Policy & Compliance
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June 13, 2025
Injunction Sought After J&J Unit's Catheter Antitrust Loss
Innovative Health is seeking a permanent injunction that would ban Johnson & Johnson health tech unit Biosense Webster from conditioning the provision of cardiac mapping services on purchases of cardiac catheters, after Innovative Health netted a $442 million trial win on its antitrust claims.
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June 13, 2025
5th Circ. Says No Private Right Of Action In No Surprises Act
The Fifth Circuit has ruled a pair of flight ambulance providers cannot pursue their lawsuit seeking to enforce out-of-network billing dispute resolution awards against a health insurance company, saying there's no private right of action built into a 2022 law that protects patients from surprise medical bills.
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June 13, 2025
Pa. Home Care Agency Owner Gets Prison, $235K Restitution
The New York-based owner of a Berks County, Pennsylvania, home care agency has been sentenced to spend a month in jail and repay $235,778 in fraudulently billed Medicaid claims, the Pennsylvania Attorney General's Office announced Friday.
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June 13, 2025
EEOC Says Henry Ford Ignored Subpoena Over Bias Charge
Michigan's Henry Ford health system has ignored a subpoena from the U.S. Equal Employment Opportunity Commission seeking information into a worker's bias charge, according to a federal court filing from the agency seeking an order enforcing the request.
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June 13, 2025
CVS Wants To Halt Ark. Law Banning PBM-Owned Pharmacies
CVS urged an Arkansas federal judge to block a new state law from taking effect that would ban pharmacy benefits managers from owning pharmacies in the state, arguing the law shirks the U.S. Constitution by tamping down competition and discriminating against out-of-state businesses.
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June 12, 2025
Florida, Sandoz Say They've Fixed Generic Drug Price-Fix Deal
The Florida Attorney General's Office and Sandoz Inc. have told a Connecticut federal court they've fixed the problems the court identified with a generic drug price-fixing settlement after other states with claims in the case objected to a clause in the deal.
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June 12, 2025
'Forum Shopping' Center Stage At 6th Circ. Drug Pricing Args
As part of an expansive effort to tee up U.S. Supreme Court review, pharmaceutical industry-backed opponents of Medicare's drug price negotiations entered less-than-hospitable territory at the Sixth Circuit, where judges pointedly questioned a local business group's basis for challenging a national healthcare program.
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June 12, 2025
Humana, Aetna Underpaid For 340B Drugs, New Suits Say
Humana and Aetna are facing new claims in a trio of suits filed in North Carolina federal court alleging they underpaid health systems for drugs purchased through the federal 340B drug discount program.
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June 12, 2025
11th Circ. Won't Revive Nurses' African Bias, Retaliation Suit
The Eleventh Circuit on Thursday backed an Atlanta hospital's defeat of a lawsuit claiming it disciplined and fired two nurses who complained that a supervisor made derogatory comments about African employees, saying neither woman could overcome evidence of their misconduct.
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June 12, 2025
Fla. Death Damages Row Signals Insurers' Tort Reform Focus
Florida Gov. Ron DeSantis' veto of a bill that would have repealed limits on noneconomic damages in fatal medical malpractice cases — despite state lawmakers' overwhelming support of the measure — signals broad concerns over how tort reform legislation could impact the insurance industry.
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June 11, 2025
Seattle Hospital Hit With Class Suit Over 'Diverted' Pain Meds
A Seattle-based hospital system has been slapped with a proposed class action in Washington state court over claims that hundreds of patients suffered unwarranted pain and risk of infection because a staff member may have been pocketing painkillers.
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June 11, 2025
RFK Jr. Picks Vaccine Critics As Part Of CDC Panel Overhaul
Robert F. Kennedy Jr., secretary of the U.S. Department of Health and Human Services, announced Wednesday he appointed eight new members to a vaccine advisory panel, just two days after he removed 17 existing members of the panel, which provides advice and guidance on the use of vaccines to the Centers for Disease Control and Prevention.
