Policy & Compliance

  • October 31, 2025

    Drugmakers Can't End States' Dermatology Price-Fixing Suits

    A Connecticut federal judge on Friday refused to throw out the vast majority of claims in a nationwide antitrust enforcement action accusing a long list of pharmaceutical companies of fixing the prices of generic dermatology drugs, rejecting the companies' argument that the claims were filed too late.

  • October 31, 2025

    Amgen Again Challenges Colo. Price Cap For Arthritis Drug

    Amgen has once again sued Colorado over its price cap for the arthritis drug Enbrel, claiming that the Centennial State's drug price-control statute violates the U.S. Constitution, conflicts with federal patent law and threatens patients' access to lifesaving medications.

  • October 31, 2025

    Hawaii Judge Declares FDA's Mifepristone Regs Unlawful

    The U.S. Food and Drug Administration failed to sufficiently justify restrictions on the abortion drug mifepristone, a Hawaii federal judge ruled in an order declaring the restrictions unlawful under the Administrative Procedure Act.

  • October 31, 2025

    Aetna Strikes $650K Deal In Lipedema Patients' Coverage Suit

    Aetna has agreed to pay up to $650,000 to resolve a class action claiming it unlawfully refused to cover liposuction for over two dozen patients with a rare condition called lipedema, according to a filing in California federal court.

  • October 31, 2025

    Garnet Health Inks $4.6M Deal In Retirement Fee, Fund Suit

    Garnet Health Medical Center has agreed to fork over $4.6 million to end a proposed class action alleging the New York healthcare network mismanaged employee retirement plan fees and investments, according to settlement documents filed by workers Friday in New York federal court.

  • October 31, 2025

    3 Argument Sessions Benefits Attys Should Watch In Nov.

    The Third Circuit will hear a union's appeal in a withdrawal liability battle, a union health plan defends its partial win in a coverage fight at the Ninth Circuit, and pharmacy benefit managers will take a challenge to the Federal Trade Commission's authority to the full Eighth Circuit. Here are three arguments to keep an eye on in November.

  • October 31, 2025

    NC Attorney General, HCA Duel Over Merger Commitments

    The North Carolina Attorney General's Office and HCA Healthcare have offered competing interpretations of a 2019 merger agreement in their efforts to secure a pretrial win in the state's compliance case involving the purchase of an Asheville hospital system.

  • October 30, 2025

    J&J's Janssen Says 3rd Circ. Should Reverse $1.6B FCA Win

    Johnson & Johnson's Janssen Products LP urged the Third Circuit to overturn a $1.6 billion False Claims Act judgment over two of its HIV drugs, arguing the district court allowed whistleblowers to prove fraud based solely on "off-label" marketing rather than any false claim actually submitted to the government.

  • October 30, 2025

    Generic-Drug Firms Want To Fast-Track Conn. Price Cap Fight

    An industry group for generic and biosimilar pharmaceutical companies has asked a Connecticut federal judge to fast-track its lawsuit seeking to block the state's new drug price cap, claiming it will suffer "imminent harm" if the case is delayed.

  • October 30, 2025

    Judge Unpauses 'Important' Suit Over Vax Guidelines

    A Massachusetts federal judge agreed Thursday to lift a government shutdown-related stay of litigation challenging new COVID-19 vaccine recommendations for children and pregnant women, calling the case a "matter of national importance" that warrants keeping the case moving over the U.S. Department of Justice's objection.

  • October 30, 2025

    Health Group Urges 1st Circ. To Deny FCA Suit Fee Challenge

    A Massachusetts health network has asked the First Circuit to deny a whistleblower's attempt to secure more attorney fees for a False Claims Act suit, arguing that a federal judge properly denied numerous claims for fees after a $2.5 million settlement.

  • October 30, 2025

    Surgical Co. Gets Tobacco Fee ERISA Suit Kicked To Texas

    A proposed class action alleging that a surgical center operator discriminated against workers who use tobacco by making them pay more for health coverage belongs in Texas, a Kentucky federal judge said, ruling that the business doesn't have enough connection to Kentucky.

  • October 29, 2025

    DOJ Subpoena Called 'Pressure' To Ax Gender-Affirming Care

    The U.S. Department of Justice issued a subpoena to intimidate a telehealth organization into ending gender-affirming medical care, a Seattle federal judge said in a ruling that found the agency is using the guise of an investigation to further the Trump administration's stated goal of eliminating transgender and gender-diverse patients' access to healthcare.

