Policy & Compliance

  • March 18, 2025

    Repeal Of Social Needs Guidance Sows Medicaid Uncertainty

    A Trump administration rollback of guidance on health-related social needs may bode poorly for the future of state-federal pilot programs that provide Medicaid recipients with tools to live healthier, safer lives.

  • March 18, 2025

    States Oppose Term In Sandoz Price-Fixing Deal With Fla.

    State enforcers still locked in price-fixing litigation against generic-drug maker Sandoz are raising objections to a cap on what they could win through settlements in Florida's recent agreement with the company, telling the Connecticut federal judge weighing approval that it would block or delay potential settlements of their own.

  • March 18, 2025

    Indirect Effexor Buyers Seek Approval Of $2.3M Antitrust Deal

    A proposed class of indirect drug purchasers have asked a New Jersey federal judge for his initial sign-off on a $2.25 million deal with Teva Pharmaceuticals to resolve antitrust claims against the company over antidepressant and anxiety disorder treatment Effexor XR.

  • March 18, 2025

    Feds Reject 'Absurd' Defense In Harvard Body Parts Case

    Federal prosecutors in Pennsylvania have blasted an "absurd argument" that a stolen-goods law doesn't criminalize buying and selling body parts stolen from cadavers donated to the Harvard Medical School's morgue.

  • March 18, 2025

    Illinois Asbestos Injury Firm Escapes 'Fraud Playbook' Suit

    A Chicago federal judge on Tuesday tossed a racketeering suit an industrial pipe company brought against a "prolific" Illinois asbestos litigation law firm, finding that the pipe company failed to adequately plead that the law firm formed an "enterprise" with various clients, witnesses, co-counsel and staff.

  • March 18, 2025

    Minn. AG, Mayo Clinic Settle Charity Probe: 3 Things To Know

    The Mayo Clinic will reform its charity care policies after an investigation by Minnesota officials found the hospital system sued its patients over medical debt even though they might have qualified for financial assistance.

  • March 17, 2025

    US Chamber Says FCA Qui Tam Provisions Unconstitutional

    The U.S. Chamber of Commerce on Monday endorsed a legal challenge aimed at bringing down the whistleblower provisions in the False Claims Act, arguing there is a "manifest conflict between the modern FCA's qui tam provisions and Article II's text."

  • March 17, 2025

    Gutting USAID Threatens US Credibility, 22 Ex-Officials Say

    A bipartisan group of former high-ranking national security and defense officials on Monday voiced opposition to the Trump administration's decision to dismantle the U.S. Agency for International Development, saying in an amicus brief filed in D.C. federal court that the shutdown undermines the United States' credibility while allowing China and Russia to build theirs.

  • March 17, 2025

    New Bills Target 'Patent Thickets' And 'Product Hopping'

    A bipartisan group of senators is backing two bills it says will use the patent system to lower the price of prescription drugs, in part by targeting "patent thickets" and making "product hopping" a violation of antitrust laws. 

  • March 17, 2025

    PBMs Hit With Antitrust Suit Over GoodRx Generics Program

    A Denver pharmacy has filed a proposed class action against GoodRx, CVS and other major pharmacy benefit managers in Colorado federal court, alleging they engaged in an illegal price-fixing scheme that artificially suppressed the prices paid to independent pharmacies for reimbursement of generic drug claims.

  • March 17, 2025

    VA To End Medical Care For Gender Dysphoria

    The U.S. Department of Veterans Affairs will stop offering medical treatments for gender dysphoria in order to comply with an executive order by President Donald Trump, the agency announced Monday.

  • March 17, 2025

    Full 7th Circ. Won't Revive Suit Over Late Medicaid Payments

    The full Seventh Circuit has answered the "enormous question" of whether a Chicago hospital can sue the state of Illinois to force the managed-care organizations it contracts with to make timely Medicaid payments, concluding the hospital doesn't have a federal right to prompt payments for fear of turning federal trial courts into "de facto Medicaid claims processors."

  • March 17, 2025

    May Trial Set For Ex-Conn. Official's New Corruption Charges

    A Connecticut federal judge said Monday that former Constitution State budget official Konstantinos Diamantis and ex-lawmaker Christopher Ziogas will go to trial on May 7 for claims they respectively took and paid bribes to stop a state audit of Ziogas' fiancée, who has admitted to healthcare fraud.

