Policy & Compliance

  • January 29, 2026

    DOL Proposes Pharmacy Benefit Manager Fee Disclosure Rule

    The U.S. Department of Labor's employee benefits subagency Thursday proposed a rule to require new fee disclosures from pharmacy benefit managers, which act as intermediaries between drugmakers, pharmacies and insurers, to help managers of employee health plans ensure PBM services are reasonably priced.

  • January 29, 2026

    Conn. Drug Price Cap Survives Distributor Challenge, For Now

    The Second Circuit has declined a bid to immediately block the state of Connecticut from enforcing a cap on generic and off-patent drug prices while the Healthcare Distribution Alliance, a collection of wholesale distributors, challenges the new law.

  • January 29, 2026

    United Healthcare Beats Class Cert. Bid Over Breast Surgery

    A New Jersey federal judge on Wednesday declined to certify a proposed class of United Healthcare Insurance plan participants who were denied coverage for post-mastectomy breast reconstruction surgery, finding that she can't determine which standard of review applies to each plan's varying language without conducting individualized, fact-specific inquiries. 

  • January 29, 2026

    Sandoz, Teva Beat Malicious Prosecution Claims, For Now

    Sandoz and Teva have won a reprieve from a former pharmaceutical marketing executive claiming the drugmakers and their officers offered him up to federal prosecutors with fabricated assertions of price-fixing, with a New York federal judge concluding the suit "does not come close" to the standard for malicious prosecution.

  • January 28, 2026

    Ambulance Billing Co. Settles Data Breach Claims

    An ambulance billing service will pay a total of $515,000 to the states of Massachusetts and Connecticut and take measures to improve its data security to settle allegations stemming from a 2022 breach, the Massachusetts Attorney General's Office announced Wednesday.

  • January 28, 2026

    ArentFox Schiff Launches Longevity Industry Group

    ArentFox Schiff LLP on Wednesday announced the launch of a group geared toward advising companies focused on advancing wellness, preventive health care and the longevity of life.

  • January 28, 2026

    Generics Makers Want Hospital Drug Data In Price-Fixing MDL

    A group of 150 hospitals suing generic-drug makers for alleged price fixing in multidistrict litigation should hand over data on their drug purchases, the drugmakers have told a Pennsylvania federal court, arguing they don't sell directly to the hospitals and therefore have no records themselves. 

  • January 27, 2026

    Ohio PBM Suit Belongs In Federal Court, 6th Circ. Rules

    The Sixth Circuit on Tuesday ruled that Ohio's lawsuit accusing pharmacy benefit managers of driving up prescription prices through rebate schemes belongs in federal court, saying in an opinion recommended for publication that the suit imposes liability on conduct undertaken at the direction of a federal officer.

  • January 27, 2026

    Texas AG's Vaccine Probe Draws Fire From Health Experts

    Public health experts are condemning a Texas Attorney General inquiry into Pfizer, UnitedHealth Group and others for allegedly tapping unlawful financial incentives behind childhood vaccines.

  • January 27, 2026

    Texas AG Says Nurse Practitioner Is Shipping Abortion Drugs

    The Texas attorney general told a state court that a Delaware-based nurse practitioner and the organization she operates have shipped abortion pills to Texas, saying Tuesday that the defendants have publicly acknowledged that they send abortion pills to the Lone Star State.

  • January 27, 2026

    CBP's Medical Care Oversight Needs Improvement, GAO Says

    A report issued by the U.S. Government Accountability Office found that U.S. Customs and Border Protection sometimes failed to provide proper medical oversight for certain people in its custody, violating its own policies and guidance for medical care.

  • January 27, 2026

    Novo Nordisk Advances Telehealth Co. Ozempic Ripoff Suit

    A Washington federal judge refused Monday to toss Novo Nordisk's lawsuit accusing telehealth platform Invigor Medical of falsely advertising Ozempic alternatives, ruling that the drugmaker has shown a "tangible stake" in correcting Invigor's alleged practice of misleading consumers into believing its compounded drugs are equivalent to federally approved medications.

  • January 27, 2026

    Long Road For Kaiser Whistleblowers Ends In Historic Payout

    The whistleblowers behind a massive Medicare Advantage "upcoding" case spent years in isolation before a historic settlement was finally reached.

