Policy & Compliance
-
March 03, 2026
Wells Fargo Escapes Ex-Workers' Prescription Cost Suit
Former Wells Fargo workers on the employer healthcare plan failed to show that the company violated federal benefits law by allowing them to overpay for prescription drugs, a Minnesota federal judge found Tuesday, tossing the proposed class action.
-
March 03, 2026
3 Argument Sessions For Healthcare Attys To Watch In March
The Ohio Supreme Court will hear the state attorney general's defense of a ban on gender transition care for minors, while the Third Circuit will consider Janssen's bid to overturn a nearly $1.64 billion False Claims Act judgment against it concerning its marketing of two HIV medications. Here, Law360 looks at three oral argument sessions to watch out for in the coming month.
-
March 03, 2026
States Can't Duck Regeneron Counterclaims In FCA Case
Eleven states pursuing a False Claims Act case against Regeneron Pharmaceuticals over what they say were inflated reimbursements for an eye drug can't block counterclaims by the drugmaker on sovereign immunity grounds, a Massachusetts federal judge has ruled.
-
March 03, 2026
Judge Won't Rely On DOJ 'Decency' In Trans Records Case
A Pennsylvania federal judge blocked the U.S. Department of Justice from getting patient-specific records of gender-affirming care at the University of Pittsburgh Medical Center Children's Hospital, excoriating the government's request and its reasoning for demanding the data.
-
March 03, 2026
1st Circ. Won't Revive Boston's Opioid Claims Against PBMs
Boston lost its bid to revive opioid crisis-related claims against two pharmacy benefit managers, as a First Circuit panel affirmed that the suit came years too late.
-
March 03, 2026
Fla. Billing Co. To Settle With Feds Over $15M Medicare Fraud
The U.S. government has settled its False Claims Act lawsuit with a medical coding and billing business it accused of aiding a Miami-based laboratory in fraudulently billing Medicare for more than $15 million in genetic tests.
-
March 02, 2026
High Court Blocks California's Gender Privacy Rule
The U.S. Supreme Court on Monday reinstated a lower court order that barred California public schools from allowing transgender and gender-nonconforming students to use different names and pronouns at school without their parents' knowledge or consent while the order is appealed.
-
March 02, 2026
Texas AG Says Gender Care Ban Includes Mental Health
Mental-health professionals in Texas risk losing their licenses and public funding if they "facilitate" the gender-affirming care banned under state law, said an opinion issued Friday by Attorney General Ken Paxton, which calls them the "gatekeepers."
-
March 02, 2026
Anthem Avoids Patients' Ghost Network Suit In NY
A New York federal judge on Monday granted Anthem escape from a proposed class action from patients who alleged inaccuracies in the insurer's mental health provider directory violated New York state laws, holding their claims were preempted by federal employee health benefits law.
-
March 02, 2026
J&J Unit Wins Bid To Revive Talc Libel Suit With New Basis
A New Jersey federal judge has revived a bankrupt Johnson & Johnson talc subsidiary's trade libel claim over a 2020 scientific article linking asbestos in talc to mesothelioma, finding that new evidence and allegations concerning the authenticity of the author's data are enough to survive a motion to dismiss.
-
March 02, 2026
Drugmakers Warn Justices Oregon Pricing Law Risks Secrets
Pharmaceutical manufacturers have asked the U.S. Supreme Court to overturn Oregon's drug‑pricing transparency law, arguing it forces companies to publicly justify their pricing decisions and give up valuable trade secrets in violation of the First Amendment and the Constitution's takings clause.
-
February 27, 2026
Recovery Provider Asks For Halt To Anthem's Claims Practices
A Colorado mental health and substance use treatment facilities operator and its patients asked a Colorado federal judge to stop Anthem Blue Cross and Blue Shield's claims practices, alleging its process violates federal benefits and mental health parity laws and disrupts access to lifesaving care.
-
February 27, 2026
3rd Circ. Preview: Janssen, Penn State Prof. Seek Relief
A packed March argument calendar will put several high‑stakes disputes before the Third Circuit, including a billion‑dollar False Claims Act judgment and challenges at the intersection of academic freedom, DEI programming, cannabis‑sector finance and campus Title IX procedures.
-
February 27, 2026
Credit Bureaus Fight Bid To Add Plaintiffs, Claims To Suit
Medical providers and a collection agency in a proposed class action accusing Equifax, Experian and TransUnion of conspiring to exclude less than $500 in medical debt from consumer credit reports lack good cause to again amend their complaint, the credit reporting agencies told a federal court.
