Policy & Compliance
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July 29, 2025
DOD Expands Tricare's Clinical Trial Benefit
The U.S. Department of Defense has issued a final rule that makes health insurance coverage for clinical trials aimed at treating and preventing COVID-19 and other infectious diseases permanent for military personnel, retirees and their families.
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July 29, 2025
Detroit Casino Can't Beat Denied Vaccine Exemption Suit
A dozen former supervisors at a Detroit casino can proceed to trial on claims that their employer refused to accommodate their religiously motivated requests to skip the COVID-19 vaccine, a Michigan federal judge has ruled.
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July 29, 2025
9th Circ. Rescinds Ruling On Wash. Abortion Coverage Law
A Ninth Circuit panel has walked back a published March opinion rejecting a Christian church's challenge to a Washington state law mandating employer health coverage of abortion services, saying in a Tuesday order that the federal appeals court would issue a new ruling following additional oral arguments.
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July 29, 2025
RFK Jr. Slams Vaccine Injury Program: 3 Things To Know
U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. is taking aim at the national program that compensates people for vaccine injuries, calling it a "heartless" system that he intends to fix.
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July 29, 2025
Travelers Gets Trim Of Ex-Worker's Tobacco Health Fee Suit
A Minnesota federal judge pared down claims Tuesday from a former Travelers worker's suit alleging the insurance and financial services company unlawfully imposed a surcharge on the health plans of employees who disclosed they were tobacco users and thereby violated nondiscrimination provisions in federal benefits law.
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July 29, 2025
UnitedHealth Urges 6th Circ. To Affirm ERISA Preemption
UnitedHealth Group Inc. urged the Sixth Circuit to affirm the dismissal of a man's claims that UnitedHealth defrauded him into reimbursing the health insurance giant for $25,000, arguing that the Employee Retirement Income Security Act of 1974 completely preempts such claims brought under state law.
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July 29, 2025
Organ Procurement's Dilemma: How Do You Diagnose Death?
A Kentucky man nearly had his organs removed for donation despite showing signs of life. Now a federal investigation is putting a spotlight on how doctors diagnose death prior to organ transplants.
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July 29, 2025
FDA Recommends Federal Restrictions On Kratom Extract
The U.S. Food and Drug Administration announced Tuesday that it recommends placing federal restrictions on 7-Hydroxymitragynine, or 7-OH, an opioid-like alkaloid compound derived from the kratom leaf that the agency said had a strong potential for abuse.
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July 29, 2025
Attys Blast 'Chilling Message' Of Judge Shopping Sanctions
Three attorneys sanctioned for judge shopping while challenging an Alabama statute that criminalizes gender-affirming care have asked the Eleventh Circuit to clear their names, castigating the process that led to their censure as "so extraordinary as to approach unprecedented."
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July 29, 2025
22 States Sue To Block Defunding Of Planned Parenthood
California and more than 20 other states on Tuesday launched their own legal challenge to budget legislation that halts federal Medicaid funding for Planned Parenthood, alleging the measure illegally targets the organization and violates its First Amendment rights.
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July 29, 2025
Ark. Law Banning PBM-Owned Pharmacies Put On Ice
Arkansas can't enforce a law banning pharmacy benefit managers from owning pharmacies in the state, a federal judge ruled, saying that CVS, Express Scripts, Optum and a trade group are likely to succeed on their claims that the statute unlawfully restricts interstate commerce.
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July 29, 2025
9th Circ. Clarifies Kickback Boundaries For Referral Bonuses
A Ninth Circuit opinion affirming a California man's fraud conviction provides some clarity — and a warning — to the owners of medical testing laboratories wondering what sales tactics are allowed under a 2018 kickbacks law.
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July 29, 2025
Meet Josh Craddock, Fetal Personhood Advocate Joining DOJ
President Donald Trump has named a former BigLaw attorney and outspoken proponent of the fetal personhood legal doctrine to serve as deputy assistant attorney general at the legal arm of the U.S. Department of Justice.
