Policy & Compliance
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November 19, 2025
Senate GOP Resists Extending Expanded ACA Tax Premiums
Senate Finance Committee Democrats on Wednesday urged their Republican counterparts to extend the enhanced tax credits for the Affordable Care Act, which is set to expire at the end of the year, but Republicans said they were looking for other options to address rising healthcare costs.
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November 19, 2025
Conn. Dentists Pay $714K To Settle Patient Kickback Claims
Two Connecticut dentists will pay more than $714,000 to the state and federal governments to settle joint allegations that their practices submitted false government benefits claims that contained kickbacks for patient recruiters.
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November 19, 2025
Pa. Health Network's $1.15M 401(k) Suit Deal Gets Initial OK
A healthcare system Wednesday secured initial approval from a Pennsylvania federal court for a $1.15 million settlement agreement that would resolve a proposed class action alleging the company misused forfeited retirement plan funds and allowed the plan's administrative costs to soar.
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November 19, 2025
Whoop Blood Pressure Tracker Hit With False Ad Suit
A consumer on Tuesday hit health and wellness wearable tech company Whoop Inc. with a proposed class action in California federal court alleging that its boasting of the blood pressure features of its fitness tracker duped consumers and prompted a warning from health regulators.
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November 19, 2025
Hospice Co. Should Face Tobacco Fee Suit, Judge Says
A hospice and home healthcare provider shouldn't escape a proposed class action challenging a tobacco surcharge in its employee health plan, a Pennsylvania federal judge recommended, finding that allegations sufficiently backed up that a wellness program implementing the fee didn't meet all regulatory requirements.
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November 19, 2025
Doctor, Husband Admit $16M Healthcare Fraud, Tax Evasion
A physician and her husband admitted to committing more than $16 million in healthcare fraud and tax evasion as part of a scheme that injected sick patients with the wrong medications or dosages, according to their plea agreements in Alaska federal court.
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November 19, 2025
COVID-19 Testing Co. Settles Wage Suit With Testers, Drivers
A COVID-19 mobile testing company told a New York federal court that it has reached a settlement with a group of testers and drivers who claimed they were not paid full wages and overtime.
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November 19, 2025
Doc Takes Plea, Avoids Prison In Novel Opioid Death Case
A retired Massachusetts doctor pled guilty and was sentenced to five years of probation in a first-of-its-kind involuntary manslaughter case over a patient's 2016 opioid overdose death, the state attorney general's office announced.
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November 18, 2025
Health Co. Execs Convicted In $100M Adderall Sales Scheme
A San Francisco federal jury weighing a first-of-its-kind case on Tuesday convicted two digital healthcare company executives of scheming to sell Adderall through deceptive advertising, allegedly bringing in $100 million in illicit profits.
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November 18, 2025
'Surrender' Note Warrants Med Mal Retrial, Ill. Justices Hear
A below-the-knee amputee who lost his medical malpractice trial urged the Illinois Supreme Court to order a retrial in his case Tuesday, arguing a note stating a juror sided with the defense simply to end deliberations proves the verdict was not unanimous.
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November 18, 2025
Severe SC Abortion Bill Falters in Committee
A South Carolina bill that would have further criminalized abortion and subjected patients and doctors to up to 30 years in prison failed to advance out of a Senate committee on Tuesday, with antiabortion committee members raising concerns that the bill went too far.
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November 18, 2025
Feds Say Hi-Tech 'Trampled' Trust At Close Of Fraud Trial
Federal prosecutors closed out a nearly monthlong fraud trial against Hi-Tech Pharmaceuticals and its longtime CEO by telling a Georgia jury Tuesday that they "proudly" stood by what defense attorneys for the supplement manufacturer and distributor previously derided as a "paper case."
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November 18, 2025
Bristol-Myers Squibb Can Appeal Pension Suit To 2nd Circ.
Drugmaker Bristol-Myers Squibb and its investment manager can ask the Second Circuit to review a decision from September denying their motion to dismiss a pension dispute for lack of standing, a New York federal judge ruled.
