Policy & Compliance
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March 07, 2024
Wash. Justices Won't Hear Unions' Wage Clawback Case
Washington's highest court has rejected three unions' request for justices to decide how private employers may respond when they erroneously overpay employees, clearing the way for a jury to hear the case contesting a healthcare system's wage clawback after its payroll system was hit by a cyberattack.
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March 07, 2024
5th Circ. Backs NLRB On Nurse Fired Over COVID Complaints
The Fifth Circuit upheld on Thursday a National Labor Relations Board ruling finding a Texas home health company unlawfully fired a nurse who raised concerns about the company's handling of the COVID-19 pandemic, but cleared the company on the claim that it barred workers from discussing wages.
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March 07, 2024
Conn. Psychologist Agrees To Repay $2.65M For Billing Fraud
A Connecticut psychologist already sentenced to 27 months in federal prison for his second alleged healthcare fraud scheme has agreed to a plan to repay $2.65 million in restitution under a proposed order that awaits approval from a federal judge.
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March 06, 2024
Pa. Pharma Co. Cops To Adulterated-Drug Charges
A Pennsylvania generic drug manufacturer has pled guilty to federal charges that it sold adulterated drugs in the U.S. into interstate commerce and agreed to pay a $1.5 million penalty, the U.S. Department of Justice said Wednesday.
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March 06, 2024
Quinn Emanuel's 2nd $185M Fee Bid Blasted As 'Indefensible'
Quinn Emanuel Urquhart & Sullivan LLP's second attempt to win $185 million in attorney fees in $3.7 billion litigation over the Affordable Care Act still fails to justify the "indefensible" amount and barely pays "lip service" to a reevaluation ordered by the Federal Circuit, health insurers told the federal claims court.
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March 06, 2024
McGuireWoods Adds 2 Former Federal Prosecutors In Dallas
McGuireWoods LLP announced Wednesday that two former federal prosecutors who specialize in healthcare regulatory and compliance issues have joined the firm as partners in Dallas.
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March 06, 2024
Ohio Neurologist Can't Shorten His Drug Kickback Sentence
An Ohio federal judge ruled an imprisoned neurologist cannot shorten his 30-month sentence for conspiring to collect illegal kickbacks for prescribing Nuedexta, a drug used to treat patients who have uncontrollable fits of laughter or crying, stating that his victims' vulnerability exempts him from his requested reduction.
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March 05, 2024
White House To Crack Down On Illegal, Unfair Pricing
President Joe Biden launched a new "strike force" Tuesday to stop companies from imposing unfair price hikes on consumers amid a rash of measures supporting the administration's push to boost competition and lower prices across the economy.
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March 05, 2024
CVS Again Defeats NY AG's Drug Rebate Tying Claims
A Manhattan judge on Tuesday threw out a second New York attorney general lawsuit accusing CVS Pharmacy Inc. of illegally forcing underserved hospitals to use its claims-processing subsidiary for federal drug reimbursements, saying the government still hasn't pled viable antitrust claims.
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March 05, 2024
FTC Chair Decries PE's Healthcare Impacts As Probe Starts
Federal Trade Commission Chair Lina Khan on Tuesday lamented what she deemed the "financialization" of healthcare resulting from private equity buyouts, in remarks coinciding with the launch of a multijurisdictional request for public comment on PE and other companies' growing control over the healthcare system.
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March 05, 2024
Express Scripts Gets Pharmacy's Contract Breach Suit Cut
A Missouri federal judge tossed out two claims in a five-count suit accusing Express Scripts of conducting a faulty audit on a New York pharmacy and then wrongfully terminating their contract, saying the pharmacy can't sue under two laws it cited.
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March 05, 2024
4th Circ. Won't Let SC Medicaid Drop Planned Parenthood
The Fourth Circuit rejected on Tuesday South Carolina's attempt to terminate its Medicaid provider agreement with Planned Parenthood, unpersuaded by the state's argument that a recent U.S. Supreme Court decision compelled a different outcome.
