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Health
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March 05, 2025
BCBS Hit With New Antitrust Suits By $2.8B Deal Opt-Outs
Dozens of hospitals and healthcare systems that opted out of a landmark $2.8 billion Blue Cross Blue Shield antitrust settlement filed fresh Sherman Act lawsuits against the insurance entities in Pennsylvania, California and Illinois federal courts Tuesday, accusing them of colluding to restrict competition for the purchase of healthcare services.
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March 05, 2025
Ga. Clinic Bilked Federal Healthcare Programs, FCA Suit Says
A Georgia federal judge has unsealed a whistleblower lawsuit against a respiratory clinic accusing it of using unlicensed medical personnel, bilking Medicare and Medicaid by submitting thousands of fraudulent claims, and pushing its patients into unnecessary treatment to milk them for cash.
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March 05, 2025
SEC Asks To Toss Subpoena Suit Against Telehealth Co.
The U.S. Securities and Exchange Commission asked a New York federal judge Wednesday to dismiss its suit aimed at forcing a weight-loss-focused telehealth company to comply with a subpoena, saying the company has since provided the requested documents and otherwise complied with the subpoena.
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March 05, 2025
Pfizer Beats Claims Of Copay Aid Scheme For Good
Litigation firms accusing Pfizer of a scheme to inflate drug prices for Medicare and Medicaid plans saw their suit dismissed permanently, with a Washington, D.C., federal judge ruling they had been given "enough chances" to remedy pleading deficiencies in their claims.
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March 05, 2025
Wash. Hospital Patient's Pixel Privacy Suit Survives Dismissal
A Washington federal judge said Tuesday that a patient has shown how an Evergreen State hospital allegedly shared her personal health information by installing Facebook browser tracking tools on its website, preserving one of her claims while giving her a final shot at revising several others.
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March 05, 2025
Nationwide Block Of Trump Trans Healthcare Orders Extended
A Maryland federal judge has extended a nationwide injunction that was set to expire this week prohibiting the Trump administration from enforcing executive orders banning federal funding for gender-affirming care for people under the age of 19, finding the harm inflicted by the orders is "non-speculative, concrete, and potentially catastrophic."
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March 05, 2025
SuperValu Wins FCA Case That Went To High Court
An Illinois federal jury cleared SuperValu of liability Tuesday on whistleblower claims that it billed the government higher-than-customary prices for millions of prescriptions, marking the end to an important test of a 2023 U.S. Supreme Court ruling reviving the case.
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March 05, 2025
Seyfarth Names Real Estate Atty As Co-Lead In San Francisco
Seyfarth Shaw LLP has named a longtime real estate attorney to be the new co-managing partner of its San Francisco office, the firm announced Wednesday.
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March 05, 2025
Senators Press Trump's NIH Nominee On Grant Cuts, Vaccines
Dr. Jay Bhattacharya vowed to support research into chronic diseases but repeatedly refused Wednesday to express an opinion on cost-cutting efforts at the National Institutes of Health, sidestepping bipartisan questions during a hearing on his nomination to run the biomedical research agency.
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March 05, 2025
DOJ Fights Bid To Pause Piece Of Amedisys Merger Case
The U.S. Department of Justice is opposing a bid from Amedisys to pause allegations that it shirked its merger filing requirements until after a trial on UnitedHealth's acquisition of the home health and hospice company.
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March 05, 2025
Trump's NIH Cost-Cutting Measure Blocked By Judge
A Massachusetts federal judge ruled Wednesday that the Trump administration cannot cap indirect costs for research grants at the National Institutes of Health, rejecting the move as a rushed cost-saving measure that violates federal law governing the expenses.
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March 05, 2025
Skin Care Tech Co. Files Ch. 11 With $400M Prepackaged Plan
Skin care and beauty technology company Cutera Inc. filed for Chapter 11 protection in a Texas bankruptcy court Wednesday with over $429 million in debt and a prepackaged debt-swap plan to cut that number by nearly $400 million.
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March 05, 2025
High Court Allows Release Of Frozen USAID Foreign Aid
The U.S. Supreme Court on Wednesday ruled that a D.C. federal judge can require the Trump administration to release up to $2 billion in frozen foreign aid funding, but told the judge he must clarify the scope of the government's responsibility and ensure it has enough time to comply with any deadline.
