sa¹ú¼Ê´«Ã½

Policy & Compliance

  • May 05, 2025

    UnitedHealth Tells Court Not To Review Special Master Report

    A special master rightly determined that no reasonable jury could render a verdict for the U.S. Department of Justice in a massive False Claims Act case targeting Medicare Advantage plans operated by UnitedHealth, the health insurance company told a D.C. federal judge.

  • May 05, 2025

    Trump Admin Urges Dismissal Of States' Abortion Pill Suit

    The Trump administration on Monday asked a Texas federal judge to dismiss a lawsuit seeking to roll back access to the abortion medication mifepristone, contending the three states pursuing the case waited too long to file and are suing in the wrong jurisdiction.

  • May 05, 2025

    Wash. Panel Quizzes State In Biologist's Vax Mandate Case

    Washington appellate judges hinted on Monday they might revive an ex-state biologist's suit claiming she was wrongfully denied a religious accommodation to keep her position without getting the COVID-19 vaccination, citing factual questions as to whether her job duties were essential and whether she was technically fired.  

  • May 05, 2025

    Fla. Judge Wants Briefs In ACA Trans Health Fight

    A Florida federal judge Monday requested briefing from the U.S. Department of Health and Human Services and the state of Florida on how to handle a suit challenging the Biden administration's regulations clarifying gender identity-based discrimination under the Affordable Care Act.

  • May 05, 2025

    20 AGs Sue To Stop 'Illegal Dismantling' Of HHS

    Twenty attorneys general sued the Trump administration Monday in Rhode Island federal court alleging that massive cuts to the U.S. Department of Health and Human Services violate the Constitution and usurp congressional authority.

  • May 05, 2025

    Fed. Circ. Affirms Coverage Denial Over Pre-Service Surgery

    A lower court did not err when it upheld the denial of a Navy veteran's shoulder disability claim based on a surgery that he had before entering the service, a Federal Circuit panel ruled.

  • May 05, 2025

    Kaiser Permanente Escapes 401(k) Forfeiture Suit, For Now

    A California federal judge tossed a proposed class action alleging Kaiser Permanente misspent forfeitures from an employee 401(k) plan, concluding the allegations failed to state a claim for a violation of federal benefits law.

  • May 05, 2025

    Novartis, Incyte Settle Drug Royalty Fight On Eve Of Trial

    A Manhattan federal judge put off trial on Monday in a five-year quest by Novartis to recover what it says are $500 million in missing royalties from its agreement to commercialize an Incyte compound used to treat blood cancers, with the sides announcing they reached a settlement.

  • May 02, 2025

    Fla. Lawmakers Vote To Repeal Law That Limits Death Suits

    Florida lawmakers have voted to do away with a statute that plaintiffs attorneys say unfairly and arbitrarily limits pain-and-suffering damages in fatal medical malpractice cases, but an attorney representing healthcare providers says that repealing the law will cause a flood of new lawsuits.

  • May 02, 2025

    Ill. Judge Questions Legal Theory In Multiplan Pricing MDL

    An Illinois federal judge handling multidistrict litigation accusing Multiplan of conspiring with insurers to fix out-of-network reimbursement rates seemed unsure Friday that a viable antitrust theory is at play, saying the plaintiffs' alleged market dynamic seems similar to various individuals independently deciding to hire the same "really good painter."  

  • May 02, 2025

    Boston Scientific, FDA Sued Over 'Unsafe' Spinal Implant

    Boston Scientific evaded safety regulations to market a defective spinal cord stimulator and the U.S. Food and Drug Administration rubber-stamped those alterations in an instance of "agency capture," according to a California federal lawsuit filed by a patient suffering from ongoing pain after the device was implanted.

  • May 01, 2025

    Planned Parenthood Slams HHS 'Attacks' On Teen Program

    Planned Parenthood on Thursday pressed a D.C. federal court to block the U.S. Department of Health and Human Services' "attacks" on a long-running, successful public health initiative aimed at preventing teen pregnancy, claiming that HHS has implemented new, "deeply inconsistent" requirements threatening the program's funding.

