Policy & Compliance

  • May 16, 2025

    HHS Says Pain Clinic's Delay Hurts $11M Bill Challenge

    The U.S. Department of Health and Human Services on Friday fought a pain clinic's bid in North Carolina federal court for a pretrial win in the clinic's suit challenging $11 million in overpayments for urine drug screening tests, saying the clinic waited too long to bring evidence that the testing was justified.

  • May 16, 2025

    Feds Want Ex-McKinsey Exec To Serve Time For Obstruction

    Prosecutors urged a Virginia federal judge Thursday to sentence a disbarred, former senior McKinsey & Co. partner to one year in prison for obstructing an investigation into the consulting giant's work with opioid-manufacturer Purdue Pharma, while defense counsel pushed for probation so that he can return to his home in Thailand.

  • May 16, 2025

    23 States Win Order Halting Billions In HHS Public Health Cuts

    A Rhode Island federal judge on Friday barred the Trump administration from cutting off billions of dollars in funding to state public health programs, determining the abrupt grant terminations likely violated congressional authority over spending.

  • May 16, 2025

    Trucking Co. Worker Says Tobacco Surcharge Violates ERISA

    An employee of Marten Transport Ltd. is suing the trucking company in Wisconsin federal court, alleging that a tobacco surcharge in its health plan violates federal antidiscrimination law.

  • May 16, 2025

    Surgical Center Operator Inks $15M Deal Over Data Breach

    Shields Health Group Inc., which runs dozens of MRI and surgical centers around New England, has agreed to pay around $15 million to resolve claims in a proposed class action stemming from a data breach that compromised the personal information of over 2 million people.

  • May 16, 2025

    Trump Admin Settles Vaccine Contract Info Suit For $10K

    The Trump administration has reached a $10,000 settlement with a consumer advocacy group over allegedly withholding information about the government's billion-dollar contracts with companies that developed and manufactured the COVID-19 vaccine, including Pfizer and Moderna.

  • May 15, 2025

    Ex-CEO Cops To Conspiracy Charge In $212M Fraud Case

    A New Jersey-based former CEO of a medical billing company has pled guilty to conspiring to commit securities fraud in connection with government claims he was part of a $212.5 million scheme to inflate the value of his company to defraud potential investors in a go-private transaction.

  • May 15, 2025

    Feds Freeze Parity Enforcement As Agencies Rethink Regs

    Federal agencies said Thursday they will hold off on enforcing a rule requiring employer group health plans to analyze how they restrict coverage for mental health and substance use disorder treatments, citing ongoing litigation aimed at blocking the policy and broader plans to reevaluate enforcement priorities.

  • May 14, 2025

    Mont. Court Blocks 'Ideological' Transgender Youth Care Ban

    A Montana judge on Tuesday struck down a state statute that banned gender-affirming care for minors, holding that the state's interest is "ideological rather than medical" and violates the constitutional rights of transgender youth seeking gender-affirming care and of healthcare professionals who provide it.

  • May 14, 2025

    9th Circ. Doubts Wash. Anti-Vaxxers' Stance In Med Board Suit

    A Ninth Circuit judge expressed skepticism on Wednesday that the federal appellate court could revive Robert F. Kennedy Jr.'s suit against the Washington Medical Commission for initiating disciplinary proceedings against physicians who publicly aired anti-vaccination views, pointing out that federal courts generally "don't interfere" with ongoing state litigation.

  • May 14, 2025

    Sage Therapeutics Brass Sued Over Drug Candidate Claims

    The top brass of Sage Therapeutics Inc. have been hit with a shareholder derivative suit in New York federal court alleging they misled investors about the safety, efficacy, durability and commercial prospects of three of the company's drug candidates and overstated their likelihood to be approved by the U.S. Food and Drug Administration.

  • May 14, 2025

    Houston Midwife Says AG Has No Evidence To Close Clinics

    A Houston-area midwife who was arrested earlier this year on a charge of providing an illegal abortion is arguing to a state appellate court that Texas Attorney General Ken Paxton "came nowhere close to meeting the state's burden" in his bid to shut down her clinics.