  • January 27, 2026

    Clinic Workers' Vax Bias Suit Needs 2nd Look, 3rd Circ. Says

    A split Third Circuit panel reinstated a religious bias suit claiming Geisinger Medical Center illegally required workers who opposed its COVID-19 vaccine mandate to undergo nasal testing, saying the employees should have been allowed to explore whether a chemical in the nasal swabs made that accommodation unreasonable.

  • January 27, 2026

    Divisions Emerge At 2nd Circ. Over Reproductive Rights Law

    A Second Circuit panel appeared split Tuesday on whether an anti-abortion group challenging a New York state law that bars employers from penalizing workers based on their reproductive health decisions has standing to challenge the law as unconstitutional.

  • January 26, 2026

    Generics Makers Fight Cert. In Cholesterol Drug Pricing MDL

    Generic-drug makers sought to defeat a bid to certify proposed classes comprising thousands of pharmacies that indirectly purchased and resold generics at the center of sprawling price-fixing litigation, telling a Pennsylvania federal court Monday that certification would result in an "unmanageable trial."

  • January 27, 2026

    Record FCA Haul Sends 'Loud' Message On Federal Priorities

    Aggressive enforcement by President Donald Trump's administration and the qui tam bar's success prosecuting fraud even without government intervention helped fuel the explosion in recoveries under the False Claims Act last year, experts say.

  • January 26, 2026

    Anthem Seeks Dismissal Of 'Ghost Network' Class Action

    A proposed class action's allegations that Anthem Health Plans maintains inaccurate mental health directories known as ghost provider networks aren't true and are "legally deficient," the insurer and its parent company, Elevance Health Inc., argued while urging a Connecticut federal court to toss the suit.

  • January 26, 2026

    3rd Circ. Finds NJ Officials Shielded From COVID Deaths Suit

    A proposed class action on behalf of the families of roughly 10,000 nursing home residents who died early in the COVID-19 pandemic cannot proceed against New Jersey officials over their response, the Third Circuit has ruled, finding the officials are protected through qualified immunity.

  • January 26, 2026

    Novo Nordisk Faces Class Claims Over GLP-1 Patent Tactics

    A South Carolina drug company has launched a proposed class action against major pharmaceutical company Novo Nordisk, alleging it engaged in anticompetitive behavior to prolong its monopoly against generic competition for the GLP-1 drug Victoza.

  • January 23, 2026

    Providers Oppose Credit Bureaus' Medical Debt Appeal

    A proposed class of medical providers and collection agencies accusing Equifax, Experian and TransUnion of colluding to exclude medical debt under $500 from consumer credit reports is opposing a bid by the credit bureaus to expedite an appeal of a ruling that denied dismissal of the claims.

  • January 23, 2026

    High Court's Med Mal Ruling Won't Spark Rise In Suits

    The U.S. Supreme Court's recent ruling that a Delaware medical malpractice statute can't be enforced in federal court won't cause a noticeable rise in cases, experts said, but it could lay the groundwork for other cases involving conflicting procedural state laws.

  • January 23, 2026

    $200M Sun, Taro Generics Deal Gets Final OK

    A Pennsylvania federal judge granted final approval Friday for a $200 million deal resolving employee benefits plans' claims against Sun Pharmaceutical and Taro Pharmaceuticals in the sprawling price-fixing litigation against generic-drug makers, while again ensuring the claims from dozens of state attorneys general remain untouched by the settlement.

  • January 22, 2026

    DC Circ. Presses Feds To Justify Military Trans Ban

    A D.C. Circuit judge pressed the government on Thursday to justify a policy that effectively bars transgender people from serving in the military, questioning why Secretary of Defense Pete Hegseth imposed a more stringent policy than the first Trump administration did. 

  • January 22, 2026

    6th Circ. Revives Law Firm Worker's Anthem Coverage Fight

    Anthem Blue Cross Blue Shield's decision denying coverage for a law firm employee's son to continue receiving residential mental health treatment was arbitrary and capricious, the Sixth Circuit ruled Thursday, saying the insurer needs to carry out a "full and fair review of the requested coverage."

Expert Analysis

  • What High Court's Tenn. Trans Care Ruling Means Nationally

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    The U.S. Supreme Court's decision in U.S. v. Skrmetti, upholding a Tennessee ban on gender-affirming medical care for minors, is fairly limited in scope and closely tailored to the specific language of Tennessee's law, but it may have implications for challenges to similar laws in other states, say attorneys at Hall Render.

