Policy & Compliance
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March 19, 2026
11th Circ. Partially Reopens Aetna Twin Birth Coverage Fight
The Eleventh Circuit on Thursday undid Aetna's escape from a worker's coverage dispute over an extended hospital stay for her newborn twins, agreeing with the lower court that allegations failed to state a claim for violating federal benefits law but holding that an amended complaint should have been allowed.
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March 19, 2026
Calif. Families Sue Rady Health Over Move To End Trans Care
Four families have asked a state judge to prevent California's largest pediatric health system from cutting off gender-affirming care for minors, alleging the move would violate state antidiscrimination laws and leave them scrambling to find new providers, some more than 100 miles away.
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March 19, 2026
CVS, Caremark Pocket Money Meant For Rebates, Suit Claims
CVS charges drug manufacturers "exorbitant" fees in exchange for pushing their products, then pockets the money instead of funneling it toward customer rebates as it promises, a federal lawsuit alleges, accusing the company of collecting billions of dollars at customers' expense and violating the anti-racketeering statute.
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March 18, 2026
Key Details As 3rd Circ. Ponders FCA's Fate, $1.6B J&J Fine
Third Circuit judges Wednesday explored divergent views of the False Claims Act's constitutionality and a record fraud verdict against Johnson & Johnson, expressing little eagerness to gut the FCA's whistleblower mechanism, and voicing uncertainty about evidence and jury instructions underpinning the drug promotion punishment.
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March 18, 2026
SelectQuote Looks To Escape Investors' Kickback Probe Suit
SelectQuote has asked a New York federal judge to dismiss a proposed class action accusing it of harming investors by concealing a kickback scheme, which is currently the subject of a suit by the U.S. Department of Justice, arguing the existence of the government's suit is not enough to show the shareholders were damaged.
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March 18, 2026
UnitedHealth Customers Denied Class Cert. In PrEP Suit
Two UnitedHealthcare customers can't turn their Affordable Care Act lawsuit against a company subsidiary into a class action, a Minnesota federal judge ruled Wednesday, denying the pair's bid to represent thousands of customers in litigation accusing the subsidiary of failing to approve full coverage for PrEP.
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March 18, 2026
Ed. Dept. Flouting Mental Health Funding Order, States Claim
The U.S. Department of Education is flouting orders that it fund K-12 mental health grants given to public schools by only partially funding the grants and threatening to withhold remaining funds, a group of state attorneys general told a Washington federal court.
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March 18, 2026
Doctor Gets 6½ Years For Healthcare Fraud, Tax Evasion
An Anchorage, Alaska, physician was sentenced to six and a half years in prison for committing over $16 million in healthcare fraud and tax evasion as part of a scheme that injected sick patients with the wrong medications or dosages, the federal government said Wednesday.
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March 18, 2026
ADA Challenge to Oregon Psilocybin Law Can Proceed
An Oregon federal judge Tuesday rejected the state's health regulator's bid for a favorable judgment in a suit brought under federal antidiscrimination law, seeking to broaden access for homebound patients to the state's regulated psilocybin program.
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March 18, 2026
Health Litigator Rejoins Holland & Knight From In-House Role
A former Holland & Knight LLP attorney has returned to the firm in Jacksonville, Florida, after a 10-year stint in-house at Florida Blue, a subsidiary of GuideWell Mutual Holding Corp.
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March 18, 2026
FDA Can't 'Refuse To File' Tobacco Applications, Suit Says
The maker and a seller of Zone nicotine pouches are suing the U.S. Food and Drug Administration in Texas federal court, alleging the agency stalled and eventually refused to file their marketing application, despite federal law requiring the FDA to either approve or deny such applications.
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March 17, 2026
The Legal Reasoning That Put RFK's Vax Panel On Ice
The legal reasoning behind a Massachusetts court's decision to freeze major changes to national vaccine policy is simpler than you might expect.
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March 17, 2026
9th Circ. Backs Rare FCA Theory In Huge Drug Prices Program
In a novel and potentially far-reaching decision, the Ninth Circuit on Tuesday revived a major hospital chain's False Claims Act suit accusing large pharmaceutical companies of massive overcharges in a prominent drug discount program where pricing disputes are common.