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July 28, 2025
PBMs Can't Escape NY State Law Claims In Opioid MDL
Two UnitedHealth subsidiaries cannot escape claims that they exacerbated the opioid crisis by providing data analytics and consulting services to drugmakers, a federal judge overseeing the multidistrict litigation ruled on Monday, saying the New York state municipalities have adequately alleged RICO by claiming they were part of the same criminal conspiracy.
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July 28, 2025
Express Scripts, Prime Urge Court To Toss Mich. Price-Fix Suit
Two pharmacy benefit managers sought to shake allegations of price-fixing brought by Michigan Attorney General Dana Nessel, arguing Friday that her antitrust suit suffers from several fatal legal flaws, including that the state does not have standing to sue on pharmacies' behalf.
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July 28, 2025
DOJ Probes NewYork-Presbyterian Over Antitrust Allegations
The U.S. Department of Justice has opened an investigation into NewYork-Presbyterian Healthcare System for allegedly violating antitrust laws by cutting deals with insurance companies that have led to rising healthcare costs, according to a subpoena viewed by Law360.
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July 28, 2025
Judge Again Cites Bias In NIH Fund Freeze As Gov't Appeals
A Massachusetts federal judge on Monday reiterated his conclusion that the Trump administration's freeze of $783 million worth of National Institutes of Health grants was based on "palpable" gender and racial discrimination, as he acknowledged a pending request by the government to the U.S. Supreme Court to stay his order that the money be released.
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July 28, 2025
Judge Says Trump Admin Can't Defund Planned Parenthood
A Massachusetts federal judge on Monday blocked President Donald Trump's administration from denying Medicaid reimbursements to Planned Parenthood clinics, expanding an earlier ruling that had applied only to those that do not provide abortions or that receive minimal federal support.
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July 25, 2025
Utah Docs Say Billing Expert's Report Rife With AI Falsehoods
Utah anesthesiologists facing a False Claims Act suit are moving to bar the testimony of a medical billing expert they say used artificial intelligence to draft a report riddled with errors and fake citations, calling it an extraordinary example of AI gone wrong.
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July 25, 2025
Hospital Giant To Pay $3.5M Over Nurse Training Repayments
HCA Healthcare Inc., a major U.S. hospital operator, has agreed to pay roughly $3.5 million to settle claims that it unlawfully trapped new nurses in agreements requiring them to repay training costs if they left their jobs within two years, according to a trio of state attorneys general.
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July 25, 2025
Health Data Co. Investor Fraud Suit Headed To Mediation
The parties in a putative class action claiming a healthcare technology company misled investors about a data platform it claimed to operate, but which didn't actually exist, told a Connecticut federal court that they "agree this case is well suited for mediation."
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July 24, 2025
Trump Admin Asks Justices To Stay Block On NIH Grant Cuts
The Trump administration on Thursday urged the U.S. Supreme Court to stay a district court's preliminary injunction so that the National Institutes of Health can resume terminating $783 million in grants, saying the lower court, under a recent high court ruling, lacked jurisdiction to make the government pay the grants.
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July 24, 2025
Hospital Must Face Claims Of Mismanaging Retirement Funds
A Colorado federal judge on Thursday said a proposed class action will continue against a hospital over allegations of mismanaging employees' retirement funds after an amended complaint added new allegations about the fund's mismanagement.
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July 24, 2025
UnitedHealth Discloses DOJ Medicare Civil, Criminal Probes
UnitedHealth Group Inc. has disclosed that it is complying with formal criminal and civil requests from the U.S. Department of Justice, following media reports about investigations into aspects of the insurance giant's participation in Medicare.
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July 24, 2025
3rd Circ. Rules Philly Injection Site Equals Religious 'Person'
A nonprofit battling government resistance to its planned safe drug injection site in Philadelphia can qualify for religious freedom protections, the Third Circuit said in a precedential opinion on Thursday, reasoning the organization meets the definition of a "person" practicing religion.
Expert Analysis
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Short-Term Takeaways From CMS' New Long-Term Care Rules
The Centers for Medicare & Medicaid Services' new final rule on nursing home staffing minimums imposes controversial regulatory challenges that will likely face significant litigation, but for now, stakeholders will need to prepare for increased staffing expectations and more specialized facility assessments without meaningful funding, say attorneys at Morgan Lewis.
