Policy & Compliance

  • April 20, 2026

    Justices Won't Block Multimillion-Dollar Health Fraud Retrial

    A man accused of pocketing $12 million as a part of a larger $140 million scheme to defraud public and private healthcare programs can't get out of a second trial, as the U.S. Supreme Court declined to review his case on Monday.

  • April 17, 2026

    9th Circ. Revives Doctor's PeaceHealth Whistleblower Suit

    A Ninth Circuit panel has reinstated a psychiatrist's claims that PeaceHealth Inc. retaliated against him for expressing concerns about potential Medicaid fraud at a Washington hospital, concluding on Friday that the district court overlooked evidence that the employer punished him by not renewing his employment contract.

  • April 17, 2026

    Up Next At High Court: SEC And FCC Enforcement Authority

    The U.S. Supreme Court's final argument session of this term kicks off Monday, when the justices will consider the U.S. Securities and Exchange Commission's authority to seek disgorgement orders against alleged wrongdoers without proving investors were harmed. Here, Law360 breaks down the week's oral arguments.

  • April 17, 2026

    Allstate Says Fla. Surgery Centers Padded Bills For Care

    Seven ambulatory surgery centers, a pain clinic and an anesthesia practice that are all run by Surgery Partners conducted "extraordinarily aggressive treatment" on patients involved in minor car crashes to inflate the bills submitted to Allstate, the insurer told a Florida federal court Friday, alleging it paid millions for unnecessary treatment.

  • April 17, 2026

    Bill Floated To Nix Medical Residency Antitrust Exemption

    U.S. Sen. Mike Lee, R-Utah, has introduced legislation to repeal an antitrust exemption given to the medical residency matching program by Congress two decades ago, over concerns about wages and a bottleneck of medical school graduates.

  • April 17, 2026

    Aramark Joins NJ Insulin Pricing Suits Against PBMs

    Aramark Services Inc. joined multidistrict litigation accusing CVS and pharmacy benefit managers of colluding to inflate the price of insulin.

  • April 17, 2026

    Doc Says Texas Man Can't Sue Over Mailed Abortion Pills

    A Texas man suing his ex-girlfriend's out-of-state doctor for prescribing mail-order abortion pills can't prove that the doctor caused the wrongful death of their unborn child, the doctor told a federal court, saying the case should be dismissed because he's not responsible for the woman's actions. 

  • April 16, 2026

    Trump Taps Ret. Rear Admiral Schwartz As New CDC Chief

    President Donald Trump on Thursday nominated Dr. Erica Schwartz, a retired rear admiral who served in the U.S. Coast Guard and as deputy surgeon general in the first Trump administration, to be the Centers for Disease Control and Prevention's next director.

  • April 16, 2026

    Feds Can't Stay Trans Healthcare Orders During Appeal

    The Trump administration won't be able to enforce two executive orders that ban federal funding for gender-affirming care for patients under the age of 19 while the federal government appeals a nationwide injunction blocking the orders, the Fourth Circuit ruled Thursday. 

  • April 16, 2026

    DOL Benefits Chief Pressed On Labor Secretary's Conduct

    The head of the U.S. Department of Labor's employee benefits arm faced tough questions from House Democrats at an oversight hearing Thursday, fielding questions about the labor secretary's on-the-job conduct as well as the DOL's take on mental health parity enforcement. 

  • April 15, 2026

    Aluminum Co. Settles Trans Worker's Suit Over Health Plan

    A subsidiary of Kaiser Aluminum has agreed to resolve a lawsuit claiming it discriminated against transgender employees by excluding coverage for medical treatments related to gender-affirming care from its health plan, according to a filing in Washington federal court.

  • April 15, 2026

    NC Judge Won't Undo $4M Philips Copyright Verdict

    A North Carolina federal judge has refused to erase a $4 million jury verdict against independent service organization Transtate Equipment Co. for violations of the Digital Millennium Copyright Act, saying trial evidence provided a "firm basis" to support the jury's statutory damages award.

  • April 14, 2026

    4th Circ. Revives Pharma Bid To Block Maryland's 340B Law

    A split Fourth Circuit panel on Tuesday tossed a Maryland district court's order denying a preliminary injunction to pharmaceutical manufacturers that have challenged a state law addressing drug delivery in the federal 340B discount program, pointing to its recent ruling that West Virginia's similar statute is likely preempted.

  • April 14, 2026

    Justices Told That Eli Lilly's FCA Qui Tam Challenge Too Late

    A whistleblower who secured a $183 million trial win against Eli Lilly urged the U.S. Supreme Court on Tuesday to reject its constitutional challenge over his ability to sue for the federal government, arguing the drugmaker's arguments came too late.

  • April 14, 2026

    Colo. Justices Weigh Bid To Restore Trans Youth Care

    Colorado's justices pushed Children's Hospital Colorado on Tuesday to explain how its decision to halt gender-affirming care for transgender youth patients is not discriminatory, even amid the federal government's threats to cut funding for providers that offer the care to children and adolescents.

  • April 14, 2026

    Trade Group Latest To Sue Wash. Over 340B Drug Pricing Law

    Pharmaceutical Research and Manufacturers of America claims a new Washington state law attempts to illegally reshape the federal 340B Drug Pricing Program and singles out participating drugmakers with burdensome regulations, according to a fresh federal lawsuit that follows similar constitutional challenges mounted by Novartis and AbbVie.

  • April 14, 2026

    Ga. Providers Say Rutledge Bars United's Preemption Win

    Medical providers are urging a Georgia federal court to deny United's bid for an early win in its case seeking a declaration that the providers' purported attempt to claw back reimbursements for out-of-network services are preempted, arguing that state-law claims involving employee benefits aren't preempted by federal benefits law.

