Policy & Compliance

  • April 29, 2026

    PBMs Say Michigan AG Price-Fixing Suit Is Unsound

    Pharmacy benefit managers Express Scripts, Evernorth Health and Prime Therapeutics have bolstered their effort to escape a federal price-fixing suit brought against them by Michigan's attorney general by arguing the statutes cited in the complaint do not apply to them.

  • April 29, 2026

    Mass. AG, Insurer Settle Deceptive Marketing Claims For $5M

    A Texas-headquartered health insurance agency will pay $5 million to settle allegations that it engaged in deceptive and unfair marketing to sell plans and other types of health programs to thousands of Massachusetts consumers, the state's attorney general announced on Wednesday.

  • April 29, 2026

    5th Circ. Will Rehear Aetna Arbitration Bid In Aramark Suit

    The full Fifth Circuit will reconsider insurance company Aetna's bid to force uniform and food services company Aramark to arbitrate its dispute over employee health benefit claims, staying a panel's ruling from December that had kept proceedings in court.

  • April 29, 2026

    AbbVie Seeks Early Win Over HHS In Botox Drug Price Suit

    When the federal government included Botox in Medicare's drug price negotiation program, which allows Medicare officials to negotiate for lower drug prices, it overstepped its authority, drugmaker AbbVie Inc. told a D.C. federal court, arguing the cosmetic drug and migraine treatment is a "plasma-derived" product ineligible for price controls.

  • April 29, 2026

    Medical Equipment Co. Settles Patient Overbilling Claims

    Patients who claim Pennsylvania-based AdaptHealth Corp. overcharged them for returned medical equipment have reached the final version of a class settlement and will soon submit it to a North Carolina federal court for approval, they told the court this week.

  • April 29, 2026

    Justices Rule NJ Info Demand Chilled Anti-Abortion Speech

    The U.S. Supreme Court on Wednesday unanimously revived an anti‑abortion pregnancy center network's constitutional challenge to a New Jersey subpoena seeking years of donor information, holding that the state's demand infringed free speech.

  • April 28, 2026

    Ohio Justices Nix 'Would Have Been Married' Obergefell Test

    The Ohio Supreme Court held Tuesday that a state law establishing parental rights for the spouse of a woman who conceives a child through artificial insemination doesn't retroactively apply to same-sex couples when a child was born before gay marriage was legalized by the U.S. Supreme Court in 2015.

  • April 28, 2026

    Ex-Fauci Adviser Charged With Concealing COVID Records

    Federal prosecutors have charged a former adviser to Dr. Anthony Fauci with deleting government emails and using his personal email account to dodge public records requests about the origins of the COVID-19 virus.

  • April 28, 2026

    Purdue Pharma's $5.5B Plea Deal Clinched As Survivors Protest

    OxyContin maker Purdue Pharma LP has to pay a $3.5 billion fine and forfeit an additional $2 billion, more than five years after it pled guilty to criminal charges related to its role in the opioid crisis, a New Jersey federal judge said Tuesday.

  • April 28, 2026

    As RFK Jr. Touts Peptides, Industry Eyes Regulatory Hurdles

    Compounding pharmacies eager to cash in on the peptide boom are watching closely as the nation’s top health official pushes to legalize the market. A regulatory minefield may mean a long wait.

  • April 28, 2026

    Attys Want To See Examples In New Mental Health Parity Rule

    The Trump administration's plans to promulgate new regulations governing mental health parity requirements for employee health plans are currently causing headaches for attorneys, but a rule that includes specific examples could ultimately ease compliance burdens for benefit plan sponsors.

  • April 28, 2026

    MedMal Case Volume Declines, But Doctor Risks Remain High

    While the volume of malpractice lawsuits against U.S. physicians has dropped in recent years, that doesn't mean the threat of legal liability is dissipating, according to a report released Monday by the American Medical Association. 

  • April 28, 2026

    Mich. Health System Inks $1.9M Deal To End ERISA Suit

    A Michigan health system agreed to pay $1.9 million to resolve a suit claiming it failed to kick an underperforming investment fund from its workers' retirement plan, causing employees to lose out on millions in savings.