-
February 27, 2026
Judge Says RFK Jr.-Tied Group Can't Join Childhood Vax Suit
A Massachusetts judge said an anti-vaccine advocacy group with ties to U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. cannot join a lawsuit over the federal government's new childhood vaccine schedule, a day after the government said it opposed the group intervening in the case.
-
February 27, 2026
Minn. State Sens. Introduce Medical Psilocybin Bill
A pair of Minnesota state senators have introduced a bill to create and regulate a medical psilocybin use program, which would allow residents over 21 with qualifying medical conditions to cultivate and use the drug to treat their conditions.
-
February 27, 2026
121-Year-Old Ruling Still A Shot In The Arm For Vax Mandates
Having already withstood five global pandemics, 21 presidencies and more than a century of developments in both the law and public health policy, the U.S. Supreme Court's most durable precedent blessing mandatory vaccination is well positioned to survive a new wave of challenges, experts say.
-
February 27, 2026
NYC Health Center Sues HHS Over $31M Medicare Repayment
The U.S. Department of Health and Human Services is unlawfully attempting to recoup more than $31 million in Medicare overpayments made during the COVID-19 pandemic, a New York City skilled nursing center told a federal court, saying it shouldn't have to repay the money.
-
February 27, 2026
Meta Must Face Worker's Transgender Health Coverage Suit
Meta can't escape a transgender employee's lawsuit claiming the company's health plan unlawfully denied her coverage of gender-affirming surgeries, an Oregon federal judge ruled, rejecting the company's assertion that she hadn't adequately alleged the plan covered her desired procedures.
-
February 27, 2026
DOL Extends Comment Window On PBM Transparency Rule
The U.S. Department of Labor said Friday that the public will be given more time to comment on a new proposed rule that would require pharmacy benefit managers to disclose how much money they've received while serving as intermediaries between drugmakers, pharmacies and insurers.
-
February 26, 2026
Health Plans Lack Expert In Avandia MDL, 3rd Circ. Told
Counsel for GlaxoSmithKline urged a Third Circuit panel on Thursday to undo an order certifying a class of health plans in the multidistrict litigation over the company's alleged deceptive marketing of the diabetes drug Avandia, arguing the plaintiffs didn't have the experts necessary to support their case.
-
February 26, 2026
$95M Kaiser Row Tees Up Challenge For Fund Returns
Kaiser Foundation Health Plan’s lawsuit seeking $95 million in coverage for a recently settled whistleblower action raises an important challenge to policy language that limits coverage for claims related to returning funds received from government agencies, as policyholder attorneys call for a broad interpretation of the policy language.
-
February 26, 2026
Feds Back Pharma In 340B Contract Pharmacy Disputes
State laws that block drugmakers from imposing restrictions on federally funded hospitals and the contract pharmacies they use to dispense discounted drugs under the 340B drug discount program are violating federal law, the Trump administration said, siding with manufacturers in their bid to strike down these laws.
-
February 25, 2026
Online Abortion Pill Provider Illegally Ships To Texas, AG Says
Texas Attorney General Ken Paxton sued Aid Access, its founder and a California doctor in state court Tuesday alleging they operate an "abortion-by-mail enterprise" that ship abortion-inducing drugs to Texas residents, which is endangering the lives of unborn children and their mothers.
-
February 25, 2026
White House Cites Fraud, Freezes $259M In Minn. Medicaid
The Trump administration on Wednesday said it would hold back $259.9 million in Medicaid funding for Minnesota as part of what it called an unprecedented effort to combat fraud in programs that support low-income families.
Pharma In Uphill Fight With Contract Pharmacy Laws
Silence in the federal law governing the 340B discount drug program on the issue of contract pharmacies is working against drugmakers in their effort to stop states from protecting provider agreements with pharmacies.
AbbVie Tests Exclusion Strategy In Drug Price Fight
Following a series of drugmaker losses in suits challenging Medicare drug price negotiations, AbbVie Inc. is trying something new in a challenge focused on Botox and a legal exclusion for drugs made from human plasma.
Oregon Racing to Block Predatory Hospice Schemes
As California's revamped laws trigger a massive crackdown on hospice fraud, Oregon lawmakers are moving to protect their residents against an influx of predatory operators. The state currently lacks robust hospice regulations, making it an attractive target for bad actors seeking a foothold as they are pushed out of neighboring markets, palliative care advocates say.
