Policy & Compliance

  • March 10, 2026

    A Look At The Real Impact Of The FTC's PBM Settlements

    It may all come down to the details in a landmark settlement between the Federal Trade Commission and one of the biggest pharmacy benefit managers in the U.S., as delayed timelines and a key carve-out provision threaten to dampen sweeping changes to the larger system.

  • March 10, 2026

    5th Circuit Revives J&J Sales Rep's Wage Dispute

    A Texas federal court did not take into consideration relevant factors to determine whether a former Johnson & Johnson sales representative's failure to retain local counsel in his wage and hour suit represented excusable neglect, the Fifth Circuit ruled on Tuesday.

  • March 10, 2026

    Sanofi Says Judge Botched Insulin Device Patent Listings

    Sanofi-Aventis sparred with drug wholesalers over a Massachusetts federal magistrate judge's pronouncements that the parties should go to trial on claims the pharmaceutical giant used improper insulin device patent listings to anticompetitively protect the blockbuster Lantus insulin pen from competition.

  • March 10, 2026

    Lab's Aetna Payment Suit Survives, But With Deep Cuts

    A Connecticut federal judge ruled Aetna and its parent company, CVS Health Corp., must face a pared down lawsuit from a medical laboratory alleging it is owed $20.6 million in unpaid invoices.

  • March 10, 2026

    Wash. To Set Its Own Vaccine Schedule Under New State Law

    Washington Gov. Bob Ferguson has signed legislation that requires health plans to cover vaccines and other preventive care recommended by the state rather than the federal government, joining a movement toward states setting their own recommendations.

  • March 10, 2026

    4th Circ. Backs W.Va.'s Trans Care Coverage Exclusion

    The Fourth Circuit said Tuesday that West Virginia's Medicaid coverage exclusion for gender-affirming care passes constitutional muster and does not discriminate based on sex, basing its conclusion on a U.S. Supreme Court ruling that upheld Tennessee's ban on gender-affirming care for minors.

  • March 10, 2026

    CVS Can't 'Relitigate' Price-Gouging Class Cert.

    A Rhode Island federal judge refused to narrow the certified classes of health plans alleging CVS schemed with pharmacy benefit managers to overcharge insured health plans for generic drugs, finding that PBM Express Scripts' refusal to produce its contracts changes nothing about how the classes will be assessed.

  • March 10, 2026

    2nd Circ. Revives Geico's Suit Over Acupuncture Referrals

    A lower court erred in granting summary judgment to Geico after the insurer sued over reimbursements to an acupuncturist involved in what Geico said was a kickback scheme, the Second Circuit ruled Tuesday, finding the district court misinterpreted a state law detailing requirements for referrals and no-fault payments. 

  • March 10, 2026

    Minn. Medicaid Funds Case A Test For CMS Tactic

    Minnesota’s fight over $243 million in Medicaid funding frozen by the Trump administration sets up an unusual, politically tinged legal clash that may shape the government’s anti-fraud tactics in other states.

  • March 10, 2026

    Former Conn. Prosecutor Can Stay On Generic-Drug Case

    Connecticut's former assistant attorney general can continue to represent insurers Humana and Molina Healthcare Inc. in multidistrict litigation over alleged price-fixing of generic drugs, after the Pennsylvania federal judge overseeing the case agreed Monday with a report that the attorney has no information that had not already been shared.

  • March 10, 2026

    AFSCME Sues Trump Admin Over $600M Health Funding Cuts

    The American Federation of State, County and Municipal Employees is seeking to block a federal government directive to cancel more than $600 million in public health grants administered by the Centers for Disease Control and Prevention, alleging that the directive was issued to target Democratic-led states.

  • March 10, 2026

    Abortion Ban, Drug Pricing: Health Litigation Week In Review

    Indiana's abortion ban and religious freedom, a proposed class action over Express Scripts pricing, and a deal over abortion pill ads. Law360 looks at big legal developments from the past week.

  • March 09, 2026

    Texas AG Gets Temporary Ban On Chest Binder Sales

    A Texas state judge has issued a temporary restraining order against a New York-based online retailer of undergarments and chest binders for young women and teens from selling its clothing in the Lone Star State.

  • March 09, 2026

    Vehicle Manufacturer Strikes Deal In Tobacco Surcharge Suit

    Commercial vehicle manufacturer International Motors LLC has agreed to end a proposed class action claiming it unlawfully charges employees who use tobacco products an additional $600 per year for health insurance without providing an alternative to the fee, according to a filing in Illinois federal court.

  • March 09, 2026

    NC Providers Sue UnitedHealth Over 'Devastating' Cyberattack

    UnitedHealth Group Inc. and several of its subsidiaries are facing a proposed class action in North Carolina state court over a 2024 data breach that took its claims processing platform offline and allegedly delayed billions of dollars in reimbursements to providers.

  • March 09, 2026

    JPMorgan Trims But Can't Escape ERISA Drug Costs Suit

    A New York federal judge pared claims Monday against JPMorgan Chase & Co. in a suit from workers who alleged they paid too much for prescription drugs, but opened discovery on allegations that the bank's contract with its pharmacy benefit manager caused transactions prohibited by federal benefits law.

