Policy & Compliance

  • 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.

  • February 25, 2026

    Fla. Court Blocks Doctor Dispensing Rules For Worker Claims

    A Florida panel on Wednesday set aside a state agency's proposed rules that would include doctors in a workers' compensation law that gives patients an "absolute choice" over which pharmacist can fill their prescriptions, saying the proposals go beyond what lawmakers intended.

  • February 25, 2026

    Centene Says Filed Rate Doctrine Dooms RICO, Fraud Claims

    Centene Corp. urged an Illinois federal judge Tuesday to grant it partial judgment in a proposed class action by patients alleging the company violated racketeering laws and cheated them out of billions with bogus policies, arguing the filed rate doctrine bars the refunds they seek for alleged overcharges.

  • February 25, 2026

    Pakistan Native Pleads Not Guilty To $10M Healthcare Fraud

    A native of Pakistan who is living in Texas pled not guilty Wednesday to a Chicago indictment claiming he participated in an alleged $10 million healthcare fraud and money laundering scheme involving fake medical companies that filed claims for items and services they never provided.

  • February 25, 2026

    9th Circ. Rules K-12 Mental Health Grants Must Continue

    The U.S. Department of Education must fund K-12 mental health grants given to public schools to help students cope with school shootings, the Ninth Circuit ruled, denying the agency's emergency request to pause a lower court's permanent injunction pending an appeal. 

Expert Analysis

  • Traditional FCA Enforcement Surges Amid Shifting Priorities

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    The U.S. Department of Justice’s January report on False Claims Act enforcement in fiscal year 2025 reveals that while the administration signaled its intent to expand FCA enforcement into new areas such as tariffs, for now the greatest exposure remains in traditional areas like healthcare — in which the risk is growing, say attorneys at Debevoise.

  • 3 Key Ohio Financial Services Developments From 2025

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    Ohio's banking and financial services sector saw particularly notable developments in 2025, including a significant Ohio Supreme Court decision on creditor disclosure duties to guarantors in Huntington National Bank v. Schneider, and some major proposed changes to the state's Homebuyer Plus program, says Alex Durst at Durst Kerridge.

  • Rescheduling Cannabis Marks New Tax Era For Operators

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    As the attorney general takes steps to move cannabis from Schedule I to Schedule III of the Controlled Substances Act, operators and advisers should prepare by considering the significant changes this will bring from tax, state, industry and market perspectives, says Michael Harlow at CohnReznick.

  • Justices' Med Mal Ruling May Spur Huge Shift For Litigators

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    The U.S. Supreme Court’s recent decision in the medical malpractice suit Berk v. Choy, holding that a Florida procedural requirement does not apply to medical malpractice claims filed in federal court, is likely to encourage eligible parties to file claims in federal court, speed the adjudicatory process and create both opportunities and challenges for litigators, says Thomas Kroeger at Colson Hicks.

  • 5 Drug Pricing Policy Developments To Watch In 2026

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    2026 may prove to be a critical year for drug pricing in the U.S., with potential major shifts including several legislative initiatives moving forward after being in the works for years, and more experimentation on the horizon concerning GLP-1s and Section 340B pricing, say attorneys at Manatt.

  • Regulatory Uncertainty Ahead For Organ Transplant System

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    Pending court cases against a Centers for Medicare and Medicaid Services final rule that introduced a competition-centric model for assessing organ procurement organizations' performance will significantly influence the path forward for such organizations and transplant hospitals, say attorneys at Crowell & Moring.

  • Key False Claims Act Trends From The Last Year

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    The False Claims Act remains a powerful enforcement tool after some record verdicts and settlements in 2025, and while traditional fraud areas remain a priority, new initiatives are raising questions about its expanding application, says Veronica Nannis at Joseph Greenwald.

  • It's Too Soon To Remove Suicide Warnings From GLP-1 Drugs

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    The U.S. Food and Drug Administration's decision this month to order removal of warnings about the risk of suicidal thoughts from GLP-1 weight-loss drugs is premature — and from a safety and legal standpoint, the downside of acting too soon could be profound, says Sean Domnick at Rafferty Domnick.

  • What To Know About DOL's New FLSA, FMLA Opinion Letters

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    The U.S. Department of Labor kicked off 2026 by releasing several opinion letters addressing employee classification, incentive bonuses and intermittent leave, reminding employers that common practices can create significant risk if they are handled inconsistently or without careful documentation, say attorneys at Woods Rogers.

  • What Changed For Healthcare Transaction Law In 2025

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    Though much of the legislation introduced last year to expand state scrutiny of healthcare transactions did not pass, investors should pay close attention to the overarching trends, which are likely to continue in this year's legislative sessions, say attorneys at Ropes & Gray.

  • Expect State Noncompete Reforms, FTC Scrutiny In 2026

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    Employer noncompete practices are facing intensified federal scrutiny and state reforms heading into 2026, with the Federal Trade Commission pivoting to case-by-case enforcement and states continuing to tighten the rules, especially in the healthcare sector, say attorneys at DLA Piper.

  • CMS 2027 Proposal Is Mixed Bag For Medicare Advantage

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    The Centers for Medicare and Medicaid Services' recent proposed rule for the Medicare Advantage and Part D programs gives small organizations reason for optimism, although certain elements may be inconsistent with the Centers' desire to enhance competition, says Christine Clements at Sheppard Mullin.

  • 3 Key Takeaways From Planned Rescheduling Of Cannabis

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    An executive order reviving cannabis rescheduling represents a monumental change for the industry and, while the substance will remain illegal at the federal level, introduces several benefits, including improving state-legal cannabis operators' tax treatment, lowering the industry's legal risk profile, and leaving state-regulated markets largely intact, say attorneys at Dentons.