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March 17, 2026
Dr. Oz Claims Florida Also Has Healthcare Fraud Problem
Dr. Mehmet Oz, the administrator for the Centers for Medicare & Medicaid Services, announced Tuesday that he is taking his efforts to combat healthcare-related fraud to Florida, where he says millions of dollars have been wasted on schemes involving durable medical equipment.
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March 17, 2026
Chaperones Alone Not Enough To Prevent Abuse, Sidley Says
A BigLaw team interviewed more than 120 witnesses as part of an investigation into failures that allowed an OB-GYN to sexually assault patients for 25 years. The report contains broader lessons on how to better protect patients.
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March 17, 2026
Ex-Database Administrator Settles OT Claim
A former database administrator who accused Express Scripts and two other companies of misclassifying him as an independent contractor reached a $30,000 deal with the entities to settle his federal law claim, the parties told a New York federal court.
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March 17, 2026
State Lawmakers Take On Practice Limits: 3 Bills To Know
Law360 Healthcare Authority looks at some of the latest moves by state lawmakers to relax practice restrictions in Florida, New York and Minnesota.
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March 17, 2026
Bipartisan Bill To Waive $100K H-1B Fee Gets AMA Backing
Medical organizations and a bipartisan group of lawmakers are backing federal legislation introduced Tuesday that would exempt physicians and other healthcare workers from the Trump administration's $100,000 fee on H-1B visas.
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March 16, 2026
1st Circ. Affirms Block Of Trump's 'Unprecedented' Aid Freeze
The First Circuit on Monday mostly upheld a lower court's order blocking the Trump administration from enacting a "sweeping and unprecedented categorical 'freeze' of federal financial assistance," ruling that the states involved in the suit will likely successfully show that the federal government acted arbitrarily and capriciously.
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March 16, 2026
Judge Tosses Kaiser Whistleblowers' Claims After $556M Deal
A California federal court on Monday officially dismissed False Claims Act lawsuits from the federal government and three people alleging that Kaiser Permanente affiliates engaged in Medicare fraud, on the heels of Kaiser's $556 million settlement reached in January.
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March 16, 2026
Mich. Jury Awards $10M To Med Resident Fired During Leave
A Michigan state jury has awarded more than $10 million to a former medical student who said she was fired from a hospital's OB-GYN residency program after being forced to take a required licensing exam while on maternity leave.
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March 16, 2026
HHS' Childhood Vaccine Policy Changes Put On Ice
A Massachusetts federal judge on Monday blocked the Trump administration's modified childhood vaccine schedule and put all decisions made by Health Secretary Robert F. Kennedy Jr.'s federal vaccine policy committee on hold, finding they veered sharply from normal procedure and likely violated the law.
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March 16, 2026
Mass. City Accused Of Bias In Mental Health 911 Response
The city of Worcester, Massachusetts, was hit with a suit Monday claiming that its 911 response is inadequate and discriminatory towards people with mental disabilities because the armed police who usually show up are ill-equipped to deal with those calls and often make matters worse.
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March 13, 2026
'Swinging Dicks' Dissent Stirs Uproar Across 9th Circ. Bench
A raunchy dissent in litigation over transgender spa patrons prompted dozens of Ninth Circuit judges to denounce the "vulgar barroom talk" of a colleague, who returned fire by ridiculing his peers for adopting the "fastidious sensibilities of a Victorian nun."
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March 13, 2026
4th Circ. Brings Back Allergan Medicaid Overcharging Suit
A split Fourth Circuit panel on Friday revived a whistleblower suit accusing an Allergan Sales LLC predecessor of overcharging Medicaid by more than $680 million, saying the whistleblower plausibly alleged the company knowingly improperly aggregated discounts into "best prices" for drugs.
Expert Analysis
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Unique Issues Facing Brand-Compounder Patent Litigation
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.
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Pros And Cons Of FDA's Push For Nonprescription Drugs
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.
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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.
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High Court's 'Skinny Label' Case May Tackle Wider Questions
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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.