Policy & Compliance

  • September 24, 2025

    Amtrak Beats Retired Worker's Suit Over Benefits Reversal

    A Rhode Island federal judge dismissed an ex-Amtrak employee's suit claiming the company illegally rolled back medical care reimbursement benefits that the rail service said it mistakenly granted him in retirement, finding he wasn't entitled to the extra credits under the plan's terms.

  • September 23, 2025

    Fed. Vaccine Panel Prompts Legal, Health Confusion

    It's been days since a Centers for Disease Control and Prevention committee updated recommendations for a common childhood vaccine and the COVID-19 booster. But healthcare and legal experts are still trying to understand the implications of the meeting and the votes that came out of it.

  • September 23, 2025

    Kansas Abortion Mandates On Trial: What You Need to Know

    The largest provider of reproductive healthcare in Kansas will face off with state officials this week at a long-awaited trial focused on a 24-hour abortion waiting period, among other state requirements.

  • September 23, 2025

    State Medicaid Cuts Mean 'Financial Squeeze' For Providers

    Law360 Healthcare Authority talks with Gayland Hethcoat of ArentFox Schiff LLP about the rationale behind major cuts coming to Medicaid state-directed payments and what they will mean for providers and patients.

  • September 23, 2025

    NC Sens. Vote To Cut Planned Parenthood's Medicaid Funds

    Republican state senators in North Carolina have greenlit a bill that would revoke Medicaid funding for Planned Parenthood, aligning the Tar Heel state with the president's "One Big Beautiful Bill," which prohibits Medicaid funding for nonprofit groups that provide abortion services.

  • September 23, 2025

    Long Time Limits In Trans Care Laws Expand Doctors' Liability

    State lawmakers are including lengthy statutes of limitations — some of them decades-long — in new bans on transgender care for minors. Advocates say long time frames for prosecutions or civil suits make sense when a child is involved. Others see a "chilling" effect for providers.

  • September 23, 2025

    EX-CTA Worker's $425K Vaccine Bias Award Capped At $300K

    An Illinois federal judge lowered a former Chicago Transit Authority employee's $425,000 jury award to $300,000 Tuesday for the ex-worker's claim that he was wrongly fired for refusing the COVID-19 vaccine, entering a judgment the judge said he'll later amend with awards that include back and front pay.

  • September 23, 2025

    Two Longtime HHS Attys Depart Posts For Crowell & Moring

    Two prominent U.S. Department of Health and Human Services attorneys have left their posts for Crowell & Moring LLP after more than two decades in the federal government.

  • September 23, 2025

    Burns White Launches Correctional Healthcare Practice Group

    Pittsburgh-based Mid-Law firm Burns White LLC has launched a practice group focused on helping clients navigate liability risk from providing healthcare in prisons and other correctional settings.

  • September 23, 2025

    Pa. Health Network To Pay $1.15M In 401(k) Forfeiture Suit

    A Pennsylvania health system agreed to pay workers $1.15 million to resolve a federal suit alleging it unlawfully used forfeited retirement plan funds to satisfy its contribution obligations and allowed workers to be overcharged for plan administrative fees.

  • September 22, 2025

    2nd Circ. Undoes $25M Restitution In Horse-Doping Case

    A veterinarian convicted of conspiracy in a sprawling horse-doping scheme has escaped $25 million in restitution and is also off the hook for the $10.3 million forfeiture of funds tied to the sale of undetectable, performance-enhancement drugs, the Second Circuit said Monday.

  • September 22, 2025

    Family Sues For $100M In Child's Hyperbaric Chamber Death

    The family of a 5-year-old boy who died in a hyperbaric chamber explosion in January sued the center that was treating the child and the manufacturer of the chamber for more than $100 million in damages Monday, alleging the Michigan clinic concealed the dangers of using the chamber. 

  • September 22, 2025

    Anthem's $12.9M ERISA Deal Clears First Hurdle

    A New York federal judge has granted preliminary approval to a nearly $12.9 million settlement resolving claims that Anthem wrongfully denied coverage for residential behavioral health treatment under employer-sponsored health plans.

  • September 22, 2025

    Mayo Clinic Can't Fully Nix Suit Over Withheld Benefits Info

    The Mayo Clinic and its benefits administrator can't entirely escape a worker's suit claiming they pushed her to work with pricey out-of-network providers and wouldn't provide reimbursement estimates, after a Minnesota federal judge said she supported some federal benefits law claims with enough detail to remain in court.

