Policy & Compliance

  • March 31, 2026

    As FCA Meets 340B, Geyser Of Qui Tam Suits May Erupt

    A Ninth Circuit ruling on the intersection of two of the most contentious laws in healthcare may be a combustible mix that triggers a new wave of fraud litigation.

  • March 31, 2026

    Insurer Says Yale Was 'Misleading' In $4.1M Transplant Claim

    A Liberty Mutual unit accused Yale University's health system of making "serious and material misstatements" about a plan member's bone marrow transplant, the insurer said in its answer and counterclaim for a declaratory judgment that it can continue to deny the $4.1 million claim.

  • March 31, 2026

    Justices Reject Colorado's LGBTQ+ 'Conversion' Ban

    The U.S. Supreme Court ruled Tuesday that a Colorado ban on therapy intended to change a minor's sexual orientation or gender identity amounts to viewpoint discrimination against a Christian therapist, a finding that split the court's liberal wing and crossed ideological lines.

  • March 30, 2026

    Don't Set Special IP Rules For 'Skinny Labels,' Justices Told

    Drugmakers, industry groups, hospitals and scholars have urged the U.S. Supreme Court to uphold a decision letting a patent suit proceed over a generic drug using a so-called skinny label, saying the generics company is seeking unwarranted special protections that would upend patent law.

  • March 30, 2026

    FCA Qui Tams Are Unconstitutional, Eli Lilly Tells Justices

    The False Claims Act's whistleblower provisions are unconstitutional, drugmaker Eli Lilly has told the U.S. Supreme Court, asking it to overturn a Seventh Circuit decision upholding a $183 million trial win for a whistleblower who claimed the drug company hid how much it charged for Medicaid-covered drugs. 

  • March 30, 2026

    FTC Says Anesthesia Group Cheered While Raising Prices

    The Federal Trade Commission pushed back against a bid from U.S. Anesthesia Partners to avoid facing trial on claims that it monopolized the market through a rollup strategy, saying the company celebrated its ability to dramatically increase prices.

  • March 27, 2026

    5th Circ. Won't Revive Ex-Health IT Co. Worker's Bias Suit

    The Fifth Circuit upheld a healthcare information technology provider's win over a Black former manager's lawsuit claiming she was fired for complaining that a white male colleague was treated better, saying she couldn't overcome the company's rationale for letting her go.

  • March 27, 2026

    Pa. Health Network's $1.15M 401(k) Suit Deal Gets Final OK

    A Pennsylvania federal judge gave the green light to a $1.15 million deal resolving a proposed class action alleging a healthcare system misused workers' forfeited employee retirement plan funds and failed to rein in administrative fees.

  • March 27, 2026

    Insurer Rips Sanctions Bid In Opioid Coverage Dispute

    An insurer asked an Illinois federal court to reject a drug wholesaler's bid for sanctions in a dispute over coverage for underlying opioid litigation, saying the accusations that it intentionally destroyed pertinent evidence are, "at best, based on half-truths and misstatements of fact."

  • March 27, 2026

    Hospital Escapes Ex-Workers' 401(k) Forfeiture, Fund Suit

    A New York federal judge on Friday tossed a proposed class action against a healthcare company alleging mismanagement of an employee 401(k) plan, concluding that ex-workers who sued lacked standing to bring some claims while the remaining allegations weren't sufficiently backed up to state a claim for violating federal benefits law.

  • March 26, 2026

    Elanco Beats Investor Suit Over Dog Drug's Reg Challenges

    A Maryland federal judge Thursday dismissed a proposed securities class action against Elanco Animal Health Inc. that claimed the animal pharmaceuticals company misled investors about the safety of a canine dermatitis treatment it was developing and its timeline for the medication's commercial launch.

  • March 26, 2026

    DOJ Says NY-Presbyterian Blocked Lower-Cost Health Plans

    New York-Presbyterian Hospital is forcing major health insurers to contract with it on an "all-or-nothing" basis, which is driving up healthcare costs in New York City and violates federal antitrust law, the U.S. Department of Justice said in a federal lawsuit filed Thursday. 