  • May 01, 2025

    Aetna And Humana Accused Of Medicare Kickbacks And Bias

    The federal government brought a bombshell False Claims Act suit Thursday against Aetna, Elevance and Humana, claiming the insurers paid hundreds of millions of dollars in illegal kickbacks to brokers in exchange for enrollments into their Medicare Advantage plans, with Humana and Aetna also accused of discriminating against disabled beneficiaries.

  • May 01, 2025

    HHS Report Finds 'Serious Concerns' On Trans Care For Youth

    The U.S. Department of Health and Human Services on Thursday released a report it says raises "serious concerns" about medical interventions used to aid young people in gender transition.

  • May 01, 2025

    Couple's J&J Pelvic Mesh Claims Too Late, 11th Circ. Affirms

    The Eleventh Circuit held Thursday that a couple's lawsuit against Johnson & Johnson over injuries allegedly caused by a pelvic mesh device made by the company's med-tech unit was filed too late despite evidence that the woman's doctors had expressed uncertainty for years about whether the mesh was causing her pain.

  • May 01, 2025

    Publix Can't Slip 'Zero-Market Share' Opioid Claims

    Publix Super Markets Inc. can't slip opioid-related claims from nine municipalities in which the supermarket chain alleges it has no pharmacies, an Ohio federal judge overseeing sprawling national opioid litigation ruled.

  • May 01, 2025

    sa¹ú¼Ê´«Ã½, Lenders Float Deal To Vacate Medical Debt Rule

    The Consumer Financial Protection Bureau has agreed to a proposed consent judgment that would vacate a Biden-era rule banning an estimated $49 billion in medical debt from credit reports, striking a deal with lender trade groups that sued in Texas federal court to block the rule.

  • May 01, 2025

    PBMs Tell 6th Circ. Ohio's Pricing Case Belongs In Fed Court

    Express Scripts and Prime Therapeutics urged the Sixth Circuit to undo a district court order returning a lawsuit from Ohio's attorney general alleging they drove up prescription drug prices to state court, arguing Wednesday an after-the-fact disclaimer of federal program-based claims isn't enough to sever a federal law connection.

  • May 01, 2025

    J&J Talc Unit Says New Doc 'Key' To Talc Study Libel Suit

    A Johnson & Johnson talc unit has asked a New Jersey federal court to reinstate its libel suit over a scientific article linking talcum powder to mesothelioma, arguing that newly discovered evidence shows statements in the article are false.

  • May 01, 2025

    Payment Math Dooms Sandoz Price-Fixing Deal With Florida

    A Connecticut federal judge on Thursday refused to put a bow on the deal the state of Florida struck with Sandoz AG and related defendants in three generic drug price-fixing lawsuits, ruling from the bench in Hartford that the settlement agreement "as written" would lead to exorbitant supplemental payments in the event that other states also reach deals to release their claims.

  • May 01, 2025

    Ex-Conn. State Employee Cops To $1.8M Medicaid Scam Role

    A former Connecticut government employee admitted to playing a part in a $1.8 million scheme to defraud the Constitution State's Medicaid program by fraudulently billing services for children with autism that her company never provided, acting U.S. Attorney Marc H. Silverman has announced.

  • May 01, 2025

    Rehab Center To Pay $19.75M To Resolve FCA Case

    A New Jersey drug and alcohol rehabilitation center will pay $19.75 million to resolve claims that it violated the False Claims Act by concealing it had no license from state regulators and billed the Veterans Health Administration and Medicaid for its services.

  • April 30, 2025

    DOJ Urges 11th Circ. To Restore FCA Whistleblower Provision

    The U.S. Department of Justice told the 11th Circuit on Wednesday that a Florida federal judge was wrong to rule that the provision of the False Claims Act that lets whistleblowers bring suits on the government's behalf was unconstitutional, arguing that the judge erred in saying whistleblowers were an unappointed part of the federal workforce.

  • April 30, 2025

    SuperValu Fights New Trial Bid In Whistleblower Drug Case

    SuperValu urged an Illinois federal judge Tuesday not to overturn its defense win on whistleblower claims of systematic prescription overbilling, saying the whistleblowers are now making "kitchen sink arguments" with little basis.

  • April 30, 2025

    Atlanta Home Health Service Faces Overtime Class Action

    An Atlanta home healthcare service was hit with a proposed class action Wednesday over allegations it failed to pay certified nursing assistants proper overtime compensation.