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March 05, 2024
GOP Sens. Voice Concern Over Biden Plan To Claim Patents
Sen. Bill Cassidy, R-La., the top Republican on the Senate health committee, and 16 other Senate Republicans recently aired concerns with the director of the National Institutes of Health about the Biden administration's plan to "illegally" seize drug patents.
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March 05, 2024
DLA Piper Adds Merck SVP As New Life Sciences Sector Chair
An experienced in-house attorney with a longtime passion for life sciences and medicine has left her position as a C-suite executive at biopharmaceutical giant Merck to join DLA Piper as the chair of its life sciences sector.
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March 05, 2024
Aetna Accused Of 'Reprehensible' ER Services Underpayment
Multiple Aetna health insurance entities were hit with a lawsuit in Ohio accusing them of "reprehensible systemic underpayments" to healthcare workers who provide emergency services, underpayments that the complaint said were damaging to the medical system.
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March 04, 2024
Crowell & Moring Int'l Names Global Life Sciences Head
Crowell & Moring International LLC has hired a new chairman of its global life sciences group, who joins with over three decades of experience working to expand market access for healthcare, life sciences and medical device clients, the firm announced Tuesday.
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March 04, 2024
5th Circ. May Uphold National Block On ACA Preventive Care
The Fifth Circuit appeared open Monday to striking down Affordable Care Act requirements forcing insurers to cover a range of preventive treatments such as mammograms and HIV prevention medication, homing in on constitutional problems with how members of a task force setting coverage mandates were appointed.
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March 04, 2024
Planned Parenthood Seeks To Weaken NC Abortion Law
Planned Parenthood and a doctor have asked a North Carolina federal court to permanently stop the enforcement of two provisions in the state's abortion law, arguing that the pair violate due process and equal protection rights.
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March 04, 2024
3rd Circ. Says Union Courted Rebuke In NLRB Reversal
A Third Circuit panel on Monday reversed a National Labor Relations Board ruling that a nonprofit nudged workers to rebuke their union before withdrawing recognition, with one member going on to question limits on courts' power to review board rulings.
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March 04, 2024
Christian Group Nabs Injunction In EEOC Trans Care Suit
A North Dakota federal judge said Monday a Christian business group's members no longer have to provide coverage for gender transition care because it violates their religious beliefs, granting the group a key win in its suit challenging the U.S. Equal Employment Opportunity Commission's take on federal anti-discrimination law.
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March 04, 2024
White House Targets PBMs In Roundtable On Medicine Prices
The chair of the Federal Trade Commission said at a Monday roundtable that pharmacy benefit managers haven't shared all the information her agency is seeking as part of its inquiry into the companies' impact on the prescription drug market.
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March 01, 2024
Judge Says TCPA Class Limits Affect Only State Law Claims
A Washington federal judge denied UnitedHealthcare's move to dismiss illegal automated call claims from non-Washington members in a Washington man's class action, calling the company's invocation of a 2017 U.S. Supreme Court ruling a "strained theory that has been rejected by every Circuit Court that has considered it."
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March 01, 2024
Tort Report: $42M Med Mal Award; Hot Coffee Suit In The Air
A suit over hot coffee spilled at 40,000 feet and the affirmation of a $42 million medical malpractice verdict in Illinois lead Law360's Tort Report, which compiles recent personal injury and medical malpractice news that may have flown under the radar.
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March 01, 2024
Fla. Officials Say Better Process Wouldn't Stop Medicaid Cuts
Florida health officials have urged a federal judge to toss a proposed class action brought by residents who argued state agencies cut their Medicaid coverage without proper notice, saying whatever notice the agencies might have provided, it wouldn't have made any difference in the residents' eligibility.
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March 01, 2024
CVS, Walgreens Receive FDA's OK To Dispense Abortion Drug
Pharmacy giants CVS and Walgreens announced Friday that they have received federal certification to dispense the abortion drug mifepristone and will begin doing so soon in certain states — a development that President Joe Biden hailed as historic and that comes amid a larger battle in the U.S. Supreme Court.
