Policy & Compliance
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June 17, 2025
Health Insurance Co. Owes Workers OT Wages, Suit Claims
Humana Inc. and Humana Government Business Inc. were hit with a proposed class action in Georgia federal court on Tuesday over allegations they failed to pay registered nurse case managers proper overtime wages.
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June 17, 2025
HHS Says Trump Orders Merit Ending Trans Health Rule Case
The federal government urged a Mississippi federal court to end a lawsuit challenging a Biden-era rule that protected gender-affirming care under the Affordable Care Act, arguing the Republican attorneys general leading the case can't show imminent harm given the Trump administration's position on the definition of "sex."
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June 17, 2025
FDA Unveils Voucher Program For Fast-Paced Drug Reviews
Pharmaceutical companies that boost domestic drug manufacturing or address other national priorities will have a chance to secure speedier review and approval of new drugs under a pilot program the U.S. Food and Drug Administration unveiled Tuesday.
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June 17, 2025
9th Circ. Backs Class Cert. In Suit Over Diabetes Drug Risk
The Ninth Circuit refused to disband a class of third-party payors who claim Takeda Pharmaceutical and Eli Lilly & Co. hid their anti-diabetes drug's bladder cancer risks, finding no issue with a lower court's analysis of expert evidence showing prescriptions fell after the risks were disclosed.
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June 17, 2025
Healthcare Worker's Wage Collective 'Amorphous,' HCA Says
A respiratory therapist's proposed collective is far too expansive and "amorphous" and is based on scant evidence that HCA Healthcare Inc. illegally manipulated workers' time sheets, the company told a North Carolina federal court, urging it to deny certification.
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June 17, 2025
Trump's Abortion Guidance U-Turn Sparks Legal Risks
Now that the Trump administration has pulled guidance telling doctors they must perform abortions in emergency situations, healthcare attorneys are warning their clients to diligently document their decisions, especially when they find themselves caught in the middle of conflicting federal and state law.
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June 17, 2025
'A Warning Shot?' Experts Eye Surge In Drug Ad Enforcement
Despite its recent staff cuts and leadership changes, the U.S. Food and Drug Administration has launched a burst of enforcement activity targeting prescription drug promotion, singling out a "sex pill" post on Instagram and an exhibit panel touting a diuretic.
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June 17, 2025
Medical AI Co. Calls Rival's Suit A Ploy To Kill Competition
A Canadian artificial intelligence company focusing on medical information has asked a Massachusetts federal judge to toss out a recent trade secrets lawsuit, saying the complaint is an attempt to thwart competition based solely on speculation.
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June 16, 2025
Life Spine Accuses Ex-CEO Of Stealing Money, Trade Secrets
Spinal device maker Life Spine slapped its founder with a civil suit in Illinois state court Friday accusing him of embezzling millions of dollars from the company through fraudulent credit card charges for motorsports, a lavish Mexico vacation for his family, customized golf clubs, jewelry and a Porsche for his wife.
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June 16, 2025
Ohio Tells 6th Circ. PBM Case Doesn't Target Federal Work
Ohio urged the Sixth Circuit to send its case accusing Express Scripts and Prime Therapeutics of driving up prescription drug prices through rebate schemes back to state court, arguing the case doesn't target any federal government work by the pharmacy benefit managers.
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June 16, 2025
HIV, AIDS Patients Denied Class Cert. In CVS Bias Fight
A California federal judge has refused to certify a proposed class of HIV and AIDS patients alleging CVS Pharmacy Inc. violated federal disability bias protections by making their medication harder to access, finding the proposed group failed to meet the commonality standards under federal law.
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June 16, 2025
Mass. Judge Blocks NIH Grant Cuts, Points To 'Discrimination'
A Massachusetts federal judge on Monday blocked the National Institutes of Health from cutting hundreds of grant programs to universities, hospitals and other organizations, saying that in his 40 years on the bench he had never seen such "palpable" racial and LGBTQ discrimination from the government.
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June 16, 2025
Justices Turn Away Merck's Bone Drug Warning Label Row
The U.S. Supreme Court on Monday rejected Merck Sharp & Dohme Corp.'s request to review a Third Circuit decision that more than 1,000 failure-to-warn claims over its osteoporosis drug Fosamax can continue despite the company's assertion that the litigation is barred by federal law.
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June 16, 2025
Justices Take Up NJ Anti-Abortion Group's Subpoena Fight
The U.S. Supreme Court on Monday agreed to review the Third Circuit's dismissal of an anti-abortion pregnancy center's federal lawsuit challenging a subpoena from the New Jersey attorney general demanding information about its donors.
