Policy & Compliance
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April 08, 2025
UnitedHealth Puts Anesthesiologists' Antitrust Suit To Sleep
A New York federal judge tossed an antitrust lawsuit accusing a United Healthcare unit of using its market power in the New York metropolitan area to cut reimbursement rates to anesthesia providers by 80% in its public-sector employee health plan, while enlisting MultiPlan to pressure providers into accepting the rates.
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April 08, 2025
Md. Board Enacts Expungement Rule For Physician Records
Maryland doctors who have faced administrative action for failing to pay taxes or attend continuing education classes can have their public records wiped clean under a new rule from the state Board of Physicians.
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April 08, 2025
2nd Circ. Rejects Biden Diary Thief's Appeal Over Medical Info
The Second Circuit denied an appeal on Tuesday from a woman who pled guilty to stealing a diary belonging to former President Joe Biden's daughter, rejecting her arguments that a judge was wrong to allow a probation officer to disclose her presentencing report and prior medical records to mental health providers without first obtaining consent.
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April 07, 2025
CMS' Nursing Home Staffing Requirements Struck Down
A Texas federal judge on Monday struck down new staffing standards for nursing homes participating in Medicare or Medicaid, ruling that federal health officials overstepped their authority by establishing a one-size-fits-all requirement.
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April 07, 2025
Policy Group Tells 4th Circ. Drug Discount Law Needs Reform
The Fourth Circuit on Monday allowed a Boston-based think tank to file an amicus brief supporting a district court's injunction against a West Virginia law that pharmaceutical companies and lobbyists claim unconstitutionally expands a federal drug discount program.
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April 07, 2025
Drug Buyers, Generics Cos. Fight Over Bellwether Litigation
Generic drug buyers vied Friday with the pharmaceutical companies they've accused of price-fixing over how to shape the first rounds of long-gestating Pennsylvania federal court litigation that the plaintiffs want heard in separate consecutive trials and that the drugmakers want combined.
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April 07, 2025
AGs Announce $335M Opioid Deal With Mylan
New York Attorney General Letitia James on Monday said her office and those of other states reached a $335 million deal with Mylan to help combat the opioid crisis.
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April 07, 2025
Ex-Conn. Budget Official Plans To Testify In Corruption Cases
Twice-indicted former Connecticut budget official Konstantinos Diamantis plans to testify in two upcoming federal corruption trials, his attorney revealed Monday during a scheduling call that snapped into focus the timeline for both cases.
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April 07, 2025
Conn. Judge Pauses 'Staggering' Hospital Data Subpoena
A Connecticut judge temporarily paused a subpoena seeking what a health nonprofit called "a staggering amount" of confidential patient data by a proposed class of Constitution State residents accusing Hartford HealthCare Corp. of monopolizing the state's healthcare industry, stating that the court must review the subpoena first.
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April 07, 2025
11 States Tell 6th Circ. To Ax Mich. Conversion Therapy Ban
Eleven U.S. states led by Iowa and South Carolina urged the Sixth Circuit to strike down Michigan's ban on conversion therapy for minors, saying the law censors therapists' speech.
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April 07, 2025
Feds Say Fla. Doctor Fleeced Medicare With Bogus Charges
A doctor and his Florida-based business, Vohra Wound Physicians Management LLC, deliberately overbilled Medicare for years, charging it for wound care procedures that were unnecessary or not performed, according to federal prosecutors.
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April 04, 2025
Split DC Circ. Denies Calif. Subsidies For Border Hospitals
A split D.C. Circuit panel on Friday found it was not unconstitutional for California to exclude hospitals bordering the state from a program distributing supplemental payments to providers that serve Medi-Cal beneficiaries.
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April 04, 2025
HHS Drops 11th Circ. Fight Over ACA Trans Rule Freeze
The U.S. Department of Health and Human Services agreed to drop its bid to overturn an order blocking it from enforcing regulations that extend the Affordable Care Act's anti-discrimination provisions to transgender individuals against Florida organizations, according to filings with the Eleventh Circuit.
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April 04, 2025
Ohio AG Takes Trans Care Limits Bid To State Justices
Ohio Attorney General Dave Yost has taken his bid to reinstate limits on gender-affirming care for transgender youths to the state's highest court and wants the law's enforcement to continue throughout his appeal.
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April 04, 2025
Seattle Children's Faces Class Action Over Nurse Meal Breaks
A Washington nurse has filed a proposed class action alleging Seattle Children's Hospital broke state law by failing to schedule or provide mandatory rest and meal breaks, in a state court complaint that said the problem was made worse by understaffing during the COVID-19 pandemic.
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April 04, 2025
AGs Sue To Halt Disruptions To NIH Grant Funding
A coalition of 16 states on Friday sued the National Institutes of Health over delays and cancellations of grant programs linked to vaccines, transgender issues and other areas they say are currently "disfavored" by the Trump administration.