Expert Analysis

  • Plan Sponsors Must Prep For New Mental Health, Drug Rules

    Author Photo

    To comply with newly published health insurance rules requiring parity between access to mental health and substance use services compared to medical and surgical services, employers with self-insured plans will need to update third-party administrator agreements and collect data, among other compliance steps, say attorneys at Kilpatrick.

  • A Primer On Navigating The Conrad 30 Immigration Program

    Author Photo

    As the Conrad 30 program opens its annual window to help place immigrant physicians in medically underserved areas, employers and physicians engaged in the process must carefully understand the program's nuanced requirements, say Andrew Desposito and Greg Berk at Sheppard Mullin.

  • Class Actions At The Circuit Courts: September Lessons

    Author Photo

    In this month's review of class action appeals, Mitchell Engel at Shook Hardy identifies practice tips from four recent class certification rulings involving denial of Medicare reimbursements, automobile insurance disputes, veterans' rights and automobile defects.

  • Proposed Legislation May Crack Down On Online Drug Ads

    Author Photo

    A bill recently proposed in Congress could serve as a sea change in how the U.S. Food and Drug Administration regulates drug-related speech, with significant trickle-down effects on various corners of not only the drug industry but also on consumers and providers themselves, say Dominick DiSabatino and Arushi Pandya at Sheppard Mullin.

  • What To Expect From Calif. Bill Regulating PE In Healthcare

    Author Photo

    A California bill currently awaiting Gov. Gavin Newsom's approval, intended to increase oversight over private equity and hedge fund investments in healthcare, is emblematic of recent increased scrutiny of investments in the space, and may affect transactions and operations in California in a number of ways, say attorneys at Ropes & Gray.

  • Vertex Suit Highlights Issues For Pharma Fertility Support

    Author Photo

    Vertex Pharmaceuticals' recent lawsuit challenging the U.S. Department of Health and Human Services' interpretation of the Anti-Kickback Statute is influenced by a number of reproductive rights and health equity issues that the Office of Inspector General should address more concretely, including in vitro fertilization and fertility preservation programs, says Mary Kohler at Kohler Health Law.

  • CMS' New 'Breakthrough' Device Policy Shows Little Promise

    Author Photo

    The Centers for Medicare & Medicaid Services’ recent procedural notice outlining a new Medicare coverage pathway for breakthrough medical devices will, at best, be a failed experiment and, at worst, result in Medicare beneficiaries denied access to innovative treatments, say attorneys at King & Spalding.

  • A Preview Of AI Priorities Under The Next President

    Author Photo

    For the first time in a presidential election, both of the leading candidates and their parties have been vocal about artificial intelligence policy, offering clues on the future of regulation as AI continues to advance and congressional action continues to stall, say attorneys at Mintz.

  • Managing Community Health Needs Assessments: A Checklist

    Excerpt from
    Author Photo

    To guide nonprofit hospitals and health systems through their required community health needs assessment every three years, this checklist outlines the steps for 12 phases of the process.

  • Pa. Health Employers Must Prep For Noncompete Restrictions

    Author Photo

    Newly enacted legislation in Pennsylvania prohibits certain noncompete covenants for healthcare practitioners in the state beginning next year, creating compliance challenges that both employers and employees should be aware of, say attorneys at Buchanan Ingersoll.

  • FTC Focus: What Access To Patent Settlements Would Mean

    Author Photo

    Settling parties should adopt a series of practice tips, including specifying rationales to support specific terms, as the Federal Trade Commission seeks to expand its access to settlements before the Patent Trial and Appeal Board, say Shannon McGowan and David Munkittrick at Proskauer.

  • Agencies Should Reward Corporate Cyber Victim Cooperation

    Author Photo

    The increased regulatory scrutiny on corporate victims of cyberattacks — exemplified by the U.S. Securities and Exchange Commission's case against SolarWinds — should be replaced with a new model that provides adequate incentives for companies to come forward proactively and collaborate with law enforcement, say attorneys at McDermott.

  • Strategies To Defend Against Healthcare Nuclear Verdicts

    Author Photo

    The healthcare industry is increasingly the target of megaclaims, particularly those alleging medical malpractice, but attorneys representing providers can use a few tools to push back on flimsy litigation and reduce the likelihood of a nuclear verdict, says LaMar Jost at Wheeler Trigg.