  • May 14, 2025

    RFK Jr. Defends HHS Cuts, Pledges To 'Spend Smarter'

    In his first appearance on Capitol Hill since his confirmation, U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. on Wednesday characterized a massive reorganization and reductions in workforce as practical moves to optimize the sprawling agency.

  • May 13, 2025

    Healthcare Hires: Ex-DOJ, Fresenius Attys On The Move

    An ex-federal prosecutor who led healthcare fraud investigations in Texas has joined Hicks Thomas LLP, and an attorney with in-house experience at Fresenius Medical Care and GE Healthcare joined King & Spalding LLP in its government investigations practice. Here, Law360 Healthcare Authority looks at the week's most notable lateral hires in the healthcare industry.

  • May 13, 2025

    Health Co. Elevance Faces Suit Over Post-COVID Costs Claims

    Health insurance provider Elevance Health Inc. and some of its executives face a proposed investor class action alleging the company hurt shareholders by mismanaging expectations about its Medicaid business's costs amid the post-pandemic eligibility redetermination process in certain markets it served.

  • May 13, 2025

    A Trump Do-Over On 'Most Favored Nation' Drug Prices

    President Donald Trump's move this week to "equalize" U.S. drug prices with lower overseas prices hearkens back to a similar effort made in his first term that faced a swarm of legal challenges before being shelved.

  • May 13, 2025

    Planned Parenthood Wants Teen Program Fund Rule Blocked

    Planned Parenthood on Monday urged a D.C. federal judge to vacate the U.S. government's "unlawful" requirements to "align" with President Donald Trump's executive orders lest risk losing Teen Pregnancy Prevention Program funding, arguing its facilities will suffer staff cuts and loss of medically accurate, age-appropriate education services absent an injunction.

  • May 13, 2025

    FDA Move On Industry Influence Only 'Cosmetic,' Experts Say

    A Trump administration move to boot pharmaceutical employees off U.S. Food and Drug Administration advisory panels won’t do much to address conflicts of interest or change how regulators interact with the industry, experts say. But that doesn't mean other measures shouldn't be considered.

  • May 13, 2025

    NIH Letters Ending Grants Lack Factual Support, Judge Says

    A Massachusetts federal judge said Tuesday that a "blast" of hundreds of virtually identical letters in March canceling National Institutes of Health-funded research projects appeared to offer no factual basis, only unsupported assertions that the projects were unscientific or discriminatory.

  • May 13, 2025

    Michigan Judge Strikes Down State's Abortion Restrictions

    A Michigan judge struck down several of the state's abortion restrictions Tuesday, including a mandatory waiting period, required counseling materials and a rule that only doctors may perform abortions, finding the laws make it harder for people to access abortion and don't protect patients' health. 

  • May 13, 2025

    PBMs Get Bipartisan Bashing At Hearing On Drug Costs

    Senators across party lines slammed pharmacy benefit managers on Tuesday, sometimes in coarse language, as they wrestled with how to reduce drug prices for patients while also preventing the closure of rural pharmacies.

  • May 13, 2025

    DOJ Puts New Target On Medicare Advantage 'Steering'

    U.S. Department of Justice officials' decision to back whistleblower claims that major health insurance companies paid millions in illegal kickbacks to brokers marks a dramatic escalation of an effort to crack down on Medicare Advantage "steering."

  • May 13, 2025

    Feldesman Grants Atty On 'Chaos' Of HHS Funding Cuts

    Massive cuts in federal funding for healthcare programs are testing the avenues of recourse for safety-net hospitals and others that depend on grants to keep their doors open.

  • May 13, 2025

    Ind. Tells Nonprofit Hospitals To Curb Prices, Or Else

    A new Indiana law gives charitable hospitals a stark choice: Lower prices or face the loss of their nonprofit status.

  • May 13, 2025

    Attys Push 11th Circ. To Weigh Judge Shopping Sanctions

    The Eleventh Circuit can hear three attorneys' appeal of sanctions against them for judge shopping during their legal challenge to an Alabama law criminalizing gender-affirming care, because the underlying case was dismissed, making the jurisdictional question moot, two of those lawyers told the appellate court.