  • April 28, 2026

    La. AG On 340B, Comstock And 'Political Act' Of Abortion Pills

    Louisiana's attorney general has sued over mifepristone, pursued charges against out-of-state doctors and sparred with drugmakers. Liz Murrill talks to Law360 Healthcare Authority about her approach to healthcare and the law.

  • April 28, 2026

    Union Urges Toss Of Tobacco Co.'s Retiree Health Fight

    A North Carolina federal judge should let a tobacco workers' union keep its win in a retiree healthcare fight with the company that makes Winston and Salem cigarettes, the union argued, saying the company's challenge to a November arbitration award can't proceed because it wasn't properly filed.

  • April 28, 2026

    Maryland Justices Allow IVF Cost Class Action To Proceed

    A Maryland couple can pursue a proposed class action against a health insurer that they say wrongfully denied coverage for embryo thawing in connection with an in vitro fertilization procedure, the Maryland Supreme Court has ruled, finding that the insurer's subsequent payment of the claim doesn't moot the suit.

  • April 28, 2026

    Meet The Attys Arguing The High Court 'Skinny Label' Case

    When the U.S. Supreme Court hears arguments Wednesday in a patent case involving "skinny labels" on generic drugs, a longtime patent attorney as well as a government attorney who often handles intellectual property cases will face an appellate specialist who has argued many high court cases.

  • April 27, 2026

    North Dakota Drug-Pricing Law Blocked In Pharma Fight

    A North Dakota federal judge on Monday blocked the state's new drug-pricing law, agreeing with pharmaceutical companies that while the law purports to "protect the underdogs," it illegally interferes with the federal drug-pricing regime.

  • April 27, 2026

    DOJ Says Wash. 340B Drug Law Is Preempted In Novartis Suit

    The U.S. Department of Justice waded into a dispute between pharmaceutical giants and the state of Washington on Monday, arguing that federal law preempts a new state law that expands discounts that drugmakers must provide under the federal 340B Drug Pricing Program.

  • April 27, 2026

    Wyoming's Latest Near-Total Abortion Ban Blocked

    A Wyoming judge has blocked enforcement of the latest effort by state lawmakers to enact a rigid anti-abortion law, after the Wyoming Supreme Court in January struck down the state's previous near-total ban on abortion. 

  • April 27, 2026

    'General Hospital' Actor Can't Revive Vax Suit Against ABC

    California appellate justices refused to reinstate a "General Hospital" actor's suit alleging ABC fired him for his political views after he declined to comply with its COVID-19 vaccine policy, ruling the evidence shows that the ultimate decision-makers who ended his employment agreement didn't know about his political views.

  • April 27, 2026

    Bioscience Co. Allegedly Hid Volatility Risks From Investors

    A company purportedly focused on using traditional Chinese medicine to treat conditions including autism spectrum disorder faces a proposed investor class action alleging it downplayed the risk it would be probed in connection with unusual volatility affecting the market for its shares.

  • April 27, 2026

    4th Circ. Says Medicaid Fraud Convictions Lacked Evidence

    The government failed to prove the former owner of a mental health counseling company in Virginia willfully committed fraud by falsely billing Medicaid $200,000 for counseling services on two specific dates, a panel of the Fourth Circuit has found, overturning his convictions.

  • April 24, 2026

    Tenn. Abortion Ban Trial Taken Off Calendar Following Appeal

    A Tennessee state court has canceled a trial scheduled to begin Monday over a suit challenging the state's abortion ban and seeking clarification on when a physician can legally terminate a high-risk pregnancy.

  • April 24, 2026

    Cigna Plan Members Say HIPAA Notice Backs Privacy Claims

    A group of Cigna health plan participants who claimed the company failed to protect their private health information when it tracked their website activities told a Pennsylvania federal judge that the insurance giant should not be allowed to dodge new allegations that their HIPAA rights were violated.

Expert Analysis

  • 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.

  • How State FCA Activity May Affect Civil Fraud Enforcement

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    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

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    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

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    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

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    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

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    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

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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.