Policy & Compliance

  • April 07, 2026

    Insurer Premera Accuses Clinic Of Misusing No Surprises Act

    Premera Blue Cross sued a weight loss clinic on Monday in Washington federal court saying it abused a federal law aimed at safeguarding patients from unexpected medical bills in order to shake down the insurer for exorbitant amounts of money — as much as 10 times what Premera pays in-network providers.

  • April 07, 2026

    Acadia Still On Hook For $9M Rehab Death Negligence Verdict

    A California state appeals court on Tuesday affirmed a more than $9 million jury verdict against Acadia Healthcare Co. Inc. in a suit stemming from the death of a patient at one of its addiction treatment centers, saying there was substantial evidence that the Marin County facility was negligently understaffed.

  • April 07, 2026

    HHS Must Face States' Suit Over RFK's 'Dramatic Overhaul'

    A Rhode Island federal judge rejected Tuesday the government's bid to toss a group of states' lawsuit challenging Robert F. Kennedy Jr.'s "dramatic overhaul" of the U.S. Department of Health and Human Services, criticizing the government for rehashing jurisdictional arguments the court already rejected and finding the states' claims are plausible.

  • April 07, 2026

    Minn. Can't Unfreeze $243M In Medicaid Funds, Judge Says

    A Minnesota federal judge on Monday denied the state's preliminary injunction request to release $243 million in Medicaid funds deferred by the federal government during a fraud investigation, holding that the "unprecedented" size and scope of the deferral action doesn't mean the Centers for Medicare & Medicaid Services isn't legally cleared to pursue the action.

  • April 07, 2026

    3 Healthcare Decisions You May Have Missed This Week

    A proposed class of HIV and AIDS patients is dropping their disability bias lawsuit, the Third Circuit on a COVID-era fraudster sentence, and Aetna escapes a testing payment lawsuit. Law360 Healthcare Authority looks at three decisions you may have missed.

  • April 07, 2026

    Judge Questions FTC's Motive In Gender-Care Probe

    A federal judge in Washington said Tuesday he would have to balance any legitimate concerns about parents and children being misled on the issue of gender-affirming care with what appeared to be retaliatory motives behind Federal Trade Commission investigative demands to a pair of nonprofits.

  • April 07, 2026

    HHS Staff Changes Likely To Lead To Uncertain 2026

    Healthcare experts are keeping a close eye on personnel changes at the U.S. Department of Health and Human Services. Law360 Healthcare Authority looks at how they could affect key agency policies.

  • April 07, 2026

    Mich. AG Says PBMs Can't Stall Discovery In Drug-Pricing Suit

    Michigan's attorney general is urging a federal court to reject a renewed bid by pharmacy benefit managers to pause discovery in an antitrust case accusing them of price-fixing reimbursement rates, claiming the companies are relying on exaggerated burden claims and an ordinary motion to dismiss that is unlikely to succeed.

  • April 07, 2026

    DC Circ. Skeptical Ex-Steward CEO Could Skip Senate Hearing

    A D.C. Circuit judge told the attorney for the embattled former CEO of Steward Health Care on Tuesday that she couldn't comprehend how his client could invoke his Fifth Amendment rights without showing up to his scheduled appearance before a Senate committee.

  • April 07, 2026

    High Court Ruling Won't End 'Conversion Therapy' Battles

    The U.S. Supreme Court's rejection of Colorado's ban on what is commonly known as gay conversion therapy may have rendered dozens of similar laws toothless, but don't expect it to be the end of legal challenges in this arena.

  • April 07, 2026

    Jury Awards $39.5M Over Discharged Psych Patient's Victims

    A Philadelphia jury on Tuesday hit a healthcare management company and a Pennsylvania hospital with a $39.5 million verdict, finding them liable for the deaths of four people who were murdered by a family member who was discharged from a psychiatric unit that failed to submit paperwork that would have prevented him from purchasing the gun he used to kill them.

  • April 06, 2026

    RFK Jr. Tweaks HHS Vaccine Policy Panel Membership Criteria

    U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. is making changes to a key federal vaccine advisory panel's charter, according to a renewal notice the agency published Monday, after a Massachusetts federal judge last month declared Kennedy's committee picks "appear distinctly unqualified."