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FDA's Data Monitoring Guidance Reveals Future Expectations
As the world of clinical research grows increasingly complex, the U.S. Food and Drug Administration's recent draft guidance on the use of data monitoring committees in clinical trials reveals how the agency expects such committees to develop, say Melissa Markey and Carolina Wirth at Hall Render.
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FDA Warning Indicates Scrutiny Of Regenerative Health Cos.
The U.S. Food and Drug Administration's recent warning letter to Akan Biosciences is a quintessential example of the agency's enforcement priorities for certain products involving human cells and tissues, and highlights ongoing scrutiny placed on manufacturers, say Dominick DiSabatino and Cortney Inman at Sheppard Mullin.
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2 Regulatory Approaches To Psychedelic Clinical Trials
Comparing the U.S. and Canada's regulatory frameworks for clinical trials of psychedelic drugs can be useful for designing trial protocols that meet both countries' requirements, which can in turn help diversify patient populations, bolster data robustness and expedite market access, say Kimberly Chew at Husch Blackwell and Sabrina Ramkellawan at AxialBridge.
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'Food As Health' Serves Up Fresh Legal Considerations
The growth of food as medicine presents a significant opportunity for healthcare organizations and nontraditional healthcare players to improve patient outcomes and reduce costs, though these innovative programs also bring compliance considerations that must be carefully navigated, say attorneys at McDermott.
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DC Circ. Ruling Heightens HHS Contract Pharmacy Challenges
The D.C. Circuit's recent ruling that the Section 340B program does not bar manufacturers from restricting deliveries of discounted drugs to contract pharmacies represents a second strike against the U.S. Department of Health and Human Services' current contract pharmacy policy and raises the stakes surrounding an upcoming Seventh Circuit ruling on the same issue, say attorneys at Foley Hoag.
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FTC Focus: Exploring The Meaning Of Orange Book Letters
The Federal Trade Commission recently announced an expansion of its campaign to promote competition by targeting pharmaceutical manufacturers' improper Orange Book patent listings, but there is a question of whether and how this helps generic entrants, say Colin Kass and David Munkittrick at Proskauer.
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3rd Circ.'s Geico Ruling May Encourage Healthcare Arbitration
The Third Circuit's recent decision in Geico v. Mount Prospect, finding that claims under New Jersey's Insurance Fraud Prevention Act can be arbitrated, strengthens arbitration as a viable alternative to litigation, even though it is not necessarily always a more favorable forum, say Khaled Klele and Jessica Osterlof at McCarter & English.
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Proposed Cannabis Reschedule Sidesteps State Law Effects
The U.S. Department of Justice's recent proposal to move cannabis to Schedule III of the Controlled Substances Act provides certain benefits, but its failure to address how the rescheduling would interact with existing state cannabis laws disappointed industry participants hoping for clarity on this crucial question, says Ian Stewart at Wilson Elser.
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A Changing Regulatory Landscape For Weight Loss Drugs
As drugs originally approved to treat diabetes become increasingly popular for weight loss purposes, federal and state regulators and payors are increasing their focus on how these drugs are prescribed, and industry participants should pay close attention to rapidly evolving compliance requirements, say attorneys at Goodwin.
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Opioid Suits Offer Case Study In Abatement Expert Testimony
Settlements in the opioid multidistrict litigation provide useful insight into leveraging expert discovery on abatement in public nuisance cases, and would not have been successful without testimony on the costs necessary to lessen the harms of the opioid crisis, says David Burnett at DiCello Levitt.
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How HHS Discrimination Rule Affects Gender-Affirming Care
The U.S. Department of Health and Human Services' new final rule, which reinterprets the Affordable Care Act's anti-discrimination provision, greatly clarifies protections for gender-affirming care and will require compliance considerations from sponsors and administrators of most group health plans, say attorneys at McDermott.
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FTC Noncompete Rule's Impact On Healthcare Nonprofits
Healthcare entities that are nonprofit or tax-exempt and thus outside of the pending Federal Trade Commission noncompete rule's reach should evaluate a number of potential risk factors and impacts, starting by assessing their own status, say Ben Shook and Tania Archer at Moore & Van Allen.