Policy & Compliance

  • June 15, 2026

    Attys Want Up To $33M In Long-Running UBH Benefits Fight

    Attorneys for employee benefit plan participants who sued to change how United Behavioral Health processed claims for mental health and substance use disorder treatment asked a California federal court for up to $33 million in fees and expenses for their work on the "groundbreaking" case.

  • June 15, 2026

    CareFirst Says Intent Standard Was Misread In Stelara Case

    CareFirst is arguing that a Virginia federal judge created a new standard for monopolization claims when he dismissed claims from the company's antitrust suit challenging Johnson & Johnson's protection of its immunosuppressive drug Stelara, arguing he misread a Fourth Circuit decision in ruling that monopolization requires a showing of specific intent.

  • June 15, 2026

    GEO Says Only ICE Controls NJ Detention Center Access

    Private prison operator The GEO Group Inc. has told a New Jersey federal court it was wrongly sued over state health inspectors allegedly being blocked from fully accessing an immigration detention facility, arguing U.S. Immigration and Customs Enforcement exclusively controls access.

  • June 15, 2026

    Wyo. Judge Nixes 3 Abortion Care Limits As Unconstitutional

    A Wyoming judge has struck down three state laws restricting abortion care, finding that the state failed to demonstrate it had a compelling interest in effectuating a 48-hour waiting period for abortions and requiring certain abortion facilities to be licensed as ambulatory surgical centers, among other restrictions.

  • June 15, 2026

    Ala. Judge Shopping Case Dismissed, But Docs Sealed For Year

    A Florida federal judge indicated in a brief order Friday that an indictment has been dismissed against an attorney in a judge shopping case, but said the motion related to the dismissal will be kept under seal for a year.

  • June 15, 2026

    Justices Decline To Hear Pa. Prison ADA Liability Challenge

    The U.S. Supreme Court declined Monday to take up Pennsylvania's petition to overturn a ruling finding it could possibly be held liable under the Americans with Disabilities Act in an incarcerated man's lawsuit alleging he was illegally denied access to proper medical care.

  • June 12, 2026

    Wellpoint Data Breach Suit Says Delay Elevated Fraud Risk

    A Washington resident accused insurer Wellpoint Washington Inc. and health services provider Independent Clinics of Washington of failing to adequately protect patient information from a June 2025 cyberattack, claiming in a proposed nationwide class action Thursday that Wellpoint also neglected to inform subscribers until nearly a year after the breach.

  • June 12, 2026

    Disability Rights Orgs. Seek To Halt NY, Ill. 'Aid-In-Dying' Laws

    Disability rights organizations hit the governors of New York and Illinois with a pair of federal lawsuits seeking to stop new laws in each state from taking effect that would allow patients with terminal illnesses to seek a doctor's assistance in ending their lives.

  • June 12, 2026

    Aetna Can't Nix Unfair Practices Claims In Medical Billing Row

    A Washington acupuncture clinic and doctor accused of submitting fraudulent bills for medical services may proceed with their counterclaims against Aetna for unfair trade practices under the state's Consumer Protection Act, a federal court ruled.

  • June 12, 2026

    $1.9M Deal In Health System Retirement Suit Gets 1st OK

    A Michigan federal judge granted initial approval to a $1.9 million deal between a health system and a proposed class of employee retirement plan participants who alleged underperforming investment options violated federal benefits law, greenlighting a deal that was first submitted to the court for approval in late April.

  • June 11, 2026

    Ed. Dept. Tries New Tack To Scrap K-12 Mental Health Grants

    The U.S. Department of Education pressed ahead with its plan to end up to a billion dollars in school mental health grants, arguing Wednesday that a Seattle federal judge's December 2025 injunction barring the discontinuation of the grants shouldn't block the government from canceling the contracts outright.

  • June 11, 2026

    AbbVie Loses Colorado 340B Drug Pricing Law Challenge

    A Colorado federal judge on Wednesday dismissed all of AbbVie Inc.'s claims against the state over its federal 340B drug pricing law, finding that the Colorado law isn't federally preempted and courts across the country have settled the issue.

  • June 11, 2026

    Stop & Shop Parent Pays $40M On Inflated Drug Price Claims

    Stop & Shop's parent company will pay $40 million to resolve allegations it violated the False Claims Act by failing to report discounted prescription drug prices as "usual and customary" in claims submitted to federal Medicare, Medicaid and TRICARE programs, which resulted in overcharges, the U.S. Department of Justice announced Wednesday.