  • October 29, 2025

    Healthcare Workers Trade HCA For Subsidiaries In Wage Deal

    A respiratory therapist has reached a tentative deal in a proposed collective action against a healthcare facility operator accused of manipulating workers' time sheets to pay them less overtime wages, North Carolina federal court records show.

  • October 29, 2025

    FDA Unveils Plan To Speed Biosimilar Drugs To Market

    The Trump administration on Wednesday said it plans to slash the cost of biologics by shortening the time required to bring a biosimilar drug to market and making it easier for patients to switch to the cheaper products.

  • October 29, 2025

    3 Pharmaceutical Firms Will Pay $4M To Tribes In Opioid MDL

    Indivior, Sun Pharmaceuticals and Zydus Pharmaceuticals have inked deals to compensate tribes for their role in the opioid crisis, according to stipulated dismissals entered on Wednesday in Ohio federal court.

  • October 28, 2025

    Off-Label Prescribing Was Common, Novo Nordisk Tells Jury

    A whistleblower suing drugmaker Novo Nordisk for allegedly defrauding Washington state's Medicaid system acknowledged from the witness stand Tuesday that she previously prescribed hemophilia drugs for off-label use in her own practice — despite concerns she raised in her lawsuit about other doctors' off-label prescription of Novo Nordisk's drug NovoSeven.

  • October 28, 2025

    4 Emergency Medical Care Rulings You Don't Want To Miss

    Following a Michigan appellate court's recent finding that evidence brought in a wrongful death suit against paramedics was enough to get around immunity protections, Law360 Healthcare Authority looks at significant rulings affecting emergency medical care in 2025.

  • October 28, 2025

    Home Health Aide Says Cos. Shaved Time Off Pay

    Home health care companies failed to pay aides for the hours they worked by failing to properly calculate their overtime, while also having a "problematic clocking system" that led to time-shaving issues, a suit filed in New York federal court on Tuesday claims.

  • October 28, 2025

    High Court Medicaid Ruling Adds To Safety-Net Hospital Pain

    Earlier this year, U.S. Supreme Court Justice Ketanji Brown Jackson raised a warning about the future of the nation's safety-net hospitals in a case focused on "disproportionate share" Medicaid payments. Funding cuts at issue in the case are now hitting hospitals.

  • October 28, 2025

    Akin Beats Malpractice Claim Over Alleged IP Theft Plot

    A Third Circuit panel on Tuesday refused to revive a malpractice claim against Akin Gump Strauss Hauer & Feld LLP lodged in a lawsuit that accused attorneys of manipulating patent litigation to steal a former Cornell University graduate student's DNA sequencing intellectual property.

  • October 28, 2025

    HHS Can't Yet Yank Sex Ed Grants Over 'Gender Ideology' Info

    An Oregon federal judge has halted the U.S. Department of Health and Human Services' plans to revoke federal funding for teen sexual health education programs that included "gender ideology," agreeing with states that this is likely a case of executive overreach.

  • October 28, 2025

    4th Circ. Overturns Landmark W.Va. Opioid Verdict

    The Fourth Circuit on Tuesday overturned a key ruling by a West Virginia judge in the first federal bellwether in multidistrict opioid litigation that went in favor of the country's three biggest drug distributors, finding that the oversupply of opioids can create a public nuisance.

  • October 28, 2025

    Wash. Hospital System Can't Undo $230M Wage Suit Loss

    A hospital system can't undo a $230 million judgment against it because it didn't sufficiently counter evidence that its default rounding system was unlawful and assumed caregivers wouldn't take a second meal break, a Washington state appeals panel ruled.

  • October 28, 2025

    Minn. Hospital Noncompetes Face Test In State AG Probe

    A Minnesota investigation could help answer key questions for doctors and employers about a 2023 state ban on noncompete provisions: When do changes to employment contracts amount to a new contract?

Expert Analysis

  • What's New In FDA's Latest Cell And Gene Therapy Guidance

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    New draft guidance from the U.S. Food and Drug Administration, along with other recent initiatives, come together to promote cell and gene therapy product development by streamlining development and review pathways, say attorneys at Holland & Knight.