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June 11, 2025
UNC Hospital System Must Face Ex-Resident's Bias Suit
The University of North Carolina's hospital system must face a discrimination lawsuit filed by a fired surgical resident, a North Carolina federal judge ruled Wednesday, tossing the system's motion to dismiss claims that the discharge decision was motivated by bias against the resident's mental health conditions.
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June 11, 2025
Children's Healthcare Nonprofit Settles Retirement Fee Suit
A Florida-based nonprofit children's healthcare network and ex-workers who alleged their employee retirement savings were dragged down by excessive fees told a Florida federal court Wednesday they'd worked out a class action settlement of the dispute after mediation.
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June 11, 2025
Ga. Hospice Provider Pays $9.2M To End Kickback Case
A Georgia hospice care provider and its CEO forked over $9.2 million to settle claims that they violated federal fraud laws by participating in a kickback scheme with medical directors who referred hospice patients to the group, prosecutors announced Wedesnday.
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June 11, 2025
Aetna Resolves Lipedema Patients' Coverage Class Action
Aetna has agreed to end a class action alleging it unlawfully refused to cover liposuction as a treatment for over two dozen patients afflicted with a rare chronic condition called lipedema, according to a Wednesday filing in California federal court.
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June 11, 2025
Cigna Accused Of Misusing $17M In 401(k) Forfeitures
Retirement plan participants and beneficiaries at Cigna say the company violated the Employee Retirement Income Security Act by using up to $17 million given up by participants who quit early to reduce the company's matching contributions, rather than using it to pay for the plan's administrative costs.
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June 11, 2025
Conn. Orthopedic Practice Faces Data Breach Class Claims
A March 2 data breach at a Connecticut orthopedic practice exposed the personal information and health data of an unknown number of patients to online hackers, a patient alleged in a proposed class action.
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June 11, 2025
Health Network Strikes Deal In Retirement Plan Forfeiture Suit
A Pennsylvania health system has settled a suit claiming it failed to tamp down on unnecessary expenses in its $1.1 billion retirement plan and used forfeited funds to cover its own contributions to the plan instead of using the abandoned cash to reduce fees.
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June 10, 2025
Ga. Justices Consider Tolling In Tongue Amputation Case
The Georgia Supreme Court on Tuesday considered whether the state's two-year statute of limitations applies to a lawsuit against Regency Hospital Co. and one of its nurses over claims that they neglected an allegedly incapacitated patient to the point that her tongue had to be amputated.Â
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June 10, 2025
IT Co. Urges 1st Circ. To Affirm It's Blameless For Data Breach
An information security technology company urged the First Circuit on Tuesday to affirm that it isn't liable for a 2018 data breach that exposed confidential information of more than 277,000 of the medical device maker's patients, arguing that the insurer assignee of the device maker had no valid points.
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June 10, 2025
Amazon Can't Duck Suit Over Non-FDA Approved Supplements
Amazon must face a proposed class action alleging it sells non-FDA approved supplements touting health-related claims without mandatory disclaimers, after a Washington federal judge rejected the company's argument the plaintiffs lack standing to pursue claims over supplements they never bought, finding the plaintiffs allege a uniform, systematic marketing practice.
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June 10, 2025
Ala. Judge Orders Trans Health Org. To Publish Training Vids
In a case challenging Alabama's ban on gender-affirming care for youths, a federal judge this week ordered a trans health organization to publish video recordings of the group's conferences and a medical training course, after the group had sought to protect the content's confidentiality.Â
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June 10, 2025
9th Circ. Skeptical Oregon Hospital Merger Law Is Too Vague
A Ninth Circuit panel on Monday appeared skeptical of a hospital association's challenge to an Oregon law that grants a state agency broad power to block proposed healthcare consolidations to ensure equitable access to healthcare, with two of the three judges questioning whether federal law could limit the state's authority.
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June 10, 2025
Attys Field Provider Fears, Queries On CMS Trans Care Probe
A new federal push to obtain a broad swath of clinical and financial data from hospitals providing gender-affirming care is triggering a wave of concerns that the Trump administration's enforcement approach will have a chilling effect on care delivery.