Expert Analysis
-
Prepping For The Future Of No Surprises Act Enforcement
This year is expected to be a transition point for the No Surprises Act framework from regulatory delay to operational enforcement, so stakeholders should use this time to stress-test systems, clean up processes and prepare for enforcement, say attorneys at Akerman.
-
Unpacking Key Themes From NY's New Healthcare Strategy
New York Gov. Kathy Hochul's 2026 State of the State agenda, read together with the state's fiscal year 2027 executive budget, reflect a clear framework to utilize Medicaid as the state's operating platform for healthcare reform, say attorneys at Sheppard.
-
Trans Care Enforcement Landscape Is Evolving Quickly
The recent coordinated federal effort to reshape pediatric gender-affirming care through enforcement and funding pressure has created a rapidly evolving regulatory environment marked by shifting risk assessments and potential downstream market effects for healthcare institutions and life sciences companies, say attorneys at Arnall Golden.
-
11th Circ. May Bring Tectonic Shift To FCA Qui Tam Actions
The Eleventh Circuit's upcoming decision in Zafirov v. Florida Medical Associates, assessing whether the False Claims Act permits ordinary citizens to stand as officers of the federal government, could significantly limit private relators' ability to bring FCA actions, say attorneys at Saul Ewing.
-
To Survive FCA Actions, Small Cos. Must Take Offensive Steps
A fumbled response to False Claims Act allegations can doom lower-middle-market businesses, and with FCA enforcement hitting record levels for two years, smaller companies must have offensive strategies ready that focus their limited resources on defeating civil qui tam and federal criminal actions, says Derrelle Janey at Olshan Frome.
-
Record FCA Recoveries Signal Intensified Healthcare Focus
In its recently released False Claims Act statistics, the U.S. government's emphasis on record healthcare recoveries and government-initiated healthcare matters last year indicates robust enforcement ahead, though the administration's focus on current policy objectives also extends beyond the healthcare sector, say attorneys at Epstein Becker.
-
A Potential Shift In FDA's Approach To Drug Trial Design
Recent guidance released by the U.S. Food and Drug Administration clarifying how Bayesian approaches — which combine prior knowledge with new data — may be used in clinical trials reflects the agency's continued interest in innovative trial designs that may accelerate drug approvals, say attorneys at Alston & Bird.
-
What FDA Guidance Means For Future Of Health Software
Two significant final guidance documents released by the U.S. Food and Drug Administration last month reflect a targeted effort to ease innovation friction around specific areas, including singular clinical decision support recommendations and sensor-based wearables, while maintaining established regulatory boundaries, say attorneys at Covington.
-
How State FCA Activity May Affect Civil Fraud Enforcement
A growing trend of state attorneys general enforcing their False Claims Act analogues independently of the U.S. Department of Justice carries potential repercussions for civil fraud enforcement and qui tam litigation considerations, say Li Yu at Bernstein Litowitz, Ellen London at London & Naor and Gwen Stamper at Vogel Slade.
-
Wage-Based H-1B Rule Amplifies Lottery Risks For Law Firms
Under the wage-based H-1B lottery rule taking effect Feb. 27, law firms planning to hire noncitizen law graduates awaiting bar admission should consider their options, as the work performed by such candidates may sit at the intersection of multiple occupational classifications with differing chances of success, says Jun Li at Reid & Wise.
-
Assessing Compliance Risks Around TrumpRx Participation
As there are novel compliance obligations and potential political opposition related to the new TrumpRx online drug platform, companies intending to participate on the site should consider the pressure points that are likely to draw enforcement scrutiny, say attorneys at Sheppard.
-
Predicting Actual Impact From CDC's New Vaccine Guidance
Recent federal changes to the childhood immunization schedule, reducing the number of vaccine recommendations from 18 to 11, do not automatically create enforceable obligations for parents, schools or healthcare providers, but may spur litigation and other downstream effects on school policies and state guidelines, says Mehdi Sinaki at Michelman & Robinson.
-
What Rescheduling Means For Cannabis Labels, Marketing
The proposed reclassification of cannabis is expected to bring heightened scrutiny of labeling, advertising and marketing from the U.S. Food and Drug Administration and the Federal Trade Commission, but the brands that tighten evidence, standardize operations and professionalize marketing controls now will see fewer surprises and better outcomes, say attorneys at Wilson Elser.