  • March 25, 2026

    AbbVie, Novartis Sue Wash. Over New 340B Drug-Pricing Law

    Pharmaceutical giants Novartis and AbbVie say a new Washington state law illegally expands drugmakers' obligations to provide deeply discounted medications under the federal government's 340B Drug Pricing Program, according to a pair of legal challenges launched in federal court on Wednesday.

  • March 25, 2026

    3rd Circ. Probes Free Speech Impact Of NJ Telemedicine Law

    A Third Circuit panel on Wednesday examined whether New Jersey can bar out-of-state doctors from consulting with Garden State patients via phone or video without a state license, pressing both sides on where to draw the line between protected speech and the regulated practice of medicine.

  • March 25, 2026

    Insurers, Brokers Can't Exit Medicare Advantage Steering Suit

    A Massachusetts federal judge on Wednesday largely rejected a bid by insurers and brokers to toss claims that they colluded in a kickback scheme to steer Medicare Advantage customers to certain companies and to push away disabled individuals.

  • March 25, 2026

    PBMs Say Mich. Price-Fixing Suit Lacks Specifics

    For the second time, pharmacy benefit managers Express Scripts Inc. and Prime Therapeutics LLC asked a Michigan federal judge on Monday to toss a price-fixing suit filed by Michigan Attorney General Dana Nessel, arguing that the state has no standing to file the suit.

  • March 25, 2026

    Judge Trims SEC Fraud Case Over Cancer Drug Claims

    A Massachusetts federal judge greenlighted U.S. Securities and Exchange Commission claims against two of three former pharmaceutical executives accused of concealing from investors the U.S. Food and Drug Administration's "harsh critiques" about a cancer drug.

  • March 25, 2026

    Foreign Aides' RICO Labor Suit Against PruittHealth Hits NC

    A Tennessee federal judge has agreed to transfer to North Carolina a year-old class action in which foreign workers say a healthcare system and recruiter trapped them in punitive contracts and buried them in grueling labor, after a judge said the action could have been filed in the Tar Heel State in the first place.

  • March 24, 2026

    Nicotine Pouch Maker To Refile FDA Suit In DC After Transfer

    The maker and seller of Zone nicotine pouches on Tuesday dismissed its own lawsuit accusing the U.S. Food and Drug Administration of unfairly holding up a market application for its product, promising to refile in D.C. federal court after a Texas federal court transferred it to South Carolina federal court.

  • March 24, 2026

    Biz Services Co. Faces ERISA Suit Over 'Tobacco Surcharge'

    Business services company Conduent unlawfully imposes health insurance surcharges on employees who use tobacco products, forcing them to pay more for coverage the company provides, a former employee and plan participant said in a proposed class action in New Jersey federal court.

  • March 24, 2026

    $5.7M Cigna Ghost Network Deal Receives Final Go-Ahead

    An Illinois federal judge gave his final sign-off Tuesday to a $5.7 million settlement in what he called an "interesting" case accusing Cigna of improperly advertising out-of-network providers as though they're in-network for certain benefit plans it administered.

  • March 24, 2026

    Health Co. Escapes Workers' 401(k) Forfeiture Suit In La.

    A Louisiana federal judge agreed to toss a federal benefits lawsuit against a health company from workers who alleged the company misspent forfeitures from their employee 401(k) plan, rejecting the workers' argument that funds should have gone toward defraying expenses instead of lowering employer-side contribution obligations.

  • March 24, 2026

    Utah Hospitals To Track Violence As States Step Up Reporting

    Under a new law, Utah hospitals will join a national effort to better understand the risks facing healthcare workers.

  • March 24, 2026

    Ohio Justices Likely Split On Trans Care Restrictions

    The Ohio Supreme Court appeared split Tuesday as to whether a new state law banning gender-affirming care for minors trumps a decade-old healthcare freedom provision passed by voters that says state laws can't block a patient from obtaining healthcare. 

  • March 24, 2026

    Fraud Task Force May Boost White Collar Defense Work

    A new federal anti-fraud task force involving at least a dozen federal agencies could soon expose more state and local governments, contractors, companies and others to compliance risks, particularly in healthcare fraud and False Claims Act cases, experts say.

Expert Analysis

  • Deregulation Memo Presents Risks, Opportunities For Cos.

