Policy & Compliance

  • September 22, 2026

    HHS Economist Warns Regulation Raises Medicare Spending

    Patient and consumer choice are crucial to driving down healthcare costs, while overregulation tends to increase insurance costs and Medicare spending, the chief economist and regulatory officer of the U.S. Department of Health and Human Services told an economic conference. 

  • September 22, 2026

    8th Circ. Questions Iowa's Bid To Unblock Parts Of PBM Law

    The Eighth Circuit on Tuesday appeared skeptical of the state of Iowa's bid to have the appellate court unblock parts of its law limiting pharmacy benefit managers' power to set drug prices, with multiple judges questioning different aspects of the state's standing and federal preemption analysis.

  • September 21, 2026

    Fla. Judge Keeps Publix Autism Claims Dispute In Fed. Court

    A Florida federal judge has denied a medical services provider's bid to send its lawsuit alleging that Publix Super Markets Inc. underpaid billing claims for children's autism healthcare back to state court, saying their claims are preempted by a federal law regulating employee benefits plans. 

  • September 21, 2026

    Calif. Health Group Accuses SEIU Of 'Shakedown' In RICO Suit

    A group representing California community health clinics has accused a Service Employees International Union affiliate of violating the federal anti-racketeering law, claiming in a new lawsuit that the union places manipulative ballot initiatives before California voters and only withdraws them if the clinics concede to its demands.

  • September 21, 2026

    HHS Can Claw Back $195M In Medicaid Payments From Mich.

    A D.C. federal judge on Monday said Michigan must return almost $200 million in Medicaid payments made to two state-operated psychiatric facilities, agreeing with a finding from the U.S. Department of Health and Human Services' appeals board that the institutions did not meet federal requirements.

  • September 21, 2026

    Ex-NFL Player Gets New Trial In $328M Medicare Fraud Case

    A Texas federal judge has granted a new trial for a former NFL player convicted in a $328 million Medicare billing scheme, finding that the government presented unreliable testimony and did not identify the alleged lies the defendant used to influence physicians.

  • September 21, 2026

    Medical Orgs Target Rule On Medicaid Work 'Frailty' Exclusion

    Federal regulation implementing a statutory "medical frailty" exclusion from Medicaid work requirements violates the Administrative Procedure Act, burdens healthcare providers and threatens to cause millions of people to lose their coverage, medical groups told a Maryland federal court in a complaint.

  • September 21, 2026

    HHS Defends Move To Limit Noncitizen Medicaid Benefits

    The U.S. Department of Health and Human Services has urged a Washington federal court not to block provisions in the 2025 federal budget bill generally denying Medicaid benefits to noncitizens receiving supplemental security income, countering claims of conflicting statutory language.

  • September 18, 2026

    NJ Seeks Quick Win On TikTok's Money Transfers

    New Jersey's attorney general urged a state court Friday to find TikTok liable for operating an unlicensed money transmission business via its livestreaming service, arguing the platform receives users' money, converts it into virtual currency and ultimately pays creators in cash.

  • September 18, 2026

    Colo. Judge Mulls Sanction For Hospital In Gender Care Suit

    Transgender adolescent patients of Children's Hospital Colorado told a state judge the court must sanction the hospital for refusing to resume providing gender-affirming medical care for transgender youth patients, saying Friday that "nothing has changed" since the patients filed their January lawsuit.

  • September 18, 2026

    Disney Plan Must Cover Trans Child's Mental Health Treatment

    Disney's benefits plan must reimburse an employee for her transgender child's medical care at a residential treatment facility for major depressive disorder, suicidal ideations and instances of self-harm, after a California federal judge ruled such care was necessary, "appropriate, and not feasible at a lower level of care."

  • September 18, 2026

    Employers See Moving Targets With H-1B Fee, And New Limits

    The Trump administration on Friday ordered federal agencies to scrutinize H-1B employers that have laid off U.S. workers, adding another layer of uncertainty for employers seeking to recruit highly skilled foreign workers.

  • September 18, 2026

    Texas Pregnancy Center Shutters To End Birth Tourism Suit

    A Texas-based pregnancy center on Friday agreed to shut down to resolve allegations by state Attorney General Ken Paxton that it helped Chinese nationals give birth in the U.S. while on tourist visas so their children could obtain birthright citizenship.