  • March 17, 2025

    House Panel Probes Medical Residency Antitrust Exemption

    The chair of the House Judiciary Committee's antitrust panel is looking into whether to do away with an antitrust exemption Congress granted over 20 years ago to the medical residency matching system, which the congressman said could be harming new doctors and even patients.

  • March 17, 2025

    Houston Midwife Arrested In Texas' 1st Criminal Abortion Case

    A Houston-area midwife has been arrested after an investigation by the Texas attorney general's office for allegedly providing illegal abortions, Attorney General Ken Paxton announced Monday, the first such criminal charges brought since the state issued its near-total abortion ban.

  • March 17, 2025

    Feds Defend Prof's Deportation As Arnold & Porter Withdraws

    Government lawyers told a Massachusetts federal judge Monday they did not disobey a court order halting the deportation of a Brown University doctor and professor with an H-1B visa, as a team of Arnold & Porter Kaye Scholer LLP lawyers who lobbed that claim abruptly withdrew from the case.

  • March 17, 2025

    Seeger Weiss Atty Tapped To Lead Depo-Provera Plaintiffs

    A Florida federal judge on Sunday selected Christopher Seeger of Seeger Weiss LLP to lead the team representing plaintiffs in the multidistrict litigation claiming Pfizer Inc. failed to adequately warn patients and doctors about the risk of brain tumors associated with the hormonal contraceptive drug Depo-Provera.

  • March 14, 2025

    Ga. Panel Says COVID-Era Legal Shield Blocks Amputee's Suit

    A divided Georgia Court of Appeals on Friday said a trial court should have dismissed a wrongful amputation suit against a Marietta hospital, holding that the patient who lost his right leg after being admitted for COVID-19 symptoms could not beat the legal immunity granted to the hospital by a pandemic-era state law.

  • March 14, 2025

    Md. Judge Joins Calif. In Reversing Federal Workers' Firing

    A Maryland federal judge has ordered the reinstatement of thousands of probationary employees who were abruptly fired from 18 federal agencies, saying the Trump administration's lack of required notice left states "scrambling" to pick up the pieces.

  • March 14, 2025

    NC Ex-Doctor Gets 2.5 Years For Drug Test Billing Scheme

    A 72-year-old doctor in North Carolina was sentenced Friday to two and a half years in prison and ordered to hand over $2 million in restitution for a fraudulent billing scheme involving medically unnecessary drug tests, prosecutors said.

  • March 14, 2025

    FTC Urges 8th Circ. Not To Pause Insulin Pricing Case

    The Federal Trade Commission has urged the Eighth Circuit not to pause its in-house case accusing Caremark Rx, Express Scripts and OptumRx of artificially inflating insulin prices, telling the appeals court the pharmacy benefit managers have no chance of winning on their constitutional claims.

  • March 14, 2025

    Dr. Oz Pledges 'Upcoding' Crackdown If Confirmed At CMS

    Dr. Mehmet Oz told lawmakers he would combat rising healthcare costs by showing there's a "new sheriff in town" opposed to so-called upcoding by Medicare Advantage plans, as he sought support Friday for his nomination to lead the U.S. Centers for Medicare and Medicaid Services.

  • March 14, 2025

    Sutter Health Reaches $4.3M Deal To End Retirement Suit

    Nonprofit healthcare system Sutter Health will pay $4.3 million to settle a class action from workers alleging their employee retirement plan was saddled with excessive fees and poorly performing investments, according to filings in California federal court.

  • March 14, 2025

    Feds Say North Carolina Cardiologist Owes $7.9M In Taxes

    A North Carolina cardiologist owes the federal government $7.9 million in taxes, fees and interest, according to a new civil complaint brought against him by the tax division of the U.S. Department of Justice seeking to hold him liable for the purportedly unpaid sum.

  • March 13, 2025

    Colo. Says Its Abortion 'Reversal' Ban Doesn't Discriminate

    The Colorado Medical Board and Colorado Board of Nursing have urged a federal court to leave in place a state law banning the use of medication to "reverse" the abortion pill, arguing that it merely regulates "substandard ineffective medical practices" and doesn't discriminate against religious health providers.