  • April 06, 2026

    Anthem Owes $2.1M For No Surprises Act Awards, Court Told

    Two medical providers said Anthem Blue Cross and Blue Shield owes them a combined $2.1 million for medically necessary services rendered to its insured members, telling a Colorado state court that the carrier is wrongfully withholding payment despite losing multiple federal arbitration proceedings.

  • April 06, 2026

    Biz Groups Urge 4th Circ. To End Allergan Overcharge Suit

    Major pharmaceutical and business associations urged the Fourth Circuit to reconsider a panel decision that revived a whistleblower lawsuit accusing an Allergan Sales LLC predecessor of overcharging Medicaid, warning it threatens to become a road map for False Claims Act abuses.

  • April 06, 2026

    Splenda Loses Bid To End Scientist's Libel Counterclaim

    The maker of Splenda lost its bid for a pretrial win on a scientist's counterclaims for libel after a North Carolina federal judge on Monday ruled they weren't filed too late because the counterclaims are directly linked to the company's defamation suit challenging her statements linking Splenda to cancer-causing chemicals.

  • April 06, 2026

    1st Circ. Suggests It May Resurrect AdTech Wiretap Case

    A panel of the First Circuit appeared receptive Monday to reinstating federal wiretap claims leveled against a Massachusetts healthcare system over its use of online tracking tools, despite arguments that such a ruling could cripple the industry amid an influx of similar cases nationwide.

  • April 06, 2026

    Cleary FCA Task Force Head On Enforcement Trends To Watch

    Former U.S. Attorney for the Eastern District of New York Breon Peace, who now leads a False Claims Act task force at Cleary Gottlieb Steen & Hamilton LLP, is predicting a continued surge in enforcement as the Trump administration wields the law in new ways.

  • April 06, 2026

    Mass. Justices Hint Insurer Owes Defense In Doc's Discipline

    An allegation that a Massachusetts doctor prescribed addictive medications to manipulate a patient into a sexual relationship could be enough to trigger a malpractice insurer's duty to defend him in a disciplinary proceeding launched years later over other alleged misconduct, justices on the state's highest court hinted Monday.

  • April 06, 2026

    WilmerHale Adds Regulatory Atty From Mayer Brown In DC

    WilmerHale announced Monday it has hired a veteran U.S. Food and Drug Administration and life sciences regulatory attorney from Mayer Brown LLP.

  • April 03, 2026

    Case-By-Case Guide As Justices Eye Landmark Pharma Law

    Drugmakers and prominent allies are inundating the U.S. Supreme Court with calls to scrutinize Medicare's new power to slash payments by tens of billions of dollars, and the justices look poised to take up or turn down a fistful of legal challenges in one fell swoop.

  • April 03, 2026

    Wash. DOC Inks Deal Over Trans Treatment In Facilities

    The Washington State Department of Corrections will start improving conditions for transgender, intersex and nonbinary people in its facilities and submit to yearly monitoring, according to a settlement agreement between the agency and a nonprofit in the state.

  • April 03, 2026

    SEC Moves To Set Up $40M Investor Fund In Cassava Case

    The U.S. Securities and Exchange Commission asked a Texas federal court on Friday to establish a $40 million fund to potentially compensate investors harmed by a Texas biopharmaceutical company and two former executives' alleged misstatements about an Alzheimer's drug, following the company's 2024 settlement with the regulator.

  • April 03, 2026

    Northwestern Can't Escape ERISA Fight Over Health Offerings

    An Illinois federal court refused to toss a proposed class action against Northwestern University alleging excessive employee healthcare costs violated federal benefits law, concluding ex-workers had sufficiently backed up their allegations that an expensive plan option breached fiduciary duties.

  • April 03, 2026

    Law360 Announces The Members Of Its 2026 Editorial Boards

    Law360 is pleased to announce the formation of its 2026 Editorial Advisory Boards.

  • April 03, 2026

    Ga. Urology Network To Pay $14M To Resolve FCA Case

    An Atlanta urology network and its founder will pay $14 million to settle allegations that they billed Medicare and Medicaid for medically unnecessary procedures, ranging from ultrasounds to endoscopic exams, according to an announcement by federal and Georgia state prosecutors.

Expert Analysis

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

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    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.

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    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

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    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

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    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

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    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

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    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

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    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.

  • 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.