  • September 18, 2026

    NJ Justices Say No To Mass Tort For No Surprises Act Suits

    The New Jersey Supreme Court has rejected an application from five health insurers to designate 160 pending cases seeking the enforcement of alleged independent dispute resolution payment determinations issued under the federal No Surprises Act as multicounty litigation.

  • September 18, 2026

    NY Surgeons Say Elevance Penalty Policy Is Anticompetitive

    A practice group for independent neurosurgeons lobbed an antitrust suit against Elevance Health Inc. in New York federal court alleging the insurer is impeding their ability to compete for patients by threatening to financially penalize and terminate in-network facilities that work with them.

  • September 18, 2026

    6th Circ. Undoes Ky. State Court Remand Of PBM Fight

    The Sixth Circuit on Friday ruled that Kentucky's lawsuit accusing pharmacy benefit managers of conspiring with drug manufacturers to increase the prescription opioid supply belongs in federal court, given the appellate court's precedential ruling from January reversing remand of another state's dispute against PBMs.

  • September 17, 2026

    Opioid MDL Judge Fears 'Chaos' If PBMs Derail 100s Of Suits

    The federal judge steering multidistrict opioid litigation is lacing into major pharmacy benefit managers for asking the Sixth Circuit to abruptly reverse a key ruling, denouncing their "spurious insinuations" about his motives and warning of disarray if they successfully break up the MDL's consolidated suits.

  • September 17, 2026

    Ore. Judge Denies HHS' Attempt To Amend Gender Care Order

    An Oregon federal judge on Thursday rejected the Trump administration's bid to narrow an earlier order that voided a policy declaration central to the government's crackdown on gender-affirming care for minors.

  • September 17, 2026

    Kennedy Taps 8 For Panel Guiding ACA Preventive Care

    Eight new members have been appointed to a key federal health task force that determines which preventive healthcare services insurers must cover, Health Secretary Robert F. Kennedy Jr. announced Thursday. 

  • September 17, 2026

    NIH Grant Terminations Violate First Amendment, Court Told

    The National Institutes of Health is violating the First Amendment by terminating research grants based on policies aimed at suppressing "disfavored" viewpoints on gender identity, climate change and a host of other topics, researchers told a California federal court in a proposed class action suit.

  • September 17, 2026

    Cole Schotz Gains Brach Eichler Health Corporate Pro In NJ

    Cole Schotz PC expanded its New Jersey office with a corporate law special counsel specializing in healthcare industry clients who joined from Brach Eichler LLC, the firm announced this week.

  • September 16, 2026

    Fecal Testing Startup Founders Reach $250K Deal With SEC

    Two founders of a now-shuttered fecal testing startup have agreed to pay $125,000 each to put to rest the U.S. Securities and Exchange Commission's allegations that they used a fraudulent insurance billing scheme to get $60 million from investors, according to an announcement made Wednesday.

  • September 16, 2026

    Express Scripts Seeks To Exit AIDS Group's Drug Rate Suit

    Express Scripts called on a Washington federal judge to toss a lawsuit accusing it of using its market power to bully the AIDS Healthcare Foundation into accepting lower reimbursement rates for life-saving drugs, contending Tuesday that the case rehashes allegations a Missouri federal court has already rejected twice.

  • September 16, 2026

    1st Circ. Seems Torn Over Health Plan Surcharge For Smokers

    A First Circuit panel appeared divided Wednesday over whether a casino company is required to refund tobacco use fees after smokers on the company's health plan complete a tobacco cessation program.

  • September 15, 2026

    8th Circ. Revives Doctor's Suit Over COVID Speech Probes

    An Eighth Circuit panel on Tuesday revived a doctor's suit seeking an order limiting a Minnesota state medical board's ability to investigate him for his public statements related to the COVID-19 pandemic, finding a district court "set the bar too high" at the dismissal stage.

Expert Analysis

  • Remote Work Rulings Show ADA Fights Hinge On Process

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    Two opposite outcomes in recent Fifth Circuit and D.C. federal court cases underscore that the legality of denying employees' disability accommodation requests for remote work depends less on broad policy and more on how it's applied, says Paul Sweeney at Ice Miller.