  • March 06, 2026

    ExThera Exec Hid Patient Deaths To Keep $10M Deal, DOJ Says

    Medical device company ExThera concealed the deaths of two U.S. patients treated with its unapproved blood filtration device at a clinic in Antigua, according to federal prosecutors, with the company agreeing to forfeit nearly $5.7 million and one executive facing up to three years in prison.

  • March 06, 2026

    Health Groups Back Bid To Bar Noncitizen Benefit Restrictions

    A group of public health organizations and scholars Friday urged a Rhode Island federal court to make permanent its order blocking the Trump administration from enacting a policy change basing access to a host of federally funded services on immigration status.

  • March 06, 2026

    FDA Vaccine Chief Prasad To Exit Agency For 2nd Time

    Dr. Vinay Prasad, the U.S. Food and Drug Administration's top vaccine regulator, will leave the agency in the coming weeks, FDA Commissioner Marty Makary said Friday.

  • March 06, 2026

    9th Circ. Mulls Whether Politics Tainted DOJ Trans Care Probe

    A Ninth Circuit panel on Friday grappled with where to draw the line between a legitimate law enforcement investigation and a politically motivated crusade, as the U.S. Department of Justice sought to revive a subpoena against a telehealth provider of gender-affirming medical care.

  • March 06, 2026

    Mass. Judge Told Vax Committee Must Be Fairly Balanced

    A key federal vaccine committee remains subject to statutory requirements that its membership be fairly balanced, a Massachusetts federal judge heard from both U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. and medical organizations challenging his overhaul of the group.

  • March 06, 2026

    Dentist Says She Was Fired For Exposing Medicaid Fraud

    A dentist filed suit against several West Michigan dental practices and a dental management company, claiming she was fired after reporting that the clinics billed Medicaid for dental procedures that were never performed.

  • March 05, 2026

    Telehealth Co. Swaps In Gordon Rees In Novo's GLP-1 Fight

    A telehealth platform facing allegations from Novo Nordisk that it falsely advertised Ozempic alternatives has picked new counsel in the dispute, withdrawing attorneys from Foley & Lardner LLP and Miller Nash LLP and substituting in two lawyers from Gordon Rees Scully Mansukhani LLP.

  • March 05, 2026

    Pharma Co. Investors Secure Class Cert. Over FDA Obstacles

    A Pennsylvania federal judge has granted certification to a group of Verrica Pharmaceuticals Inc. investors who claim the company defrauded them by hiding obstacles it faced in obtaining approval from the U.S. Food and Drug Administration for its lead product, though she made a slight change to the class definition to avoid what she called a "heads I win, tails you lose strategy."

  • March 05, 2026

    9th Circ. Denies Bail Pending Nurse Wage-Fixing Appeal

    A Ninth Circuit panel summarily refused to allow a Las Vegas home nursing executive to avoid prison while appealing the U.S. Department of Justice's first-ever criminal wage-fixing conviction.

Expert Analysis

  • Lessons From Justices' Split On Major Questions Doctrine

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    The justices' varied opinions in Learning Resources v. Trump, which held the International Emergency Economy Powers Act did not confer the power to impose tariffs, offer a meaningful window into the U.S. Supreme Court's perspective on the major questions doctrine that will likely shape lower courts' approach to executive action challenges, say attorneys at Venable.

  • Drug Wholesaler's DPA Shows Imperfect Efforts Still Count

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    Atlantic Biologicals’ recent deferred prosecution agreement with federal prosecutors for allegedly distributing controlled substances to pill mill pharmacies demonstrates that even subpar cooperation, when combined with genuine remediation and strategic advocacy, can yield outcomes that protect a company's long-term interests, says Jonathan Porter at Husch Blackwell.

  • Key Takeaways As HRSA Aims To Revive 340B Rebate Pilot

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    The U.S. Department of Health and Human Services' recent request for feedback on the 340B Rebate Model Pilot Program demonstrates that it intends to correct the model's procedural defects, which is positive news for participating manufacturers, but a setback for covered entities, say attorneys at Manatt.

  • Unique Issues Facing Brand-Compounder Patent Litigation

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    Recent litigation and potential enforcement action against Hims & Hers Health raise questions about how compounders and branded pharmaceuticals companies would be positioned in patent litigation as compared to generics companies, which would require strategies different from those that would be used in traditional Hatch-Waxman Act litigation, say attorneys at Morgan Lewis.

  • Pros And Cons Of FDA's Push For Nonprescription Drugs

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    The U.S. Food and Drug Administration's recent moves to shift more prescription drugs to over-the-counter status could increase access to important medications, but also bring potential safety risks and other trade-offs for drug companies, say attorneys at Hogan Lovells.

  • Prepping For The Future Of No Surprises Act Enforcement

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    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.

  • High Court's 'Skinny Label' Case May Tackle Wider Questions

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    The U.S. Supreme Court's upcoming decision in Hikma v. Amarin will have important ramifications for broader debates over what defines a generic version of a drug, and the pending case is already altering patent practice, say attorneys at Taft.

  • Unpacking Key Themes From NY's New Healthcare Strategy

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    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

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    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

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    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

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    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

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    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

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    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.