Policy & Compliance

  • May 18, 2026

    Aetna Denied A Freeze On Trans Facial Surgery Order

    A Connecticut federal judge ordered Aetna to comply with a preliminary injunction requiring it to reconsider coverage denials affecting two transgender health plan participants who sought gender-affirming facial surgery, refusing to stay the insurer's compliance obligations during its pending appeal in the proposed class action.  

  • May 18, 2026

    Morgan & Morgan Atty Barred From Harvard Suit Over AI Error

    A Massachusetts judge on Monday said a Morgan & Morgan PA attorney may not appear before him in a suit against Harvard University over the theft of body parts donated to its medical school, saying the lawyer did not learn his lesson after signing off on briefs in another case with fake case law generated by artificial intelligence.

  • May 18, 2026

    Justices Deny Eli Lilly's Qui Tam Constitutional Challenge

    The U.S. Supreme Court on Monday declined to review Eli Lilly's $183 million trial loss to a whistleblower who claimed the drugmaker knowingly defrauded the government by underpaying Medicaid drug rebates.

  • May 18, 2026

    Colo. Justices Tell Hospital To Resume Gender-Affirming Care

    The Colorado Supreme Court ordered Children's Hospital Colorado on Monday to resume its provision of gender-affirming care for transgender youth patients, finding the patients demonstrated actual harm from the denial of care.

  • May 18, 2026

    High Court Spurns Pharma Challenges To IRA Drug Price Talks

    The U.S. Supreme Court rejected six petitions Monday from pharmaceutical giants seeking to bring down the Medicare drug price negotiations established as part of the Inflation Reduction Act three years ago.

  • May 15, 2026

    Texas Hospital Creates 'De-Transition Clinic' After Settlement

    The Texas attorney general announced a settlement with Texas Children's Hospital that will see the creation of a detransition clinic, saying Friday that the hospital will pay $10 million for billing Texas Medicaid for "illegal 'gender-transition' interventions."

  • May 15, 2026

    Minn. Twins Doctor Can't Claim Immunity In Player Death Suit

    A doctor employed by the Minnesota Twins can't claim immunity in a lawsuit alleging he failed to diagnose a heart condition in a ballplayer that led to his death, a Florida appeals panel ruled on Friday.

  • May 15, 2026

    4th Circ. Hands Express Scripts Jury Trial In W.Va. Opioid Suit

    The Fourth Circuit on Friday issued a writ of mandamus backing Express Scripts Inc.'s right to a jury trial in litigation over the pharmacy benefit manager's alleged role in contributing to the opioid crisis in West Virginia.

  • May 15, 2026

    Texas Justices Revive Anti-SLAPP Bid In Abortion Fund Suit

    The Texas Supreme Court on Friday revived a woman's anti-SLAPP bid in an abortion fund's suit against her, holding that the suit was filed in response to the woman's earlier attempt to investigate the fund's deputy director for potential violations of state abortion law.

  • May 15, 2026

    NC Social Worker Wants Resentencing In Medicaid Fraud Suit

    A clinical social worker in North Carolina serving more than 11 years in prison on healthcare fraud charges is challenging her sentence in the Fourth Circuit, saying Thursday that a lower court used overly generalized findings to apply a vulnerable victim sentence enhancement.

  • May 14, 2026

    NJ Doctor Prescribed Medical Marijuana To Kids, AG Says

    A New Jersey doctor had his medical license temporarily suspended by a state board, which found there is good reason to believe he is "a grave danger" to his patients after prosecutors accused him of repeatedly prescribing marijuana to adults and children without complying with state law.

  • May 14, 2026

    NC Republicans Want Fetal Personhood Question On '26 Ballot

    Two Republicans in the North Carolina House who have a history of advancing so-called fetal personhood bills have made another attempt to put a constitutional amendment to voters in November to decide if life begins at fertilization.