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November 18, 2025
1st Circ. May Nix Trump Funding Freeze In 'Weird' Case
The First Circuit on Tuesday hinted that a federal judge may have been in bounds when blocking the Trump administration from withholding certain funds for states, expressing skepticism that the judge's order was improper or overly broad.
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November 18, 2025
Mass. Health Co. Settles 401(k) Suit Over Pricey Fees, Funds
A Cambridge hospital system agreed to settle a proposed class action claiming it mismanaged its $280 million retirement plan and cost workers millions in savings by failing to reduce management fees and trim costly funds from the plan, according to a Massachusetts federal court filing.
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November 18, 2025
Eye Doc's Hospital Competition Lawsuit Gets NC Panel Trial
Five years after being denied “certificate of need” application for an eye surgery center, a North Carolina doctor was in court Tuesday challenging a state law that has been on the books in some form since the Carter administration.
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November 18, 2025
Feds Look To 'False Certification' FCA Strategy
Prosecutors shifted strategy in a kickback case against a biotech giant. FCA attorneys are closely watching the Regeneron case for clues on how the DOJ will establish causation in a growing number of states implicated by recent circuit court rulings.
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November 18, 2025
McGuireWoods Is Delaying Defamation Case, NC Justices Told
The former CEO of a managed care organization who alleges McGuireWoods and one of its ex-partners defamed him during a press conference more than seven years ago has told North Carolina's top court not to take up the case, panning their petition as yet another stalling tactic.
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November 18, 2025
Massage Therapist Prevails In Fla. Health Dept. License Saga
Florida health officials' yearslong effort to revoke a massage therapist's license resulted in a notable appeals court decision that found a licensing board wrongly disregarded an administrative law judge's findings.
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November 17, 2025
DC Circ. Mulls If Gov't Can Say No To 340B Rebate Program
The D.C. Circuit is set to decide "who's the decision-maker" in a fight brought by drugmakers over the federal government's efforts to reshape the way they do drug rebates after spending more than an hour and a half Monday morning hearing out all sides.
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November 17, 2025
2 Execs Found Guilty In $233M ACA Fraud Scheme
A Florida federal jury returned a guilty verdict on Monday against a marketing company CEO and insurance brokerage executive who were accused of submitting fraudulent enrollments to fully subsidized Affordable Care Act insurance plans to get millions in commission payments from insurers.
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November 17, 2025
B. Braun Unit Inks $38.5M Deal To End FCA Knee Implant Case
The U.S. Department of Justice on Monday announced a $38.5 million False Claims Act settlement with a subsidiary of German medical device giant B. Braun Melsungen AG resolving accusations it sold a knee replacement implant allegedly known to fail prematurely after surgery.
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November 17, 2025
2nd Circ. Questions Experts' Rejection In Tylenol Autism Suits
A Second Circuit panel on Monday appeared skeptical of a lower-court order that barred every expert witness set to testify for families who allege that patients taking Tylenol while pregnant can cause autism or attention deficit hyperactivity disorder in their children.
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November 17, 2025
Hospital Inks $335K Deal To End EEOC Gender Bias Suit
A Kentucky federal judge signed off Monday on a $335,000 settlement to end a U.S. Equal Employment Opportunity Commission suit claiming a hospital system fired its chief nursing officer after she complained that she lost a promotion due to her gender.
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November 17, 2025
Mass. Justices Say Panel Overstepped In Sepsis Death Suit
Massachusetts' highest court on Monday reinstated medical malpractice claims against a nurse practitioner over a patient's sepsis death, saying a tribunal had stepped beyond its role in vetting an offer of proof by the man's widow.
Expert Analysis
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How DOJ's New Data Security Rules Leave HIPAA In The Dust
The U.S. Department of Justice's recently effective data security requirements carry profound implications for how healthcare providers collect, store, share and use data — and approach vendor oversight — that go far beyond the Health Insurance Portability and Accountability Act, say attorneys at Nelson Mullins.
