Policy & Compliance
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March 19, 2025
Anesthesiology Giant Says Private Antitrust Suit Has No Legs
U.S. Anesthesia Partners wants out of a proposed class action accusing it of monopolizing the Texas anesthesia market through a private equity-powered "roll-up" strategy, saying the man behind the lawsuit doesn't have standing to sue and has simply "repackaged" FTC allegations.
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March 19, 2025
UMass Medical Execs To Face Retaliation Claim In Vax Dispute
The medical director at UMass Memorial Medical Center has won dismissal of retaliation claims brought by one of the Massachusetts institution's former compliance executives who declined a COVID-19 vaccine, but two other leaders will have to face claims that the ex-executive's firing was tied to her request for work accommodations.
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March 19, 2025
Law360 Announces The Members Of Its 2025 Editorial Boards
Law360 is pleased to announce the formation of its 2025 Editorial Advisory Boards.
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March 19, 2025
Purdue Pharma Files New $7.4B Ch. 11 Plan Settlement
Bankrupt OxyContin maker Purdue Pharma LP filed a new Chapter 11 plan in a New York bankruptcy court, including a $6.5 billion payment from members of the Sackler family who own the company and $900 million from the debtor, that aims to compensate thousands of creditors for damages from opioid sales.
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March 18, 2025
Texas Abortion Charges, HHS Rehirings And FTC Deal Warning
The Trump administration is seeking an emergency halt of a Maryland federal court order that led the Department of Health and Human Services to delay the terminations of almost 3,000 probationary employees, arguing it has burdened HHS and over a dozen other federal agencies behind the mass firings. Here, Law360 Healthcare Authority looks at these and other significant cases and decisions that shaped the healthcare industry over the last week.
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March 18, 2025
HHS Seeks Early Win Over Lilly, Novartis, BMS In Rebate Row
The U.S. Department of Health and Human Services urged a D.C. federal judge Monday to grant it an early win against behemoth drugmakers' claims that it unlawfully blocked their plans to offer after-the-fact rebates, rather than up-front discounts, to safety-net hospitals via a decades-old federal drug pricing program.
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March 18, 2025
Ga. Hospital Failed To Protect Data Of 120K, Patient Says
A former patient of a southwest Georgia hospital hit the provider with a proposed class action Monday over a data breach last year, alleging that it failed to secure 120,000 customers' personal information before it was filched in a cyberattack.
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March 18, 2025
NIH Avoids Contempt In Trans Case Despite Judge's Criticism
A federal judge said there is no clear evidence that the National Institutes of Health's revoking a Washington hospital's research grant violated her order blocking President Donald Trump's efforts to cut funding for gender-affirming care for young people, but the judge chastised the administration for its "narrow and self-serving view" of what makes up care.
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March 18, 2025
Ky. Abortion Ban Carveouts Stir Concerns Over Clarity
Kentucky lawmakers passed a bill spelling out medical exceptions to the state's strict post-Dobbs abortion ban. The bill, drafted by anti-abortion lawmakers, is stoking concerns that it could lead to more restrictions in emergency situations.
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March 18, 2025
Reg Attys Talk FTC Healthcare and Antitrust Under Ferguson
Regulatory attorneys focused on the healthcare industry aren't expecting huge changes in federal antitrust activity under new leadership at the Federal Trade Commission.
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March 18, 2025
Ohio Appeals Court Blocks Trans Care Restrictions
An Ohio state appeals court on Tuesday ruled that a portion of a state law restricting gender-affirming care for transgender youth was unconstitutional, overturning a county court judge's decision siding with the state.
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March 18, 2025
Elevance Inks $3.3M Deal To End Surgery Claim Denial Suit
Elevance has agreed to pay $3.3 million to close a suit claiming it denied coverage for a spinal surgery through employee health plans after incorrectly deeming the procedure medically unnecessary, according to a Kentucky federal court filing.
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March 18, 2025
Feds Say Wash. Hospital Can't Strike Facts From Fraud Suit
The government has accused a hospital operator in Washington state of "grasping at straws" by trying to strike inconvenient facts from the court record in a bid to defeat a False Claims Act lawsuit, a tactic prosecutors urged the court to see through and reject.