  • April 14, 2026

    FDA Offers Guidance On Safety Testing For Gene-Editing Tech

    The U.S. Food and Drug Administration on Tuesday issued draft guidance recommending steps drug companies should take to evaluate the safety of gene-editing technology as they seek federal approval for cutting-edge treatments aimed at genetic diseases.

  • April 14, 2026

    Doctors Hope Justices Maintain Shield Against Med Mal Suits

    A case headed to the U.S. Supreme Court next week could roll back a legal doctrine that physicians say is key to protecting them from frivolous medical malpractice suits filed by patients who've already lost in state court.

  • April 14, 2026

    7th Circ. Suggests High Court Ruling Supports Ark. PBM Rule

    The Seventh Circuit appeared reluctant Tuesday to revive a union fund's challenge to an Arkansas rule making health plans disclose pharmacy compensation and pay fees, with judges pointing to a 2020 U.S. Supreme Court ruling that permitted state cost regulations on pharmacy benefit managers.

  • April 14, 2026

    Mich. AG Says PBMs Can't Duck Drug-Pricing Suit

    Two pharmacy benefit managers can't dodge an antitrust lawsuit accusing them of price-fixing reimbursement rates because Michigan has properly claimed an antitrust violation, state Attorney General Dana Nessel told a federal court, asking it to toss aside the PBMs' dismissal bid. 

  • April 14, 2026

    Vehicle Co. Inks $150K Deal To End Tobacco Fee Suit

    International Motors LLC, formerly Navistar, has agreed to pay $150,000 to resolve a suit claiming the company illegally charged workers an extra $600 a year if they used tobacco without giving them a proper avenue to dodge the fee, according to an Illinois federal court filing.

  • April 14, 2026

    Screening Time Deal Doesn't Bar Break Suit, Wash. Panel Says

    An eldercare company's class settlement over COVID-19 screening time doesn't bar a separate suit claiming the company failed to pay workers for missed meal breaks, a Washington state appeals court ruled, reviving the break claims.

  • April 13, 2026

    Ill. Judge Wants More Proof To Recalculate Kickback Damages

    An Illinois federal judge tasked with recalculating damages from a home health company's referral kickback scheme said Monday that she needs more complete and reliable evidence to help determine the appropriate amount, but allowed the government to continue offsetting Medicare payments as part of its judgment collection bid.

  • April 13, 2026

    Mylan Can't Revive Copaxone Antitrust Claims Against Teva

    A New Jersey federal judge sided Monday with a special master's recommendations to nix some of the parallel claims from Mylan and retailers like Walgreens accusing Teva of using regulatory deception, false advertising, improper rebates and more to delay generic competition to its Copaxone multiple sclerosis treatment.

Expert Analysis

  • What FDA Guidance Means For Future Of Health Software

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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.

  • What's At Stake In Possible Circuit Split On Medicaid Rule

    Author Photo

    A recent Eleventh Circuit decision, reviving Florida's lawsuit against a federal rule that reduces Medicaid funding based on agreements between hospitals, sets up a potential circuit split with the Fifth Circuit, with important ramifications for states looking to private administrators to run provider tax programs, say Liz Goodman, Karuna Seshasai and Rebecca Pitt at FTI Consulting.

  • Courts' Rare Quash Of DOJ Subpoenas Has Lessons For Cos.

    Author Photo

    In a rare move, three federal courts recently quashed or partially quashed expansive U.S. Department of Justice administrative subpoenas issued to providers of gender-affirming care, demonstrating that courts will scrutinize purpose, cabin statutory authority and acknowledge the profound privacy burdens of overbroad government demands for sensitive records, say attorneys at ArentFox Schiff.

  • Remote Patient Monitoring Is At Regulatory Inflection Point

    Author Photo

    With remote patient monitoring at the center of new federal pilot programs and a recent report from the U.S. Department of Health and Human Services' Office of Inspector General examining Medicare billing for those services, it is clear that balancing innovation and risk will be a central challenge ahead for digital health stakeholders, say attorneys at Morgan Lewis.

  • Utah's AI Prescription Renewal Pilot Could Inform Policy

    Author Photo

    Utah recently became the first state to approve an artificial intelligence system for autonomously renewing certain prescription medicines, providing a test case for how regulators may be able to draw boundaries between administrative automation and medical judgment, say Jashaswi Ghosh at Holon Law Partners and Bryant Godfrey at Foley Hoag.

  • Ramped Up Psychedelic Production Carries Opportunity, Risk

    Author Photo

    Kimberly Chew at Husch Blackwell discusses the key legal implications of the U.S. Drug Enforcement Administration's recent dramatic increases in the production quotas for a range of psychedelic substances, offering guidance on compliance, risk management and strategic opportunities for practitioners navigating this rapidly evolving landscape.

  • New Biotech Nat'l Security Controls May Have Blunted Impact

    Author Photo

    While the newly enacted federal prohibition against contracting with certain biotechnology providers associated with countries of concern may have consequences on U.S. companies' ability to develop drugs, the restrictions may prove to be less problematic for the industry than the significant publicity around their passage would suggest, say attorneys at Wilson Sonsini.

  • Takeaways From The DOJ Fraud Section's 2025 Year In Review

    Author Photo

    Former acting Principal Deputy Chief Sean Tonolli of the U.S. Department of Justice's Fraud Section, now at Cahill Gordon, analyzes key findings from the section’s annual report — including the changes implemented to adapt to the new administration’s priorities — and lays out what to watch for this year.