  • June 11, 2026

    HHS OIG Reports 'Concerning' Medicare Advantage Denials

    A pair of reports released by the inspector general for the U.S. Department of Health and Human Services on Thursday found that UnitedHealth Group, Humana and CVS Health logged some of the highest prior authorization denial rates among their Medicare Advantage peers for post-acute care.

  • June 11, 2026

    Braidwood Files New Challenge To ACA Birth Control Mandate

    For-profit healthcare company Braidwood Management and several individuals sued the government in Texas federal court to challenge no-cost contraception coverage requirements under the Affordable Care Act, arguing that the court should enjoin enforcement of the policy because it burdened their faith in violation of federal religious freedom law.

  • June 10, 2026

    Morgan & Morgan Atty Again Blocked From Harvard Suit

    A Massachusetts judge rebuffed a Morgan & Morgan PA attorney's second attempt to appear in a lawsuit over the theft of body parts from a Harvard Medical School morgue, saying he would not reconsider his earlier decision to bar the attorney over an incident in a separate court involving fake AI-generated case citations.

  • June 10, 2026

    Judge Won't Certify Class Of Health Workers In No-Poach Suit

    An Illinois federal judge on Wednesday refused to certify a class of former healthcare employees claiming that their wages were suppressed by alleged no-poach agreements among DaVita, UnitedHealth Group's Surgical Care Affiliates and Tenet Healthcare Corp. unit United Surgical Partners International, ruling that the proposed class is too diverse.

  • June 10, 2026

    Abbott Offered Faulty Health Plan Option, Ex-Worker Says

    Abbott Laboratories violated federal benefits law by offering a health plan option with higher premiums and lower deductibles without disclosing that participants would always pay less if they chose a high-deductible plan, according to a proposed class action filed Wednesday in Illinois federal court.

  • June 10, 2026

    NJ High Court Says Nonprofit Hospital Gets Limited Immunity

    The New Jersey Supreme Court unanimously concluded Wednesday that a nonprofit federally qualified health center isn't immune from a patient's negligence suit under a statute shielding nonprofits organized "exclusively" for charitable or educational purposes, reversing a lower court's finding to the contrary.

  • June 10, 2026

    Insurance Cos. Score Dismissal Of Zepbound Coverage Case

    A D.C. federal judge Wednesday agreed to toss a proposed class action against CVS Caremark and CareFirst BlueCross BlueShield from a worker who challenged coverage denials for Zepbound to treat sleep apnea, holding an exclusion in his employee health plan that the companies administered complied with federal benefits law.

  • June 10, 2026

    Lab To Pay $4.9M To Settle AGs' COVID Test Pricing Suit

    Eighteen states' attorneys general have entered into a $4.87 million settlement with GS Labs to resolve claims that the defunct testing company overcharged consumers for COVID-19 tests, according to statements issued Wednesday.

  • June 10, 2026

    Houston Hospital System Settles Retirement Fee, Fund Fight

    A Texas hospital system agreed to settle a proposed class action from ex-workers alleging the healthcare nonprofit failed to curb excessive recordkeeping fees and remove underperforming funds from its $2.8 billion employee retirement plan, after a magistrate judge recommended denying its motion to dismiss an amended complaint in May.

  • June 09, 2026

    Novartis, AbbVie Lose Bid To Halt Wash. 340B Pharmacy Law

    A Washington federal judge declined Tuesday to block a state law passed to protect prescription drug access for low-income and uninsured patients, rejecting arguments from AbbVie and Novartis that the new measure illegally adds to pharmaceutical manufacturers' obligations under the federal 340B Drug Pricing Program.

  • June 09, 2026

    Trans Care In Court: 7th Circ. Appeal, Atty Discipline And More

    Law360 Healthcare Authority looks at an emergency request related to the American Academy of Pediatrics, a Rhode Island judge's referral of Justice Department attorneys to a disciplinary committee, and other top news of the past week.

  • June 09, 2026

    Calif. Judge Blocks DOJ's Bid For Trans Patients' Medical Info

    A California federal judge ordered Stanford Medicine hospital not to disclose medical information belonging to trans adolescents who received gender-related care in response to a Texas grand jury subpoena, and blocked the U.S. Department of Justice from taking further steps to obtain their patient records.