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March 18, 2025
Repeal Of Social Needs Guidance Sows Medicaid Uncertainty
A Trump administration rollback of guidance on health-related social needs may bode poorly for the future of state-federal pilot programs that provide Medicaid recipients with tools to live healthier, safer lives.
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March 18, 2025
States Oppose Term In Sandoz Price-Fixing Deal With Fla.
State enforcers still locked in price-fixing litigation against generic-drug maker Sandoz are raising objections to a cap on what they could win through settlements in Florida's recent agreement with the company, telling the Connecticut federal judge weighing approval that it would block or delay potential settlements of their own.
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March 18, 2025
Indirect Effexor Buyers Seek Approval Of $2.3M Antitrust Deal
A proposed class of indirect drug purchasers have asked a New Jersey federal judge for his initial sign-off on a $2.25 million deal with Teva Pharmaceuticals to resolve antitrust claims against the company over antidepressant and anxiety disorder treatment Effexor XR.
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March 18, 2025
Feds Reject 'Absurd' Defense In Harvard Body Parts Case
Federal prosecutors in Pennsylvania have blasted an "absurd argument" that a stolen-goods law doesn't criminalize buying and selling body parts stolen from cadavers donated to the Harvard Medical School's morgue.
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March 18, 2025
Illinois Asbestos Injury Firm Escapes 'Fraud Playbook' Suit
A Chicago federal judge on Tuesday tossed a racketeering suit an industrial pipe company brought against a "prolific" Illinois asbestos litigation law firm, finding that the pipe company failed to adequately plead that the law firm formed an "enterprise" with various clients, witnesses, co-counsel and staff.
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March 18, 2025
Minn. AG, Mayo Clinic Settle Charity Probe: 3 Things To Know
The Mayo Clinic will reform its charity care policies after an investigation by Minnesota officials found the hospital system sued its patients over medical debt even though they might have qualified for financial assistance.
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March 17, 2025
US Chamber Says FCA Qui Tam Provisions Unconstitutional
The U.S. Chamber of Commerce on Monday endorsed a legal challenge aimed at bringing down the whistleblower provisions in the False Claims Act, arguing there is a "manifest conflict between the modern FCA's qui tam provisions and Article II's text."
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March 17, 2025
Gutting USAID Threatens US Credibility, 22 Ex-Officials Say
A bipartisan group of former high-ranking national security and defense officials on Monday voiced opposition to the Trump administration's decision to dismantle the U.S. Agency for International Development, saying in an amicus brief filed in D.C. federal court that the shutdown undermines the United States' credibility while allowing China and Russia to build theirs.
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March 17, 2025
New Bills Target 'Patent Thickets' And 'Product Hopping'
A bipartisan group of senators is backing two bills it says will use the patent system to lower the price of prescription drugs, in part by targeting "patent thickets" and making "product hopping" a violation of antitrust laws.
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March 17, 2025
PBMs Hit With Antitrust Suit Over GoodRx Generics Program
A Denver pharmacy has filed a proposed class action against GoodRx, CVS and other major pharmacy benefit managers in Colorado federal court, alleging they engaged in an illegal price-fixing scheme that artificially suppressed the prices paid to independent pharmacies for reimbursement of generic drug claims.
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March 17, 2025
VA To End Medical Care For Gender Dysphoria
The U.S. Department of Veterans Affairs will stop offering medical treatments for gender dysphoria in order to comply with an executive order by President Donald Trump, the agency announced Monday.
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March 17, 2025
Full 7th Circ. Won't Revive Suit Over Late Medicaid Payments
The full Seventh Circuit has answered the "enormous question" of whether a Chicago hospital can sue the state of Illinois to force the managed-care organizations it contracts with to make timely Medicaid payments, concluding the hospital doesn't have a federal right to prompt payments for fear of turning federal trial courts into "de facto Medicaid claims processors."
Expert Analysis
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A New Way Forward For COVID Vaccine Lawsuit Immunity
As Public Readiness and Emergency Preparedness Act protections for COVID-19 vaccines wane, adding those vaccines to coverage by the National Vaccine Injury Compensation Program would bolster defenses for administrators and manufacturers while also providing stronger remedies for those injured by vaccines, says Altom Maglio at MCT Law.