Expert Analysis

  • 6 Lessons From DOJ's 1st Controlled Drug Case In Telehealth

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    Following the U.S. Department of Justice’s first-ever criminal prosecution over telehealth-prescribed controlled substances in U.S. v. Ruthia He, healthcare providers should be mindful of the risks associated with restricting the physician-patient relationship when crafting new business models, says Jonathan Porter at Husch Blackwell.

  • After Chevron: Scale Tips Favor Away From HHS Agencies

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    The loss of Chevron deference may indirectly aid parties in challenging the U.S. Department of Health and Human Services' interpretations of regulations and could immediately influence several pending cases challenging HHS on technical questions and agency authority, say attorneys at Ropes & Gray.

  • After Chevron: FDA Regulations In The Crosshairs

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    The U.S. Supreme Court's overturning of the Chevron doctrine is likely to unleash an array of challenges against the U.S. Food and Drug Administration, focusing on areas of potential overreach such as the FDA's authority under the Federal Food, Drug and Cosmetic Act, say attorneys at Debevoise.

  • USPTO Disclaimer Rule Would Complicate Patent Prosecution

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    The U.S. Patent and Trademark Office's proposed changes to terminal disclaimer practice could lead to a patent owner being unable to enforce a valid patent simply because it is indirectly tied to a patent in which a single claim is found anticipated or obvious in view of the prior art, say attorneys at Sterne Kessler.

  • Navigating Scrutiny Of Friendly Professional Corps. In Calif.

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    In light of ongoing scrutiny and challenges to private equity participation in the California healthcare marketplace, particularly surrounding the use of the friendly professional corporation model, management services organizations should consider implementing four best practices, say attorneys at Holland & Knight.

  • Takeaways From New HHS Substance Use Disorder Info Rules

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    A new U.S. Department of Health and Human Services rule continues the agency's efforts to harmonize complex rules surrounding confidentiality provisions for substance use disorder patient records, though healthcare providers will need to remain mindful of different potentially applicable requirements and changes that their compliance structures may require, say attorneys at Ropes & Gray.

  • Calif. Banking Brief: All The Notable Legal Updates In Q2

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    The second quarter of 2024 in California, which saw efforts to expand consumer protection legislation and enforcement actions in areas of federal focus like medical debt and student loans, demonstrated that the state's role as a trendsetter in consumer financial protection will continue for the foreseeable future, say attorneys at Sheppard Mullin.

  • How Cannabis Rescheduling May Affect Current Operators

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    The U.S. Drug Enforcement Agency's proposal to reschedule marijuana to Schedule III provides relief in the form of federal policy from the stigma and burdens of Schedule I, but commercial cannabis operations will remain unchanged until the federal-state cannabis policy gap is remedied by Congress, say Meital Manzuri and Alexis Lazzeri at Manzuri Law.

  • Air Ambulance Ruling Severely Undermines No Surprises Act

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    A Texas federal court's recent decision in Guardian Flight v. Health Care Service — that the No Surprises Act lacks a judicial remedy when a health insurer refuses to pay the amount established through an independent review — likely throws a huge monkey wrench into the elaborate protections the NSA was enacted to provide, says Mark DeBofsky at DeBofsky Law.

  • Class Actions At The Circuit Courts: June Lessons

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    In this month's review of class action appeals, Mitchell Engel at Shook Hardy considers two recent decisions from the Third and Tenth Circuits, and identifies practice tips around class action settlements and standing in securities litigation.

  • How Congress Is Tackling The US Healthcare Shortage

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    With healthcare shortages continuing across the U.S. despite industry efforts to improve patient access to care, increased Medicare support for graduate medical education could be a crucial component of the solution, say Sarah Crossan and Miranda Franco at Holland & Knight.

  • The Current State Of Healthcare Transaction Reviews In Calif.

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    As of April, certain healthcare transactions in California have been subject to additional notification compliance requirements, and complying with these new rules could significantly delay and discourage some deals, says Andrew Demetriou at Husch Blackwell.

  • High Court's Abortion Pill Ruling Shuts Out Future Challenges

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    The U.S. Supreme Court's unanimous ruling in U.S. Food and Drug Administration v. Alliance for Hippocratic Medicine maintains the status quo for mifepristone access and rejects the plaintiffs' standing theories so thoroughly that future challenges from states or other plaintiffs are unlikely to be viable, say Jaime Santos and Annaka Nava at Goodwin.