  • Adapting To Enforcement Focus On Wound Care Fraud

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    As federal agencies target wound care industry fraud as a top enforcement priority, attorneys advising industry stakeholders should evaluate business relationships for Anti-Kickback Statute violations, emphasize appropriate product use and documentation, and use internal data analytics to monitor billing patterns, say David Tarras at Tarras Defense and Jay McCormack at Verrill Dana.

  • AG Watch: Illinois A Key Player In State-Level Enforcement

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    Illinois Attorney General Kwame Raoul has systematically strengthened his office to fill federal enforcement gaps, oppose Trump administration mandates and advance state policy objectives, particularly by aggressively pursuing labor-related issues, say attorneys at Troutman.

  • Organ Transplant System Reforms Mark Regulatory Overhaul

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    Recent oversight, enforcement and operational developments in the U.S. organ procurement and transplantation system, alongside challenges like the federal shutdown, highlight heightened regulatory scrutiny and the need for compliance to maintain public trust, say attorneys at Hall Render.

  • Federal Grantees May Soon Face More Limitations On Speech

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    If courts accept the administration’s new interpretation of preexisting case law, which attempts to graft onto grant recipients the existing limitations on government contractors' free speech, a more deferential standard may soon apply in determining whether an agency’s refusal or termination of a grant was in violation of the First Amendment, say attorneys at Venable.

  • HHS Wound Care Report Highlights Need For Payment Reform

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    The U.S. Department of Health and Human Services' recent report on potential abuse in Medicare Part B payments for skin substitutes highlights specific fraud schemes, but more importantly emphasizes that broader changes are needed for the wound care sector's fundamentally flawed payment system, say attorneys at Paul Hastings.

  • Assessing The Future Of The HIPAA Reproductive Health Rule

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    In light of a Texas federal court's recent decision to strike down a U.S. Department of Health and Human Services rule aimed to protect the privacy of patients seeking abortions and gender-affirming care, entities are at least temporarily relieved from compliance obligations, but tensions are likely to continue for the foreseeable future, says Liz Heddleston at Woods Rogers.

  • DOJ's Tracing Rule For Pandemic Loan Fraud Is Untenable

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    In conducting investigations related to COVID-19 relief fraud, the government's assertion that loan proceeds are nonfungible and had to have been segregated from other funds is unsupported by underlying legislation, precedent or the language establishing similar federal relief programs, say Sharon McCarthy, Jay Nanavati and Lasya Ravulapati at Kostelanetz.

  • New Health AI Guidance Features A Provider-Centric Approach

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    New guidance from the Joint Commission and Coalition for Health AI regarding the responsible use of artificial intelligence in healthcare deviates from preexisting guidance by recommending a comprehensive framework for using AI tools, focusing on healthcare provider organizations rather than on AI developers, say attorneys at Ropes & Gray.

  • Mass. Ruling May Pave New Avenue To Target Subpoenas

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    A Massachusetts federal court’s recent decision to quash a subpoena seeking information on gender-affirming care at Boston Children’s Hospital is a significant departure from courts' deferential approach to subpoena enforcement, and may open a new pathway for practitioners challenging investigative tools in the future, say attorneys at Gibson Dunn.

  • What To Expect After FDA Warnings To GLP-1 Compounders

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    The U.S. Food and Drug Administration's recent warning letters to companies advertising compounded versions of GLP-1 medications raise questions not just about the enforcement outlook for marketing such products, but also about the future of drug compounding as a whole, say attorneys at Spencer Fane.

  • How Financial Cos. Can Prep As NYDFS Cyber Changes Loom

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    Financial institutions supervised by the New York State Department of Financial Services can prepare for two critical cybersecurity requirements relating to multifactor authentication and asset inventories, effective Nov. 1, by conducting gap analyses and allocating resources to high-risk assets, among other steps, say attorneys at Pillsbury.

  • How Courts May Interpret Data-Driven Healthcare Fraud Suits

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    As the U.S. Department of Justice and other agencies increasingly turn to data mining as an enforcement tool, courts will have to determine how far data alone can take a fraud case, and sound theory, clinical expertise and institutional context will play an important role, say Jaime Jones at Sidley and Andrée-Anne Fournier and Atang Gilika at Analysis Group.