  • September 19, 2025

    Ga. Providers Seek Exit From 'Conspiratorial' BCBS Fraud Suit

    Healthcare consulting firm HaloMD and several providers urged a federal judge Friday to toss a lawsuit from Blue Cross Blue Shield of Georgia accusing them of abusing a federal dispute resolution process for surprise medical bills, arguing the insurer's suit offers little more than "inflammatory, conspiratorial rhetoric."

  • September 19, 2025

    CDC Panel Urges Caution On COVID Vax, Punts On Hep B

    A panel of advisers at the Centers for Disease Control and Prevention on Friday voted unanimously to recommend that people receiving the COVID-19 vaccine this season do so only after discussing it with their health providers.

  • September 18, 2025

    Brothers Blame Associate For $90M HIV Drug Fraud Scheme

    Two Maryland brothers accused of selling $90 million worth of mislabeled HIV drugs told a Florida federal jury on Thursday that their charges stem from an associate hired for his pharmaceutical industry connections, but who instead lied about the medication's black market origins and told them it was purchased legitimately.

  • September 18, 2025

    Mich. Top Court To Weigh Medicare's Role In No-Fault Cases

    Michigan's highest court will weigh whether an injured driver who opted out of personal injury protection due to his Medicare coverage must offset his damages by billing the insurance program for accident-related medical expenses in a no-fault dispute. 

  • September 18, 2025

    HHS Shutters Miami Organ Donor Org. For 'Unsafe' Practices

    Federal health officials have decertified a Miami-based organ procurement organization that arranges organ donations after an investigation found a pattern of "unsafe" practices, marking the first time the federal government has revoked the certification of such a group, according to an announcement Thursday from Health Secretary Robert F. Kennedy Jr. 

  • September 18, 2025

    Elevance Won't Cover Zepbound To Treat Apnea, Patient Says

    Elevance Health, formerly known as Anthem Inc., arbitrarily excludes coverage of FDA-approved Zepbound to treat moderate to severe obstructive sleep apnea and refuses to consider requests for exceptions by maintaining that the medication is for weight loss, alleges a proposed class action filed by an enrollee in Indiana federal court Tuesday.

  • September 18, 2025

    Senate Confirms Trump's Pick To Lead DOL Benefits Arm

    The Senate confirmed fiduciary liability insurance expert Daniel Aronowitz on Thursday to lead the U.S. Department of Labor's employee benefits division, which oversees regulation and enforcement of employer-provided health and retirement plans.

  • September 18, 2025

    Couple Slam NC Defense Attys In Hospital Negligence Appeal

    A couple pursuing negligence claims against a local hospital scoffed at the idea that they were lurking on the sidelines waiting to cash in on a favorable outcome in a similar case, telling the North Carolina appeals court to ignore an amicus brief by defense attorneys arguing as much.

  • September 18, 2025

    1st Circ. Won't Lift Block On HHS Job, Program Cuts

    The First Circuit on Wednesday rejected a bid by the Trump administration to let it move ahead with cutting 10,000 jobs and end a number of programs at the U.S. Department of Health and Human Services while it appeals a Rhode Island federal judge's order temporarily barring the plan.

  • September 18, 2025

    Withheld Email Not Enough To Revive Doc's Retaliation Suit

    A psychiatrist failed to convince the Second Circuit to reinstate his suit claiming a New York City-area hospital system forced him out because he raised patient safety concerns, with the appeals court saying he couldn't show the hospital's omission of an email during discovery was purposeful.

  • September 17, 2025

    J&J Whistleblowers Defend $1.6B False Claims Act Win

    Whistleblowers filed a brief Wednesday in the Third Circuit in a closely watched False Claims Act appeal involving a $1.6 billion judgment against Johnson & Johnson unit Janssen as well as the constitutionality of the FCA's "qui tam" whistleblower provisions, arguing that the act's lawfulness has been settled by its "unbroken 162-year history."

Expert Analysis

  • Courts Keep Upping Standing Ante In ERISA Healthcare Suits

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    As Article III standing becomes increasingly important in litigation brought by employer-sponsored health plan members under the Employee Retirement Income Security Act, several recent cases suggest that courts are taking a more scrutinizing approach to the standing inquiry in both class actions and individual matters, say attorneys at Crowell & Moring.