Expert Analysis

  • What US Medicine Onshoring Means For Indian Life Sciences

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    Despite the Trump administration's latest moves to onshore essential medicine manufacturing, India will likely remain an indispensable component of the U.S. drug supply chain, but Indian manufacturers should prepare for stricter compliance checks, says Jashaswi Ghosh at Holon Law Partners.

  • FCA Working Group Reboot Signals EHR Compliance Risk

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    The revival of the False Claims Act working group is an aggressive expansion of enforcement efforts by the Justice Department and the U.S. Department of Health and Human Services targeted toward technology-enabled fraud involving electronic health records and other data, say attorneys at ArentFox Schiff.

  • FDA's Hasty Policymaking Approach Faces APA Challenges

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    Though the U.S. Food and Drug Administration has abandoned its usual notice-and-comment process for implementing new regulatory initiatives, two recent district court decisions make clear that these programs are still susceptible to Administrative Procedure Act challenges, says Rachel Turow at Skadden.

  • The Metamorphosis Of The Major Questions Doctrine

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    The so-called major questions doctrine arose as a counterweight to Chevron deference over the past few decades, but invocations of the doctrine have persisted in the year since Chevron was overturned, suggesting it still has a role to play in reining in agency overreach, say attorneys at Crowell & Moring.

  • A Rapidly Evolving Landscape For Noncompetes In Healthcare

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    A wave of new state laws regulating noncompete agreements in the healthcare sector, varying in scope, approach and enforceability, are shaped by several factors unique to the industry and are likely to distort the market, say attorneys at Seyfarth.

  • Arguing The 8th Amendment For Reduction In FCA Penalties

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    While False Claims Act decisions lack consistency in how high the judgment-to-damages ratio in such cases can be before it becomes unconstitutional, defense counsel should cite the Eighth Amendment's excessive fines clause in pre-trial settlement negotiations, and seek penalty decreases in post-judgment motions and on appeal, says Scott Grubman at Chilivis Grubman.

  • $95M Caremark Verdict Should Put PBMs On Notice

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    A Pennsylvania federal judge’s recent ruling that pharmacy benefits manager CVS Caremark owes the government $95 million for overbilling Medicare Part D-sponsored drugs highlights the effectiveness of the False Claims Act, as scrutiny of PBMs’ outsized role in setting drug prices continues to increase, say attorneys at Duane Morris.

  • DOJ Actions Signal Rising Enforcement Risk For Health Cos.

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    The U.S. Department of Justice's announcement of a new False Claims Act working group, together with the largest healthcare fraud takedown in history, underscore the importance of sophisticated compliance programs that align with the DOJ's data-driven approach, say attorneys at Debevoise.

  • Spotlight On Medicare Marketing Practices Enforcement Trend

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    Recent U.S. Department of Justice actions, including its recent Medicare kickback allegations in Shea v. eHealth, demonstrate increasing enforcement scrutiny on Medicare Advantage marketing practices, say Ellen London at London & Naor, Li Yu at Bernstein Litowitz and Erica Hitchings at the Whistleblower Law Collaborative.

  • Federal Regs Order May Spell Harsher FDCA Enforcement

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    A recent executive order aimed at reducing criminal prosecutions of those who unknowingly violate complex federal regulations may actually lead to more aggressive felony indictments under the Federal Food, Drug and Cosmetic Act, but companies and executives can mitigate risks by following several key principals, say attorneys at McGuireWoods.

  • What High Court's Tenn. Trans Care Ruling Means Nationally

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    The U.S. Supreme Court's decision in U.S. v. Skrmetti, upholding a Tennessee ban on gender-affirming medical care for minors, is fairly limited in scope and closely tailored to the specific language of Tennessee's law, but it may have implications for challenges to similar laws in other states, say attorneys at Hall Render.

  • High Court ACA Ruling May Harm Preventative Care

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    The U.S. Supreme Court's decision in Kennedy v. Braidwood last week, ruling that the U.S. Department of Health and Human Services secretary has authority over an Affordable Care Act preventive care task force, risks harming the credibility of the task force and could open the door to politicians dictating clinical recommendations, says Michael Kolber at Manatt.

  • Rising Enforcement Stakes For Pharma Telehealth Platforms

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    Two pieces of legislation recently introduced in Congress could transform the structure and promotion of telehealth arrangements as legislators increasingly scrutinize direct-to-consumer advertising platforms, potentially paving the way for a new U.S. Food and Drug Administration policy with bipartisan support, say attorneys at Sheppard Mullin.