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March 04, 2025
Dems Demand Halt To Trump Admin's Tribal Program Cuts
More than 100 Democratic lawmakers have urged the Trump administration to halt any executive orders that hurt programs and services in Indian Country, saying in a letter to the White House that the U.S. government must honor its trust and treaty obligations to tribes.
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March 04, 2025
Gov't Says 2 Lab Owners Billed $40M In COVID Test Scheme
Federal prosecutors opened their case Tuesday against two laboratory owners, telling jurors in Florida that they ran a more than $40 million scheme to submit medically unnecessary COVID-19 testing claims to healthcare benefit programs.
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March 04, 2025
Apple Seeks Ban Against Masimo's Original Smartwatch
Apple has urged a Delaware federal judge to issue an injunction against a healthcare technology company found last year to have infringed two of the tech giant's design patents with its W1 smartwatch and charger, calling the defense's refusal to agree to the injunction "telling."
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March 04, 2025
Fla. Med Mal Damages Loophole Facing Lawmaker Scrutiny
With the new legislative session now underway in the Florida Legislature, state lawmakers are once again considering doing away with a statute that plaintiffs attorneys say unfairly and arbitrarily limits pain-and-suffering damages in fatal medical malpractice cases, but healthcare providers are saying not so fast.
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March 04, 2025
Health Providers Fight To Keep MultiPlan Pricing MDL Alive
Healthcare providers targeting MultiPlan and several major insurers with horizontal price-fixing claims argued Monday an Illinois federal judge should let their multidistrict litigation proceed because the defendants simply constructed a "strawman" to convince him to toss it.
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March 04, 2025
Trump To Drop Biden-Era Suit Against Idaho Abortion Ban
The Trump administration has said it plans to drop a federal lawsuit alleging that Idaho's strict abortion ban conflicts with a federal emergency stabilization law, a reversal from the Biden administration's legal efforts that fought the ban up to the U.S. Supreme Court.
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March 04, 2025
Insurer Says Claims Of Illegally Tracked Info Erase Coverage
An insurer for a fertility treatment provider told an Illinois federal court that an exclusion on the disclosure of personal information precludes commercial general liability coverage for a lawsuit accusing the provider of unlawfully installing tracking technologies to collect website users' private information.
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March 04, 2025
Calif. PBM Opioid Suit Belongs In Federal Court, 9th Circ. Told
Pharmacy benefit managers Express Scripts Inc. and OptumRx Inc. urged the Ninth Circuit on Tuesday to require California to litigate its public nuisance claims over their opioid dispensing practices in federal court, arguing that allowing the state to litigate in state court would create a circuit split.
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March 04, 2025
Special Master Recommends Win For UnitedHealth In FCA Suit
A massive False Claims Act case targeting Medicare Advantage plans operated by UnitedHealth relies on "speculation and assumptions," according to a special master's report that recommends ruling in the company's favor and ending the lawsuit.
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March 04, 2025
Colo. Justices Won't Review Hospital Tax Classification Suit
The Colorado Supreme Court declined to review an appeals court ruling finding that a rehabilitation hospital should be classified as a commercial property for tax purposes because it was predominantly designed for its services and not for residency.
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March 04, 2025
PBMs Ask 8th Circ. To Pause FTC's Insulin Pricing Case
Caremark Rx, Express Scripts and OptumRx have asked the Eighth Circuit to pause the Federal Trade Commission's in-house case accusing the pharmacy benefit managers of artificially inflating insulin prices as they push their constitutional claims against the agency.
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March 04, 2025
Petersen Health Care Opposes Vendor's Ch. 11 Fee Demand
Bankrupt skilled nursing facility operator Petersen Health Care told a Delaware bankruptcy judge Tuesday that a vendor seeking payment of its legal costs in pursuing a $163,000 administrative expense claim against the debtor should have the request slashed because the fees exceed the amount of the claim.
Expert Analysis
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Cos. Should Inventory Issues To Prep For New Congress
As the legislative and oversight agendas of the 119th Congress come into sharper focus, corporate counsel should assess and plan for areas of potential oversight risk — from tax policy changes to supply chain integrity — even as much uncertainty remains, say attorneys at WilmerHale.