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June 13, 2025
Injunction Sought After J&J Unit's Catheter Antitrust Loss
Innovative Health is seeking a permanent injunction that would ban Johnson & Johnson health tech unit Biosense Webster from conditioning the provision of cardiac mapping services on purchases of cardiac catheters, after Innovative Health netted a $442 million trial win on its antitrust claims.
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June 13, 2025
5th Circ. Says No Private Right Of Action In No Surprises Act
The Fifth Circuit has ruled a pair of flight ambulance providers cannot pursue their lawsuit seeking to enforce out-of-network billing dispute resolution awards against a health insurance company, saying there's no private right of action built into a 2022 law that protects patients from surprise medical bills.
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June 13, 2025
Pa. Home Care Agency Owner Gets Prison, $235K Restitution
The New York-based owner of a Berks County, Pennsylvania, home care agency has been sentenced to spend a month in jail and repay $235,778 in fraudulently billed Medicaid claims, the Pennsylvania Attorney General's Office announced Friday.
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June 13, 2025
EEOC Says Henry Ford Ignored Subpoena Over Bias Charge
Michigan's Henry Ford health system has ignored a subpoena from the U.S. Equal Employment Opportunity Commission seeking information into a worker's bias charge, according to a federal court filing from the agency seeking an order enforcing the request.
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June 13, 2025
CVS Wants To Halt Ark. Law Banning PBM-Owned Pharmacies
CVS urged an Arkansas federal judge to block a new state law from taking effect that would ban pharmacy benefits managers from owning pharmacies in the state, arguing the law shirks the U.S. Constitution by tamping down competition and discriminating against out-of-state businesses.
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June 12, 2025
Florida, Sandoz Say They've Fixed Generic Drug Price-Fix Deal
The Florida Attorney General's Office and Sandoz Inc. have told a Connecticut federal court they've fixed the problems the court identified with a generic drug price-fixing settlement after other states with claims in the case objected to a clause in the deal.
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June 12, 2025
'Forum Shopping' Center Stage At 6th Circ. Drug Pricing Args
As part of an expansive effort to tee up U.S. Supreme Court review, pharmaceutical industry-backed opponents of Medicare's drug price negotiations entered less-than-hospitable territory at the Sixth Circuit, where judges pointedly questioned a local business group's basis for challenging a national healthcare program.
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June 12, 2025
Humana, Aetna Underpaid For 340B Drugs, New Suits Say
Humana and Aetna are facing new claims in a trio of suits filed in North Carolina federal court alleging they underpaid health systems for drugs purchased through the federal 340B drug discount program.
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June 12, 2025
11th Circ. Won't Revive Nurses' African Bias, Retaliation Suit
The Eleventh Circuit on Thursday backed an Atlanta hospital's defeat of a lawsuit claiming it disciplined and fired two nurses who complained that a supervisor made derogatory comments about African employees, saying neither woman could overcome evidence of their misconduct.
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June 12, 2025
Fla. Death Damages Row Signals Insurers' Tort Reform Focus
Florida Gov. Ron DeSantis' veto of a bill that would have repealed limits on noneconomic damages in fatal medical malpractice cases — despite state lawmakers' overwhelming support of the measure — signals broad concerns over how tort reform legislation could impact the insurance industry.
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June 11, 2025
Seattle Hospital Hit With Class Suit Over 'Diverted' Pain Meds
A Seattle-based hospital system has been slapped with a proposed class action in Washington state court over claims that hundreds of patients suffered unwarranted pain and risk of infection because a staff member may have been pocketing painkillers.
Expert Analysis
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Incoming Admin May Shake Up Life Sciences Regulation
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.
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Navigating DOJ's Patchwork Whistleblower Regime
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.
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What To Expect Next From Federal Health Tech Regulation
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.
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5 Areas Congress May Investigate After GOP Election Wins
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.
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Takeaways From State Votes On Abortion In The 2024 Election
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.
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Loper Bright Offers New Materiality Defense To FCA Liability
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.
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How Expanded Birth Control Coverage May Affect Employers
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.
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Legislation Most Likely To Pass In Lame Duck Session
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.
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Preserving The FCA Is Crucial In Trump's 2nd Term
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.
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PREVAIL Bill Is Another Misguided Attempt To Restrict PTAB
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.
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Justices Face Tough Question On HHS Hospital Pay Formula
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.
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Key Healthcare Issues That Hinge On The Election Outcome
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.
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The Key To Solving High Drug Costs Is Understanding Causes
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.