Expert Analysis

  • How 2025 NDAA May Affect DOD Procurement Protests

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    A bid protest pilot program included in the 2025 National Defense Authorization Act shifts litigation costs onto unsuccessful bid protesters and raises claim-filing thresholds, which could increase risks to U.S. Department of Defense contractors who file protests, and reduce oversight of DOD procurement awards, say attorneys at Venable.

  • Top 10 Noncompete Developments Of 2024

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    Following an eventful year in noncompete law at both state and federal levels, employers can no longer rely on a court's willingness to blue-pencil overbroad agreements and are proceeding at their own peril if they do not thoughtfully review and carefully enforce such agreements, say attorneys at Faegre Drinker.

  • What 2024 Tells Us About Calif. Health Transaction Reviews

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    Looking back at the California Office of Health Care Affordability's first year accepting notices for material healthcare transactions reveals critical lessons on what the OHCA's review process may mean for the future of covered transactions in the state, say attorneys at Ropes & Gray.

  • Updated HIPAA Rule Is A Necessary Step For Data Protection

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    The U.S. Department of Health and Human Services' updated rules addressing cybersecurity threats in healthcare will necessitate significant investment in technology, training and compliance infrastructure, but are an essential evolution in safeguarding data in an increasingly digital world, say attorneys at Clark Hill.

  • Courts Must Curb The Drug Price Negotiation Program

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    The Inflation Reduction Act's drug price negotiation program upends incentive structures that drive medical innovation, and courts must act appropriately to avoid devastating consequences for American healthcare and the pharmaceutical industry, says Jeff Stier at the Consumer Choice Center.

  • The OIG Report: Preparing For Oversight In 2025

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    Across sectors, Office of Inspector General work plans and challenge reports for 2025 provide a trove of information on the issues and industries that will likely be the focus of government oversight in the year to come, says Diana Shaw at Wiley.

  • 5 Drug And Device Developments That Shaped 2024

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    The last year saw significant legal developments affecting drug and device manufacturers, with landmark decisions and regulatory changes that require vigilance and agility from the industry, say attorneys at Faegre Drinker.

  • How New Fraud Enforcement Tool Affects Gov't Contractors

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    Government contractors will likely face greater scrutiny under the recently enacted Administrative False Claims Act, which broadens federal agencies' authority to pursue low-dollar fraud claims, but contractors may also find the act makes settlement of such claims easier to negotiate, say attorneys at Wiley.

  • Consultants Should Be Aware Of DOJ's Potential New Reach

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    The U.S. Department of Justice's recent first-of-its-kind settlement with McKinsey & Co. indicates not only the DOJ's more aggressive stance toward businesses' potential criminal wrongdoings, but also the benefits of self-disclosure and cooperation when wrongdoing becomes apparent, says Dom Caamano at Kibler Fowler.

  • Health Tech Regulatory Trends To Watch In 2025

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    With an upcoming change in administration and the release of some long-awaited rules, the healthcare industry should prepare for shifting trends, including a growing focus on health data and interest in technology-enabled delivery of healthcare, say attorneys at Orrick.

  • 10 Noteworthy CFPB Developments From 2024

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    In a banner year for consumer finance regulation, the Consumer Financial Protection Bureau made significant strides in its efforts to rein in Big Tech and nonbank financial firms, including via rules regarding open banking, credit card late fees, and buy now, pay later products, say attorneys at Wiley.

  • The Future Of GLP-1 Policy After Drug Shortage Ends

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    If and when the U.S. Food and Drug Administration determines that GLP-1 RA drugs are no longer in short supply, regulators will face questions of how to balance access to GLP-1 RAs with statutory and policy considerations applicable to compounded drugs, say attorneys at Skadden.

  • Top 10 Whistleblowing And Retaliation Events Of 2024

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    From a Florida federal court’s ruling that the False Claims Act’s qui tam provision is unconstitutional to a record-breaking number of whistleblower tips filed with the U.S. Commodity Futures Trading Commission, employers saw significant developments in the federal and state whistleblower landscapes this year, say attorneys at Proskauer.