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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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Axed ALJ Removal Protections Mark Big Shift For NLRB
A D.C. federal court's recent decision in VHS Acquisition Subsidiary No. 7 v. National Labor Relations Board removed long-standing tenure protections for administrative law judges by finding they must be removable at will by the NLRB, marking a significant shift in the agency's ability to prosecute and adjudicate cases, say attorneys at Proskauer.
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11th Circ. TCPA Ruling Signals Erosion Of Judicial Deference
The U.S. Court of Appeals for the Eleventh Circuit recently came to the rescue of the lead generation industry, striking down new regulations that were set to go into effect on Jan. 27, a decision consistent with federal courts' recent willingness to review administrative decisions, say attorneys at Troutman.
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The Case For Compliance During The Trump Administration
Given the Trump administration’s shifting white collar enforcement priorities, C-suite executives may have the natural instinct to pare back compliance initiatives, but there are several good reasons for companies to at least stay the course on their compliance programs, if not enhance them, say attorneys at Riley Safer.
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Opinion
Undoing An American Ideal Of Fairness
President Donald Trump’s orders attacking birthright citizenship, civil rights education, and diversity, equity and inclusion programs threaten hard-won constitutional civil rights protections and decades of efforts to undo bias in the law — undermining what Chief Justice Earl Warren called "our American ideal of fairness," says Reuben Guttman at Guttman Buschner.
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Dispelling 10 Myths About Health Provider-Based Compliance
Congress appears intent on requiring hospitals to submit provider-based attestations for all off-campus outpatient hospital locations, so now is the time for hospitals to prepare for this change by understanding common misconceptions about provider-based status and proactively correct noncompliance, say attorneys at McDermott.
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A Look At HHS' New Opinion On Patient Assistance Programs
A recent advisory opinion from the U.S. Department of Health and Human Services' Office of Inspector General follows a recent trend of blessing patient assistance program arrangements that implicate the Anti-Kickback Statute, as long as they are structured with appropriate safeguards to minimize the risk of fraud and abuse, say attorneys at Sheppard Mullin.
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How Ill. Ruling Could Influence Future Data Breach Cases
The Illinois Supreme Court's recent decision in Petta v. Christie Business Holding, which was based solely on standing, establishes an important benchmark for the viability of Illinois-based lawsuits arising out of data security incidents that defendants can cite in future cases, say attorneys at Wilson Elser.
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Opinion
Inconsistent Injury-In-Fact Rules Hinder Federal Practice
A recent Third Circuit decision, contradicting a previous ruling about whether consumers of contaminated products have suffered an injury in fact, illustrates the deep confusion this U.S. Supreme Court standard creates among federal judges and practitioners, who deserve a simpler method of determining which cases have federal standing, says Eric Dwoskin at Dwoskin Wasdin.
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Virginia AI Bills Could Serve As Nationwide Model
If signed into law, two Virginia bills focused on regulating the use of high-risk AI systems in the private and public sectors have the potential to influence similar legislation in other states, as well as the compliance strategies of companies operating in the commonwealth and across the U.S., say attorneys at Woods Rogers.
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2 Anti-Kickback Developments Hold Lessons For Biopharma
The U.S. Department of Justice's Anti-Kickback Statute settlement with QOL Medical and a favorable advisory opinion from the U.S. Department of Health and Human Services provide a study in contrasts, but there are tips for biopharma manufacturers trying to navigate the vast compliance space between them, says Mary Kohler at Kohler Health Law.
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In-House Counsel Pointers For Preserving Atty-Client Privilege
Several recent rulings illustrate the challenges in-house counsel can face when attempting to preserve attorney-client privilege, but a few best practices can help safeguard communications and effectively assert the privilege in an increasingly scrutinized corporate environment, says Daniel Garrie at Law & Forensics.
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Disability Ruling Guides On Cases With Uncertain Causation
In Dime v. MetLife, a Washington federal court’s recent ruling in favor of a disability claimant instructs both claimants and insurers on the appropriate standard for establishing and making a disability determination when there is limited medical evidence explaining the disability’s cause, says Mark DeBofsky at DeBofsky Law.
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What's Next For State Regulation Of Hemp Cannabinoids
Based on two recent federal court cases that indisputably fortify broad state authority to regulate intoxicating hemp cannabinoid products, 2025 will feature continued aggressive state regulation of such products as industry stakeholders wait for Congress to release its plans for the next five-year Farm Bill, say attorneys at Foley Hoag.
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Series
Collecting Rare Books Makes Me A Better Lawyer
My collection of rare books includes several written or owned by prominent lawyers from early U.S. history, and immersing myself in their stories helps me feel a deeper connection to my legal practice and its purpose, says Douglas Brown at Manatt Health.
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Opinion
New DOJ Leaders Should Curb Ill-Conceived Prosecutions
First-of-their-kind cases have seemingly led to a string of overly aggressive prosecutions in recent years, so newly sworn-in leaders of the U.S. Department of Justice should consider creating reporting channels to stop unwise prosecutions before they snowball, says Jonathan Porter at Husch Blackwell.