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April 03, 2025
Optum, Express Scripts Want Judge Ousted From Opioid MDL
Pharmacy benefit managers Optum and Express Scripts say the Ohio federal judge overseeing multidistrict opioid litigation should recuse himself because he "regularly communicates" with plaintiffs' attorneys in the litigation and is biased in favor of plaintiffs, according to a motion filed Wednesday.
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April 03, 2025
TV Star Dr. Oz Confirmed As New Medicare, Medicaid Leader
The U.S. Senate on Thursday voted 53 to 43, along party lines, to confirm former talk show host and surgeon Dr. Mehmet Oz to be the next administrator of the Centers for Medicare & Medicaid Services.
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April 03, 2025
Swedish Health Services Found Liable For Wage Violations
A Washington state judge has put Seattle-area hospital system Swedish Health Services on the hook for state wage law violations in an employee class action, finding workers were shortchanged by its timekeeping practices and failure to provide a second meal break on longer shifts.
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April 03, 2025
Senate Panel Advances Bills Tackling Drug Patents, Pricing
A U.S. Senate panel on Thursday approved a group of bills tackling pharmaceutical patents and drug pricing, including measures that claim to address so-called patent thickets and an industry practice called "product hopping."
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April 03, 2025
2nd Circ. Judge Thinks Drug Price Fight Sounds Like Antitrust
A Second Circuit judge on Thursday suggested that the federal government may be insulated from claims over its demand for lower prices for Medicare and Medicaid recipients, musing that Boehringer Ingelheim Pharmaceuticals Inc.'s constitutional challenge to an Inflation Reduction Act provision sounds more like an antitrust allegation.
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April 03, 2025
RI Judge Hits Pause On Billions In Health Grant Funding Cuts
A Rhode Island federal judge on Thursday barred the Trump administration from moving forward, for now, with the termination of billions of dollars in grants supporting state public health programs.
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April 03, 2025
Baker Donelson Elevates Health Law And Public Policy Heads
Three Baker Donelson Bearman Caldwell & Berkowitz PC shareholders have been tapped for leadership roles within the firm's national health law and public policy department.
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April 02, 2025
NIH Sued By Researchers Over 'Ideological Purge' On Grants
The American Public Health Association and others sued the federal government in Massachusetts federal court on Wednesday over the cancellations of billions of dollars worth of National Institutes of Health research grants on such issues as gender identity, diversity, vaccine hesitancy and climate change, claiming the "ideological purge" is illegal.
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April 02, 2025
GoodRx, PBM Price-Fixing MDL Set In Rhode Island
The Judicial Panel on Multidistrict Litigation on Wednesday consolidated in Rhode Island litigation alleging that GoodRx conspired with pharmacy benefit managers, including CVS Caremark and Express Scripts, to suppress reimbursements to independent pharmacies for dispensing generic prescription medications.
Expert Analysis
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Takeaways From DOJ Fraud Section's 2024 Year In Review
Attorneys at Paul Weiss highlight notable developments in the U.S. Department of Justice Fraud Section’s recently released annual report, and discuss what the second Trump administration could mean for enforcement in the year to come.
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IVF Suits Highlight Need For Better Legal Frameworks
The high number of in vitro fertilization embryo losses underscores the need for more cohesive legal and regulatory guidance related to human errors, property versus personhood, and liability, says Jeff Korek at Gersowitz Libo.
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Takeaways From FDA's Updated Confirmatory Trial Guidance
The U.S. Food and Drug Administration's latest draft guidance about accelerated drug approval indicates the FDA's intent to address the significant lag time between accelerated approval and full approval of drugs and may help motivate the industry to complete confirmatory trials, say attorneys at Sheppard Mullin.
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A Look At FDA's Plans To Establish New OTC Drug Category
The U.S. Food and Drug Administration's recently finalized rule, creating a new over-the-counter pathway for drugs when patients satisfy certain conditions, may be useful for off-patent drugs with established safety records, though switching to OTC comes with additional costs and considerations, say attorneys at Skadden.
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2024 Was A Significant Year For HIPAA Compliance
The Office of Civil Rights' high level of Health Insurance Portability and Accountability Act activity in 2024 and press releases about its specific focus on certain cybersecurity issues make it abundantly clear that the OCR is not going to tolerate widespread compliance complacency, says Nathan Kottkamp at Williams Mullen.
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How 2025 NDAA May Affect DOD Procurement Protests
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.
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Top 10 Noncompete Developments Of 2024
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.
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What 2024 Tells Us About Calif. Health Transaction Reviews
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.
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Updated HIPAA Rule Is A Necessary Step For Data Protection
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.
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Courts Must Curb The Drug Price Negotiation Program
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.
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The OIG Report: Preparing For Oversight In 2025
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.
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5 Drug And Device Developments That Shaped 2024
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.
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How New Fraud Enforcement Tool Affects Gov't Contractors
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.