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    A recent Trump administration memo providing direction to agencies tasked with rescinding regulations under an earlier executive order — without undergoing the typical notice-and-review process — will likely create much uncertainty for businesses, though they may be able to engage with agencies to shape the regulatory agenda, say attorneys at Blank Rome.

  • The IRS Shouldn't Go To War Over Harvard's Tax Exemption

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    If the Internal Revenue Service revokes Harvard's tax-exempt status for violating established public policy — a position unsupported by currently available information — the precedent set by surviving the inevitable court challenge could undercut the autonomy and distinctiveness of the charitable sector, says Johnny Rex Buckles at Houston Law Center.

  • New Hospice Regulations Should Enforce Core Principles

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    As the U.S. Department of Health and Human Services' Office of Inspector General prepares to research and expand on oversight of Medicare hospice care, the OIG should keep in mind certain core principles, such as an emphasis on preventing the entry of hospices that raise red flags, says Bill Dombi at Arnall Golden.

  • 7 Considerations For Conducting Drug Clinical Trials Abroad

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    With continuing cuts to U.S. Food and Drug Administration staffing motivating some pharmaceutical companies to consider developing drugs abroad, it's important to understand the additional risks and compliance requirements associated with conducting clinical studies in other countries, say attorneys at Morgan Lewis.

  • Compliance Lessons From Warby Parker's HIPAA Fine

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    The U.S. Department of Health and Human Services' civil money penalty against Warby Parker highlights the emerging challenges that consumer-facing brands encounter when expanding into healthcare-adjacent sectors, with Health Insurance Portability and Accountability Act compliance being a potential focus of regulatory attention, say attorneys at Saul Ewing.

  • 5th Circ. Ruling Is Latest Signal Of Shaky Qui Tam Landscape

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    In his recent concurring opinion in U.S. v. Peripheral Vascular Associates, a Fifth Circuit judge joined a growing list of jurists suggesting that the False Claims Act's whistleblower provisions are unconstitutional, underscoring that acceptance of qui tam relators can no longer be taken for granted, say attorneys at Miller & Chevalier.

  • Medicare Advantage Enforcement Strong Amid Agency Cuts

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    The second Trump administration's actions thus far suggest that Medicare Advantage enforcement remains a bipartisan focus despite challenges presented by evolving trends in federal agency staffing and resources, say attorneys at Ropes & Gray.

  • A New Tool For Assessing Kickback Risks In Health Marketing

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    The Seventh Circuit's recent decision in U.S. v. Sorensen, reversing a conviction after trial of a durable medical equipment distributor, highlights two principle considerations for determining whether payments to marketers in healthcare are unlawful under the Anti-Kickback Statute, says Elisha Kobre at Sheppard Mullin.

  • How Trump Orders Affect Health Orgs.' Care For Trans Minors

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    Two recent executive orders issued by President Donald Trump regarding gender-affirming care for minors have put healthcare organizations in a precarious situation, and these institutions should prepare for various implications and potential scenarios, say attorneys at ArentFox.

  • Reproductive Health Under Trump So Far, And What's Next

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    Based on priorities stated so far, the Trump administration will likely continue to weaken Biden-era policies that protect reproductive health, with abortion, in vitro fertilization and contraception all being issues to watch closely amid a post-Dobbs shift, say attorneys at McDermott.

  • What's Next For Lab Test Regulation Without FDA Authority

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    A recent Texas federal court decision vacating the U.S. Food and Drug Administration's final rule that would apply FDA regulations to laboratory-developed tests signals potential positive impacts in the diagnostic space, and could inspire more healthcare entities to litigate against the government, say attorneys at Hooper Lundy.

  • 6 Criteria Can Help Assess Executive Branch Actions

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    With new executive policy changes announced seemingly every day, several questions can help courts, policymakers and businesses determine whether such actions are proper, effective and in keeping with our democratic norms, say Marc Levin and Khalil Cumberbatch at the Council on Criminal Justice.

  • Learning From COVID-19 Enforcement Against Nursing Homes

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    Five years after the COVID-19 outbreak caused a high number of deaths in nursing homes, an examination of enforcement actions against nursing homes in New York and elsewhere in the country highlights obstacles that may arise when bringing cases of this type, and ways to overcome them, says Kenneth Levine at Stone & Magnanini.