  • Calif. Bill May Shake Up Healthcare Investment Landscape

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    If signed by the governor, newly passed California legislation would significantly expand the Office of Health Care Affordability's oversight of private equity and hedge fund investments in healthcare companies and management services organizations, and raise several questions about companies' data confidentiality and filing burdens, say attorneys at Ropes & Gray.

  • Pharma Copay Programs Raise Complex Economic Questions

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    The growing prevalence of copay accumulator and maximizer programs in the pharmaceutical industry is drawing increased scrutiny from patients, advocacy groups, lawmakers and courts, bringing complex questions about how financial responsibility for prescription drug purchases is determined and complicating damages assessments in litigation, say analysts at Analysis Group.

  • When AI Denies, Insurance Bad Faith Claims May Follow

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    Two recent rulings from Minnesota and Kentucky federal courts signal that past statements about claims-handling practices may leave insurers using artificial intelligence programs in claims administration vulnerable to suits alleging bad faith and unfair trade practices, say attorneys at Cozen O'Connor.

  • Health Insurance Kickback Cases Signal Greater Gov't Focus

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    A series of recent indictments by federal prosecutors in California suggests that the Eliminating Kickbacks in Recovery Act is gaining momentum as an enforcement tool against illegal inducement of patient referrals in the realm of commercial health insurance, say attorneys at BakerHostetler.

  • FDA Transparency Plans Raise Investor Disclosure Red Flags

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    The U.S. Food and Drug Administration’s recently announced intent to publish complete response letters for unapproved drugs and devices implicates certain investor disclosure requirements under securities laws, making it necessary for life sciences and biotech companies to adopt robust controls going forward, say attorneys at Arnold & Porter.

  • With Obligor Ruling, Ohio Justices Calm Lending Waters

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    A recent decision by the Ohio Supreme Court, affirming a fundamental principle that lenders have no duty to disclose material risks to obligors, provides clarity for commercial lending practices in Ohio and beyond, and offers a reminder of the risks presented by guarantee arrangements, says Carrie Brosius at Vorys.

  • Federal AI Action Plan Marks A Shift For Health And Bio Fields

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    The Trump administration's recent artificial intelligence action plan significantly expands federal commitments across biomedical agencies, defining a pivotal moment for attorneys and others involved in research collaborations, managing regulatory compliance and AI-related intellectual property, says Mehrin Masud-Elias at Arnold & Porter.

  • Preparing For DEA Rescheduling Of 2 Research Chemicals

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    A recent decision to allow the U.S. Drug Enforcement Administration to reclassify two research psychedelics in Schedule I under the Controlled Substances Act may pose significant barriers to scientific study, including stringent registration requirements, heightened security protocols and burdensome reporting obligations, say Kimberly Chew at Husch Blackwell and Jackie von Salm at Psilera.

  • 9th Circ.'s Kickback Ruling Strengthens A Prosecutorial Tool

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    The Ninth Circuit's decision last month in U.S. v. Schena, interpreting the Eliminating Kickbacks in Recovery Act to prohibit kickback conduct between the principal and individuals who do not directly interact with patients, serves as a wake-up call to the booming clinical laboratory testing industry, say attorneys at Kendall Brill.

  • Fla. Misses Opportunity To Rectify Wrongful Death Damages

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    Florida Gov. Ron DeSantis' recent veto of a bill that would have removed certain arbitrary and unfair prohibitions on noneconomic wrongful death damages in medical negligence cases highlights the urgent need for reforms to current state law, say attorneys at Farah & Farah.

  • A Shifting Trend In FDA Form 483 Disclosure Obligations

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    A New York federal court's Checkpoint Therapeutics decision extends a recent streak of dismissals of securities class actions alleging that pharmaceutical companies failed to disclose U.S. Food and Drug Administration Form 483 inspection reports, providing critical guidance for companies during the FDA approval process, say attorneys at Alston & Bird.

  • The Future Of Lab-Test Regs After FDA Rescinds Rule

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    The U.S. Food and Drug Administration recently rescinded its laboratory-developed tests rule in response to a Texas federal court decision this spring, reinforcing a separation of authority between the FDA and the Centers for Medicare & Medicaid Services, and calling into question the FDA's role in overseeing such tests without congressional action, say attorneys at Venable.