  • May 14, 2026

    Pa. Psych Hospital Faces Multiple Abuse Lawsuits

    A Pittsburgh-area psychiatric hospital has been hit with five state court lawsuits alleging it allowed patients as young as 10 years old to be physically and sexually abused by staff members and other patients, despite multiple investigations and warnings.

  • May 14, 2026

    Moda Health Settles Wilderness Therapy Coverage Suit

    Health insurance provider Moda Health has agreed to settle a lawsuit alleging it unlawfully denied a family's claims for their daughter's stays at two wilderness therapy programs and left them with thousands of dollars in medical bills, according to a filing in Oregon federal court.

  • May 14, 2026

    Albertsons Not Covered In Opioid Litigation, Del. Judge Says

    Albertsons isn't entitled to defense or indemnity for more than 100 suits accusing the pharmacy and grocery chain of fueling the opioid epidemic, a Delaware state court ruled, tracking the state high court's rulings in nearly identical disputes involving Rite Aid and CVS.

  • May 14, 2026

    High Court Maintains Abortion Pill Access Amid Circuit Appeal

    The U.S. Supreme Court on Thursday extended a stay preserving telehealth access to the abortion medication mifepristone while the Fifth Circuit weighs a challenge to the mail-order distribution of the pill.

  • May 14, 2026

    NC Healthcare Workers Get Final Nod On $1.5M Wage Deal

    A federal judge has given final approval to a $1.56 million settlement with the owners of several North Carolina hospitals and healthcare facilities accused of manipulating workers' time sheets to skirt overtime requirements.

  • May 14, 2026

    Time For Trial, Judge Says, Nixing DQ Appeal In Generics MDL

    A Pennsylvania federal judge has refused to let generic-drug makers seek Third Circuit intervention in their bid to disqualify the lead counsel for insurers Humana and Molina, concluding the fight would only further delay the long-running case ahead of its first trial in the price-fixing multidistrict litigation.

  • May 13, 2026

    CMS To Keep $1.3B From Calif., Halt New Hospice Enrollment

    The federal government on Wednesday announced it will defer more than $1.3 billion in Medicaid funds from California and halt new Medicare enrollments for hospices and home health agencies, saying it was part of an effort to crack down on fraudulent activity.

  • May 13, 2026

    3 NJ Employers Accused Of Pregnancy Discrimination

    A New Jersey hospital system, a laboratory company and a cleaning business must answer to allegations that they engaged in pregnancy discrimination in the workplace, state enforcers said this week.

  • May 13, 2026

    Washington Hits Providence Health With Pregnancy Bias Suit

    Washington slapped Providence Health & Services with a lawsuit Wednesday claiming the health system routinely rejected accommodation requests from pregnant employees, denying them spaces to pump breast milk, seating and schedule flexibility to attend doctor appointments.

  • May 13, 2026

    DOJ Fraud Division Set To Shake Up White-Collar Enforcement

    President Donald Trump's administration created the U.S. Department of Justice's National Fraud Enforcement Division with a narrow focus on combating government program fraud, but a move to retain federal prosecutors focused on other types of fraud could signal a wider scope with potential ripple effects across white-collar enforcement.

  • May 13, 2026

    Becton Hernia Mesh Antitrust Case Survives Dismissal

    A Pennsylvania federal court has refused to toss an antitrust case from Tela Bio Inc. accusing Becton Dickinson & Co. of abusing its dominant position in the hernia mesh market to block competing products.

  • May 13, 2026

    Provider Says NY Is On The Hook For $3.3M Medicaid Shortfall

    The New York State Department of Health's refusal to enforce payment obligations by Medicaid managed care organizations has cost a Queens-based safety net provider at least $3.3 million in underpayments for behavioral health services, according to a suit filed in New York federal court.

  • May 12, 2026

    Trans Care In Court: Gov't Probes, Forum Concerns And More

    Law360 Healthcare Authority looks at developments over the past week in legal challenges to probes by the Justice Department and Federal Trade Commission concerning the provision of gender-affirming care for transgender minors.

Expert Analysis

  • 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.

  • What FDA Guidance Means For Future Of Health Software

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    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.