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Texas Med Spas Must Prepare For 2 New State Laws
Two new laws in Texas — regulating elective intravenous therapy and reforming healthcare noncompetes — mark a pivotal shift in the regulatory framework for medical spas in the state, which must proactively adapt their operations and contractual practices, says Brad Cook at Munsch Hardt.
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DOJ-HHS Collab Crystallizes Focus On Health Enforcement
The recently announced partnership between the U.S. Department of Justice and U.S. Department of Health and Human Services to combat False Claims Act violations, following a multiyear trend of high-dollar DOJ recoveries, signals a long-term enforcement horizon with major implications for healthcare entities and whistleblowers, say attorneys at RJO.
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How The Healthline Privacy Settlement Redefines Ad Tech Use
The Healthline settlement is the first time California has drawn a clear line in the sand around how website tracking must function in practice, so if your site uses tracking technologies, especially around sensitive content like health or finance, regulators are inspecting your website's back end, not just its banner, say attorneys at Baker Donelson.
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How Sweeping Budget Bill Shakes Up Health Industry
With the recently passed One Big Beautiful Bill Act marking one of the most significant overhauls of federal health policy since the passage of the Affordable Care Act, providers, managed care organizations and life sciences companies must now shift focus from policy review to implementation planning, say advisers at Holland & Knight.
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New DOJ Penalty Policy Could Spell Trouble For Cos.
In light of the U.S. Department of Justice’s recently published guidance making victim relief a core condition of coordinated resolution crediting, companies facing parallel investigations must carefully calibrate their negotiation strategies to minimize the risk of duplicative penalties, say attorneys at Debevoise.
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A Look At Key 5th Circ. White Collar Rulings So Far This Year
In the first half of 2025, the Fifth Circuit has decided numerous cases of particular import to white collar practitioners, which collectively underscore the critical importance of meticulous recordbuilding, procedural compliance and strategic litigation choices at every stage of a case, says Joe Magliolo at Jackson Walker.
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What US Medicine Onshoring Means For Indian Life Sciences
Despite the Trump administration's latest moves to onshore essential medicine manufacturing, India will likely remain an indispensable component of the U.S. drug supply chain, but Indian manufacturers should prepare for stricter compliance checks, says Jashaswi Ghosh at Holon Law Partners.
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FCA Working Group Reboot Signals EHR Compliance Risk
The revival of the False Claims Act working group is an aggressive expansion of enforcement efforts by the Justice Department and the U.S. Department of Health and Human Services targeted toward technology-enabled fraud involving electronic health records and other data, say attorneys at ArentFox Schiff.
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FDA's Hasty Policymaking Approach Faces APA Challenges
Though the U.S. Food and Drug Administration has abandoned its usual notice-and-comment process for implementing new regulatory initiatives, two recent district court decisions make clear that these programs are still susceptible to Administrative Procedure Act challenges, says Rachel Turow at Skadden.
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The Metamorphosis Of The Major Questions Doctrine
The so-called major questions doctrine arose as a counterweight to Chevron deference over the past few decades, but invocations of the doctrine have persisted in the year since Chevron was overturned, suggesting it still has a role to play in reining in agency overreach, say attorneys at Crowell & Moring.
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A Rapidly Evolving Landscape For Noncompetes In Healthcare
A wave of new state laws regulating noncompete agreements in the healthcare sector, varying in scope, approach and enforceability, are shaped by several factors unique to the industry and are likely to distort the market, say attorneys at Seyfarth.
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Arguing The 8th Amendment For Reduction In FCA Penalties
While False Claims Act decisions lack consistency in how high the judgment-to-damages ratio in such cases can be before it becomes unconstitutional, defense counsel should cite the Eighth Amendment's excessive fines clause in pre-trial settlement negotiations, and seek penalty decreases in post-judgment motions and on appeal, says Scott Grubman at Chilivis Grubman.