Risks Are Shifting As Feds Pull Back

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    As the federal government continues its retreat from white collar enforcement, companies should expect False Claims Act risk to grow through private whistleblower suits and Foreign Corrupt Practices Act scrutiny to shift toward foreign prosecutors, requiring more adaptability as accountability becomes less centralized, says Temidayo Aganga-Williams at Selendy Gay.

  • Trump Admin's Agency Records Purge Tests Judicial Notice

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    While courts commonly take judicial notice of data in government websites and reports, the Trump administration's recent modification or wholesale deletion of these sources means that litigants must look elsewhere to support trial admission of this information, says Jon Gryskiewicz at Lewis Baach.

  • West Coast Health Cos. Must Brace For Federal Enforcement

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    In light of the U.S. Department of Justice's newly established West Coast strike force targeting healthcare fraud across Northern California, Arizona and Nevada, health organizations will need to prioritize knowledge, vigilance and operational discipline to reduce exposure from potentially parallel criminal and civil investigations, says Michael Beckwith at Dickinson Wright.

  • High Court's Hikma Decision Reshapes 'Skinny Label' Suits

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    The U.S. Supreme Court's decision in Hikma v. Amarin marks a significant victory for generic drug manufacturers, but rather than putting an end to so-called skinny label inducement claims, it narrows and refocuses them, say attorneys at Sterne Kessler.

  • Turning To The Courts When PBM Reform Falls Short

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    The effectiveness of state laws intended to regulate pharmacy benefit managers remains uncertain, but litigation — utilizing tried-and-true theories like breach of contract and fair dealing — offers another mechanism through which stakeholders may seek relief from PBMs, say attorneys at Reed Smith.

  • High Court's Abortion Pill Stay Reinforces Appellate Principles

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    The U.S. Supreme Court's recent order in Danco Laboratories v. Louisiana, staying a Fifth Circuit ruling that reinstated an in-person requirement for dispensing the abortion medicine mifepristone, should be seen not as a definitive ruling on reproductive rights, but as an affirmation of a more disciplined jurisdictional reality, says Daniel Nardo at Nardo & Associates.

  • Bracing For Enforcers' Growing Focus On Behavioral Health

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    While recent law enforcement scrutiny of the behavioral health industry has resulted in several settlements, indicating that more enforcement activity is on the way, organizations now have an opportunity to take proactive compliance measures, says Jeffrey Fitzgerald at Polsinelli.

  • DOJ Activity Indicates Rising Antitrust Risk For Hospitals

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    Two civil actions filed by the U.S. Department of Justice against New York-Presbyterian Hospital and OhioHealth, both alleging that the hospital systems used their market power to stifle competition, highlight the government's growing scrutiny of barriers to lower-cost insurance options, say attorneys at Freshfields.

  • Engaging With FDA's New Complete Response Letter Policy

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    A citizen petition filed with the U.S. Food and Drug Administration last month puts renewed focus on the agency's practice of releasing complete response letters in near real time, materially altering the context in which life sciences companies communicate with investors regarding regulatory developments, say attorneys at Debevoise.