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Incoming Admin May Shake Up Life Sciences Regulation
Though President-elect Donald Trump has not yet articulated policy priorities regarding the life sciences industry, the sector is positioned to see significant changes that could affect everything from drug exclusivity and generic drug approvals, to the availability of over-the-counter drugs, to laboratory-developed tests and digital health, say attorneys at Morgan Lewis.
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Next Steps In The $2.8B Blue Cross Payout To Providers
Healthcare providers deciding whether to participate in Blue Cross Blue Shield network's recent $2.8 billion antitrust class action settlement must weigh key recovery factors, including provider type and litigation cost, say attorneys at Hall Render.
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Navigating DOJ's Patchwork Whistleblower Regime
In the past few months, the U.S. Department of Justice and several individual U.S. attorney’s offices have issued different pilot programs aimed at incentivizing individuals to blow the whistle on misconduct, but this piecemeal approach may create confusion and suboptimal outcomes, say attorneys at BakerHostetler.
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What To Expect From State AGs As Federal Control Changes
Under the next Trump administration, Democratic attorneys general are poised to strengthen enforcement in certain areas as Republican attorneys general continue their efforts with stronger federal support — resulting in a confusing patchwork of policies that create unintended liabilities for businesses operating in multiple jurisdictions, say attorneys at Morgan Lewis.
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So You Want To Move Your Law Practice To Canada, Eh?
Google searches for how to move to Canada have surged in the wake of the U.S. presidential election, and if you’re an attorney considering a move to the Great White North, you’ll need to understand how the practice of law differs across the border, says David Postel at Henein Hutchison.
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What To Expect Next From Federal Health Tech Regulation
Healthcare organizations should pay close attention to federal health information technology regulators' recent guidance concerning barriers to accessing electronic health information, which signals that more enforcement in this area is likely forthcoming, say attorneys at Ropes & Gray.
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5 Areas Congress May Investigate After GOP Election Wins
With Republicans poised to take control of Congress in addition to the executive branch next year, private companies can expect an unprecedented uptick in congressional investigations focused on five key areas, including cryptocurrency and healthcare, say attorneys at Cahill Gordon.
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Takeaways From State Votes On Abortion In The 2024 Election
Attorneys at Epstein Becker discuss how 10 states voted on ballot initiatives to either protect or restrict access to abortion in the 2024 general election, and analyze overarching trends.
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Loper Bright Offers New Materiality Defense To FCA Liability
The U.S. Supreme Court's decision in Loper Bight Enterprises v. Raimondo, ending Chevron deference, may have created a new defense to False Claims Act liability by providing the opportunity to argue that a given regulation is not material to the government's payment decision, says Tanner Cook at Husch Blackwell.
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How Expanded Birth Control Coverage May Affect Employers
Employers should consider the potential impact of recently proposed regulations that would expand group health plans' required coverage of preventive services and contraceptives, including questions about how the agencies would implement their plans to eliminate the prescription requirement and alter the exceptions process, says Jennifer Rigterink at Proskauer.
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Legislation Most Likely To Pass In Lame Duck Session
As Congress begins its five-week post-election lame duck session, attorneys at Greenberg Traurig break down the legislative priorities and which proposals can be expected to pass.
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Promoting Diversity In The Selection Of ADR Neutrals
Excerpt from Practical Guidance
Choosing neutrals from diverse backgrounds is an important step in promoting inclusion in the legal profession, and it can enhance the legitimacy and public perception of alternative dispute resolution proceedings, say attorneys at Lowenstein Sandler.
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Opinion
Preserving The FCA Is Crucial In Trump's 2nd Term
While the Trump administration may pursue weaker False Claims Act enforcement, it remains an essential tool in safeguarding public funds and maintaining corporate accountability, so now is not the time to undermine ethical behavior, or reduce protections and incentives for whistleblowers, says Adam Pollock at Pollock Cohen.
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Series
Playing Ultimate Makes Us Better Lawyers
In addition to being fun, ultimate Frisbee has improved our legal careers by emphasizing the importance of professionalism, teamwork, perseverance, enthusiasm and vulnerability, say Arunabha Bhoumik and Adam Bernstein at Regeneron.