Expert Analysis
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How Plan Sponsors Can Mitigate Risk In PBM Contracts
A recent lawsuit in New York federal court alleges that JPMorgan caused exorbitant prescription costs by mishandling the pharmacy benefit manager arrangement, adding to a growing body of Employee Retirement Income Security Act fiduciary breach litigation and affirming that fiduciaries must proactively manage their healthcare plan vendors, say attorneys at Hall Benefits Law.
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4th Circ. Health Data Ruling Opens Door To State Law Claims
In Real Time Medical v. PointClickCare, the Fourth Circuit recently clarified that state law claims can rest in part on violations of a federal law that prohibits electronic health information blocking, expanding legal risks for health IT companies and potentially creating exposure to a range of competitive implications, say attorneys at BCLP.
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Unpacking Trump Admin Plans For Value-Based Care
Recent developments from the Center for Medicare and Medicaid Innovation suggest the Trump administration intends to put its own stamp on value-based care, emphasizing cost savings assessment in particular, with its recent cancellation of several payment models that had supported primary care, says Miranda Franco at Holland & Knight.
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What To Expect For Stem Cell Regulation Under Trump Admin
The new administration's push for deregulation, plus the post-Chevron legal landscape, and momentum from key political and industry players to facilitate stem cell innovation may create an opportune backdrop for a significant reduction in the U.S. Food and Drug Administration's regulatory framework for stem cells, say attorneys at Sheppard Mullin.
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How Importers Can Minimize FCA Risks Of Tariff Mitigation
False Claims Act risks are inherent in many tariff mitigation strategies, making it important for importers to implement best practices to identify and report potential violations of import regulations before they escalate, says Samuel Finkelstein at LMD Trade Law.
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10 Practical Takeaways From FDA's Biopharma AI Guidance
Recent guidance from the U.S. Food and Drug Administration provides much-needed insight on the usage of artificial intelligence in producing information to support regulatory decision-making regarding drug safety, with implications ranging from life cycle maintenance to AI tool acquisition, say attorneys at Covington.
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Lawmakers Shouldn't Overlook Rare Disease Therapies' Value
As the ORPHAN Cures Act is pending in Congress, policymakers assessing the value of certain drugs for price regulation should consider data beyond what is collected in clinical trials, say Alice Chen at the University of Southern California, and Molly Frean and Yao Lu at Analysis Group.
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What Trump's Order Means For The Legal Status Of IVF
An executive order signed by President Donald Trump last month signals the administration's potential intention to increase protections for in vitro fertilization services, though more concrete actions would be needed to resolve the current uncertainty around IVF access or bring about a binding legal change, says Jeanne Vance at Weintraub Tobin.
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Mitigating Tariff Risks For Healthcare In US And Canada
Healthcare stakeholders should take steps to evaluate the impact of cross-border tariffs, as the historically strong ties between Canada and the U.S. demonstrate the potential for real disruption and harm to the healthcare industry in both countries, say attorneys at Norton Rose.
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What's At Stake In High Court Transgender Care Suit
The outcome of U.S. v. Skrmetti will have critical implications for the rights of transgender youth and their access to gender-affirming care, and will likely affect other areas of law and policy involving transgender individuals, including education, employment, healthcare and civil rights, say attorneys at ArentFox Schiff.
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6 Laws Transforming Calif.'s Health Regulatory Framework
Attorneys at Hooper Lundy discuss a number of new California laws that raise pressing issues for independent physicians and small practice groups, ranging from the use of artificial intelligence to wage standards for healthcare employees.
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Anticipating Calif. Oversight Of PE Participation In Healthcare
A new bill recently introduced in the California Senate revives last year's attempt to increase oversight of healthcare transactions involving private equity groups and hedge funds, meaning that attorneys may soon need to assess the compliance status of existing management relationships and consider modifying contract terms, says Andrew Demetriou at Husch Blackwell.
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Considering The Future Of AI Regulation On Health Sector
As Texas looks to become the next state to pass a comprehensive law regulating artificial intelligence, the healthcare industry should consider how AI regulation will continue to evolve in the U.S. and how industry members can keep up with compliance considerations, say attorneys at Kirkland & Ellis.