Expert Analysis
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Merger Proposals Reflect Agency Leaders' Antitrust Principles
Attorneys at Covington trace the recently proposed Hart-Scott-Rodino and merger guidelines changes to certain foundational concerns of the Federal Trade Commission and U.S. Department of Justice Antitrust Division leadership, including issues related to concentration associated with horizontal and vertical mergers.
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The Basics Of Being A Knowledge Management Attorney
Excerpt from Practical Guidance
Michael Lehet at Ogletree Deakins discusses the role of knowledge management attorneys at law firms, the common tasks they perform and practical tips for lawyers who may be considering becoming one.
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A Look At The Tribal Health Reimbursements Circuit Split
A circuit split regarding whether Native American tribes are entitled to contract support costs on health care services paid by third-party revenues sets the stage for potential review by the U.S. Supreme Court, and could result in the Indian Health Service paying hundreds of millions more in much-needed funding to tribal health programs, say Geoffrey Strommer and Steve Osborne at Hobbs Straus.
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What Big Tobacco's Cannabis Investments Mean For Market
The tobacco industry appears to be shoring up investments in the cannabis market, most recently with Philip Morris’ purchase of an Israeli cannabis tech company, pointing to a bright future for vaped and noncombustible products, and signaling that marijuana rescheduling may be on the horizon, say Slates Veazey and Whitt Steineker at Bradley Arant.
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To Hire And Keep Top Talent, Think Beyond Compensation
Firms seeking to appeal to sophisticated clients and top-level partners should promote mentorship, ensure that attorneys from diverse backgrounds feel valued, and clarify policies about at-home work, says Patrick Moya at Quaero Group.
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How Merger Review Overhaul Could Affect Health Industry
For those in the health care industry considering growth and expansion strategies, the antitrust agencies' recent proposals for new Hart-Scott-Rodino rules and more complex merger guidelines will increase deal timelines, the merging parties' burden, and overall uncertainty and potential antitrust risk as to the outcome, say attorneys at Husch Blackwell.
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What Circuit Split May Mean For FCA Kickback Liability
The recent circuit split on the meaning of the resulting-from provision in False Claims Act kickback cases could have significant ramifications for FCA liability, as it could affect the standard of causation that plaintiffs must meet to establish liability, say former federal prosecutors Li Yu, Ellen London and Gregg Shapiro.
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More States Should Join Effort To Close Legal Services Gap
Colorado is the most recent state to allow other types of legal providers, not just attorneys, to offer specific services in certain circumstances — and more states should rethink the century-old assumptions that shape our current regulatory rules, say Natalie Anne Knowlton and Janet Drobinske at the University of Denver.
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How Health Cos. Can Brace For Tracking Tech Scrutiny
A joint letter sent by the U.S. Department of Health and Human Services Office for Civil Rights and Federal Trade Commission last month highlights the agencies' concerns about tracking technologies, and may foreshadow a spike in enforcement actions, say attorneys at Moses Singer.
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Identifying Trends And Tips In Litigation Financing Disclosure
Growing interest and controversy in litigation financing raise several salient concerns, but exploring recent compelled disclosure trends from courts around the country can help practitioners further their clients' interests, say Sean Callagy and Samuel Sokolsky at Arnold & Porter.
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What's Next For Adult-Use Marijuana In Ohio
After Ohio voters defeated a proposal that would have made it harder to pass any citizen-initiated constitutional amendment, a state ballot measure to legalize adult-use marijuana has fairly good chances of passing — but advocates still face a long road ahead, say Perry Salzhauer and David Waxman at McGlinchey Stafford.
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Unpacking CMS' Latest Proposals For Telehealth Flexibilities
The Centers for Medicare and Medicaid Services' calendar year 2024 proposed rule includes a number of important extensions to telehealth flexibilities, acknowledging the importance of these temporary policies, but permanent certainty will require further legislative action and agency rulemaking, say attorneys at Baker Donelson.
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Congress Needs Better Health Care Fraud Data From DOD
The U.S. Department of Defense does not collect enough data to prevent health care and service contractor fraud and waste, so Congress should enact benchmarks that the DOD must meet when gathering and reporting data, enabling lawmakers to make better-informed decisions about defense appropriations, says Jessica Lehman at Verizon.