  • High Court ACA Ruling May Harm Preventative Care

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    The U.S. Supreme Court's decision in Kennedy v. Braidwood last week, ruling that the U.S. Department of Health and Human Services secretary has authority over an Affordable Care Act preventive care task force, risks harming the credibility of the task force and could open the door to politicians dictating clinical recommendations, says Michael Kolber at Manatt.

  • Rising Enforcement Stakes For Pharma Telehealth Platforms

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    Two pieces of legislation recently introduced in Congress could transform the structure and promotion of telehealth arrangements as legislators increasingly scrutinize direct-to-consumer advertising platforms, potentially paving the way for a new U.S. Food and Drug Administration policy with bipartisan support, say attorneys at Sheppard Mullin.

  • 3 Judicial Approaches To Applying Loper Bright, 1 Year Later

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    In the year since the U.S. Supreme Court overturned Chevron deference in its Loper Bright Enterprises v. Raimondo decision, a few patterns have emerged in lower courts’ application of the precedent to determine whether agency actions are lawful, say attorneys at Husch Blackwell.

  • How Providers Can Brace For Drug Pricing Policy Changes

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    Though it's uncertain which provisions of the Trump administration's executive order aimed at addressing prescription drug costs will eventually be implemented, stakeholders can reduce potential negative outcomes by understanding pathways that could be used to effectuate the order's directives, say attorneys at McDermott.

  • Debunking 4 Misconceptions Around Texas' IV Therapy Law

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    Despite industry confusion, an IV therapy law enacted in Texas last week may actually be the most business-friendly regulatory development the medical spa industry has seen in recent years, says Keith Lefkowitz at Hendershot Cowart.

  • Legacy Of 3 Justices Should Guide Transgender Rights Ruling

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    Three Republican-appointed U.S. Supreme Court justices — Anthony Kennedy, Sandra Day O'Connor and David Souter — gave rise to a jurisprudence of personal liberty that courts today invoke to protect gender-affirming care, and with the court now poised to decide U.S. v. Skrmetti, it must follow the path that they set, says Greg Fosheim at McDermott.

  • Recent Reports Shed Light On Section 340B's Effectiveness

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    Recent analyses of the Section 340B program's effectiveness in helping patients afford drugs in Minnesota reinforce concerns about the program's lack of transparency and underscore the need for further evaluation of whether legislative reform should be enacted, say William A. Sarraille at the University of Maryland, and Andrée-Anne Fournier and Molly Frean at Analysis Group.

  • What Parity Rule Freeze Means For Plan Sponsors

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    In light of a District of Columbia federal court’s recent decision to stay litigation challenging a Mental Health Parity and Addiction Equity Act final rule, as well as federal agencies' subsequent decision to hold off on enforcement, attorneys at Morgan Lewis discuss the statute’s evolution and what plan sponsors and participants can expect going forward.

  • CMS Guidance May Complicate Drug Pricing, Trigger Lawsuits

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    Recent draft guidance from the Centers for Medicare & Medicaid Services proposes to expand the scope of what counts as the same qualifying single-source drug, which would significantly alter the timeline for modified drugs facing price controls and would likely draw legal challenges from innovator drug companies, say attorneys at Debevoise.

  • 3 Takeaways From Recent Cyberattacks On Healthcare Cos.

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    For the healthcare industry, the upward trend in styles of cyberattacks, costs, and entities targeted highlights the critical importance of proactive planning to help withstand the operational, legal and reputational turmoil that can follow a data breach, say attorneys at Troutman Pepper.

  • Most-Favored Nation Drug Pricing Could Shake Up US Pharma

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    Recent moves from the executive and legislative branches represent a serious attempt to revive and refine the first Trump administration's most-favored-nations model for drug pricing, though implementation could bring unintended consequences for pharmaceutical manufacturers and will likely draw significant legal opposition, say attorneys at Morgan Lewis.

  • How Focus On Menopause Care Is Fueling Innovation, Access

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    Recent legislative developments concerning the growing field of menopause care are creating opportunities for increased investment and innovation in the space as they increase access to education and coverage, say attorneys at Kirkland.