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Why DOJ's Whistleblower Program May Have Limited Impact
The U.S. Department of Justice’s new whistleblower pilot program aims to incentivize individuals to report corporate misconduct, but the program's effectiveness may be undercut by its differences from other federal agencies’ whistleblower programs and its interplay with other DOJ policies, say attorneys at Milbank.
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How Cos. With Chinese Suppliers Should Prep For Biotech Bill
A proposed bill to prohibit government-affiliated life sciences companies from contracting with Chinese biotech companies of concern may necessitate switching to other sources for research and supplies, meaning they should begin evaluating supply chains now due to the long lead times of drug development, say John O'Loughlin and Christina Carone at Weil Gotshal.
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FTC's Drug Middlemen Probe Highlights Ongoing Scrutiny
The Federal Trade Commission's interim staff report on its inquiry into pharmacy benefit managers suggests that the industry will remain under an enforcement microscope for the foreseeable future due to concerns about how PBMs affect drug costs and accessibility, say attorneys at Arnold & Porter.
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What Cos. Should Note In DOJ's New Whistleblower Pilot
After the U.S. Department of Justice unveiled a new whistleblower pilot program last week — continuing its efforts to incentivize individual reporting of misconduct — companies should review the eligibility criteria, update their compliance programs and consider the risks and benefits of making their own self-disclosures, say attorneys at Skadden.
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Motion To Transfer Venue Considerations For FCA Cases
Several recent decisions highlight the importance for practitioners of analyzing as early as possible whether a False Claims Act case warrants a change of venue, and understanding how courts weigh certain factors for defendants versus whistleblowers, say Ellen London at London & Stout, and Li Yu and Corey Lipton at DiCello Levitt.
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A Primer On EU's Updated Human Substance Regulations
The European Union's updated standards regarding quality and safety of substances of human origin meant for human application carry significant implications for companies that work with cells and tissues, and U.S. companies active in the EU market should pay particular attention to the import and export rules, say Geneviève Michaux and Georgios Symeonidis at King & Spalding.
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CFPB's Medical Debt Proposal May Have Side Effects
The Consumer Financial Protection Bureau’s recent proposal to prevent medical debt information from appearing on consumer reports and creditors from basing lending decisions on such information may have initial benefits for some consumers, but there are potential negative consequences that should also be considered, say attorneys at Cooley.
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15 Areas That Would Change Under Health Data Rule Proposal
If finalized, the Office of the National Coordinator for Health Information Technology's proposed rule will significantly progress its efforts to advance interoperability, respond to stakeholder concerns and clarify compliance with the health IT certification program, say attorneys at Ropes & Gray.
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3 Healthcare FCA Deals Provide Self-Disclosure Takeaways
Several civil False Claims Act settlements of alleged healthcare fraud violations over the past year demonstrate that healthcare providers may benefit substantially from voluntarily disclosing potential misconduct to both the U.S. Department of Justice and the U.S. Department of Health and Human Services, say Brian Albritton and Raquel Ramirez Jefferson at Phelps Dunbar.
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Takeaways From High Court's Tribal Health Admin Cost Ruling
The U.S. Supreme Court's recent determination that the government must reimburse two Native American tribes for administrative healthcare costs will help tribes maintain equal footing with the Indian Health Service when administering programs, and continues a pattern of how the current court aligns on tribal concerns, say attorneys at Lewis Roca.
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FTC Focus: Private Equity Investments In Healthcare
As the Federal Trade Commission is tightening its scrutiny of private equity investment in healthcare, the agency is finding novel grounds to challenge key focus areas, including rollup acquisitions, the flip-and-strip approach and minority investments in rival providers, say attorneys at Proskauer.
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High Court's Expert Ruling May Help Health Fraud Defendants
The U.S. Supreme Court's decision in Diaz v. U.S. appears to give the government a powerful new tool in calling its own agents as expert witnesses, but it could also benefit defense counsel in criminal healthcare fraud and other white collar criminal cases that arise in complex legal or regulatory environments, say attorneys at Holland & Knight.