  • How Justices' TPS Ruling Affects Workforce Planning

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    The U.S. Supreme Court’s recent holding in Mullin v. Doe that courts lack jurisdiction to review temporary protected status determinations greenlights the end of TPS for thousands of Syrian and Haitian nationals, and means employers must reevaluate TPS-designees' employability while avoiding discriminatory document practices, says attorney Richard Herman.

  • A New Regulatory Environment For PE In Calif. Healthcare

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    The California Office of Health Care Affordability's proposed revisions to its cost and market impact review regulations, amid broader state scrutiny of private equity-backed healthcare arrangements, represent a qualitative shift in California's regulatory posture toward institutional healthcare investment, say attorneys at Ropes & Gray.

  • FDA Moves Leave Peptides In A Legal Gray Zone

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    While the U.S. Food and Drug Administration has taken a concrete step forward on reclassifying certain peptides, the practical consequence of their interim status cannot be overstated — these substances are no longer designated as posing a significant safety risk, but they have not been affirmatively authorized for compounding, say attorneys at Sheppard.

  • NY Banking Brief: All The Notable Legal Updates In Q2

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    The year's second quarter brought several notable banking law developments to New York, including a proposal to align state stablecoin rules with the federal Genius Act, fresh fair lending and cybersecurity guidance from state regulators, and a significant Second Circuit holding on preemption, say attorneys at Ashurst Perkins Coie.

  • A New Defense For Medicaid Fraud Cases In Texas

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    The Texas Supreme Court decision in LabCorp v. Texas last month, finding that the state's False Claims Act requires proof that an omission is material, is among the first to establish that the government's lack of reaction to the defendant's disclosures rendered alleged omissions immaterial, say attorneys at Sheppard.

  • Pregnancy Bias Suits Highlight EEOC's Expanding Reach

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    Recent U.S. Equal Employment Opportunity Commission suits show that enactment of the Pregnant Workers Fairness Act has drawn scrutiny to a wider range of employment decisions and an increasing focus on individual decisions as indicators of whether an employer's policies comply with evolving federal requirements, say attorneys at Krevolin Horst.

  • Legal Risks Of Using AI To Screen Psychedelic Trial Patients

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    Though using artificial intelligence to preemptively identify drug trial participants likely to experience placebo effects could produce clearer research results, sponsors will need to be ready for the new legal questions these methods raise about informed consent, accountability for algorithmically derived criteria, and potential bias in data training sets, says Kimberly Chew at Husch Blackwell.

  • How 6th Circ. Tightened NLRB Injunction Standard

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    The Sixth Circuit's recent ruling in Kerwin v. Trinity Health Grand Haven Hospital, dissolving a Section 10(j) injunction obtained by the National Labor Relations Board against an employer that refused to bargain, will make it harder for the NLRB to obtain injunctions while prosecuting unfair labor practice proceedings, say attorneys at Bass Berry.

  • Md. Ruling Reflects Classic Administrative Law Principle

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    A Maryland federal court's recent decision in Columbus v. Kennedy significantly limits how far the Centers for Medicare & Medicaid Services can go in reshaping the Affordable Care Act through regulation, highlighting a principle that will likely be applied in similar Administrative Procedure Act challenges, says Michael King at Brownstein Hyatt.

  • Healthcare Orgs Should Prep For Greater Grant Oversight

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    The U.S. Department of Health and Human Services' new Audit Enforcement and Risk Oversight initiative, and a proposed overhaul of the governmentwide framework for grants management, signal an aggressive and data-driven approach to federal grant enforcement, and could significantly expand the pathways leading to enforcement actions and private litigation, say attorneys at Norton Rose.

  • 3rd Circ. Decision Sheds Light On BIPA Bank Exemption

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    The Third Circuit's recent decision in McGoveran v. Amazon illuminates how courts are extending the Illinois Biometric Information Privacy Act's financial institution carveout beyond banks and insurers to technology vendors and other businesses handling biometric data, a defendant-friendly shift that still casts uncertainty around BIPA's enforcement, say attorneys at Dorsey & Whitney.

  • Data Reveals Pivot In Feds' Financial Fraud Priorities

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    Recent Justice Department data shows fraud prosecutions fell to their lowest rate in a decade in 2025, illustrating a move away from traditional financial cases and toward a targeted mix of healthcare, government program, consumer and sanctions matters, say Paul Hinton and Adrienna Huffman at The Brattle Group.