Policy & Compliance

  • March 10, 2026

    Lab's Aetna Payment Suit Survives, But With Deep Cuts

    A Connecticut federal judge ruled Aetna and its parent company, CVS Health Corp., must face a pared down lawsuit from a medical laboratory alleging it is owed $20.6 million in unpaid invoices.

  • March 10, 2026

    Wash. To Set Its Own Vaccine Schedule Under New State Law

    Washington Gov. Bob Ferguson has signed legislation that requires health plans to cover vaccines and other preventive care recommended by the state rather than the federal government, joining a movement toward states setting their own recommendations.

  • March 10, 2026

    4th Circ. Backs W.Va.'s Trans Care Coverage Exclusion

    The Fourth Circuit said Tuesday that West Virginia's Medicaid coverage exclusion for gender-affirming care passes constitutional muster and does not discriminate based on sex, basing its conclusion on a U.S. Supreme Court ruling that upheld Tennessee's ban on gender-affirming care for minors.

  • March 10, 2026

    CVS Can't 'Relitigate' Price-Gouging Class Cert.

    A Rhode Island federal judge refused to narrow the certified classes of health plans alleging CVS schemed with pharmacy benefit managers to overcharge insured health plans for generic drugs, finding that PBM Express Scripts' refusal to produce its contracts changes nothing about how the classes will be assessed.

  • March 10, 2026

    2nd Circ. Revives Geico's Suit Over Acupuncture Referrals

    A lower court erred in granting summary judgment to Geico after the insurer sued over reimbursements to an acupuncturist involved in what Geico said was a kickback scheme, the Second Circuit ruled Tuesday, finding the district court misinterpreted a state law detailing requirements for referrals and no-fault payments. 

  • March 10, 2026

    Minn. Medicaid Funds Case A Test For CMS Tactic

    Minnesota’s fight over $243 million in Medicaid funding frozen by the Trump administration sets up an unusual, politically tinged legal clash that may shape the government’s anti-fraud tactics in other states.

  • March 10, 2026

    Wyoming Abortion Ruling Sets Off Lawmaker Backlash

    Lawmakers in Wyoming won't let judges have the final word on abortion and have considered slashing judicial security funding and shrinking the top court. This week, the governor signed a new "heartbeat" abortion ban likely to see new legal challenges.

  • March 10, 2026

    Former Conn. Prosecutor Can Stay On Generic-Drug Case

    Connecticut's former assistant attorney general can continue to represent insurers Humana and Molina Healthcare Inc. in multidistrict litigation over alleged price-fixing of generic drugs, after the Pennsylvania federal judge overseeing the case agreed Monday with a report that the attorney has no information that had not already been shared.

  • March 10, 2026

    AFSCME Sues Trump Admin Over $600M Health Funding Cuts

    The American Federation of State, County and Municipal Employees is seeking to block a federal government directive to cancel more than $600 million in public health grants administered by the Centers for Disease Control and Prevention, alleging that the directive was issued to target Democratic-led states.

  • March 10, 2026

    Abortion Ban, Drug Pricing: Health Litigation Week In Review

    Indiana's abortion ban and religious freedom, a proposed class action over Express Scripts pricing, and a deal over abortion pill ads. Law360 looks at big legal developments from the past week.

  • March 09, 2026

    Texas AG Gets Temporary Ban On Chest Binder Sales

    A Texas state judge has issued a temporary restraining order against a New York-based online retailer of undergarments and chest binders for young women and teens from selling its clothing in the Lone Star State.

  • March 09, 2026

    Vehicle Manufacturer Strikes Deal In Tobacco Surcharge Suit

    Commercial vehicle manufacturer International Motors LLC has agreed to end a proposed class action claiming it unlawfully charges employees who use tobacco products an additional $600 per year for health insurance without providing an alternative to the fee, according to a filing in Illinois federal court.

  • March 09, 2026

    NC Providers Sue UnitedHealth Over 'Devastating' Cyberattack

    UnitedHealth Group Inc. and several of its subsidiaries are facing a proposed class action in North Carolina state court over a 2024 data breach that took its claims processing platform offline and allegedly delayed billions of dollars in reimbursements to providers.

  • March 09, 2026

    JPMorgan Trims But Can't Escape ERISA Drug Costs Suit

    A New York federal judge pared claims Monday against JPMorgan Chase & Co. in a suit from workers who alleged they paid too much for prescription drugs, but opened discovery on allegations that the bank's contract with its pharmacy benefit manager caused transactions prohibited by federal benefits law.

  • March 06, 2026

    ExThera Exec Hid Patient Deaths To Keep $10M Deal, DOJ Says

    Medical device company ExThera concealed the deaths of two U.S. patients treated with its unapproved blood filtration device at a clinic in Antigua, according to federal prosecutors, with the company agreeing to forfeit nearly $5.7 million and one executive facing up to three years in prison.

  • March 06, 2026

    Health Groups Back Bid To Bar Noncitizen Benefit Restrictions

    A group of public health organizations and scholars Friday urged a Rhode Island federal court to make permanent its order blocking the Trump administration from enacting a policy change basing access to a host of federally funded services on immigration status.

  • March 06, 2026

    FDA Vaccine Chief Prasad To Exit Agency For 2nd Time

    Dr. Vinay Prasad, the U.S. Food and Drug Administration's top vaccine regulator, will leave the agency in the coming weeks, FDA Commissioner Marty Makary said Friday.

  • March 06, 2026

    9th Circ. Mulls Whether Politics Tainted DOJ Trans Care Probe

    A Ninth Circuit panel on Friday grappled with where to draw the line between a legitimate law enforcement investigation and a politically motivated crusade, as the U.S. Department of Justice sought to revive a subpoena against a telehealth provider of gender-affirming medical care.

  • March 06, 2026

    Mass. Judge Told Vax Committee Must Be Fairly Balanced

    A key federal vaccine committee remains subject to statutory requirements that its membership be fairly balanced, a Massachusetts federal judge heard from both U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. and medical organizations challenging his overhaul of the group.

  • March 06, 2026

    Dentist Says She Was Fired For Exposing Medicaid Fraud

    A dentist filed suit against several West Michigan dental practices and a dental management company, claiming she was fired after reporting that the clinics billed Medicaid for dental procedures that were never performed.

  • March 05, 2026

    Telehealth Co. Swaps In Gordon Rees In Novo's GLP-1 Fight

    A telehealth platform facing allegations from Novo Nordisk that it falsely advertised Ozempic alternatives has picked new counsel in the dispute, withdrawing attorneys from Foley & Lardner LLP and Miller Nash LLP and substituting in two lawyers from Gordon Rees Scully Mansukhani LLP.

  • March 05, 2026

    Pharma Co. Investors Secure Class Cert. Over FDA Obstacles

    A Pennsylvania federal judge has granted certification to a group of Verrica Pharmaceuticals Inc. investors who claim the company defrauded them by hiding obstacles it faced in obtaining approval from the U.S. Food and Drug Administration for its lead product, though she made a slight change to the class definition to avoid what she called a "heads I win, tails you lose strategy."

  • March 05, 2026

    9th Circ. Denies Bail Pending Nurse Wage-Fixing Appeal

    A Ninth Circuit panel summarily refused to allow a Las Vegas home nursing executive to avoid prison while appealing the U.S. Department of Justice's first-ever criminal wage-fixing conviction.

  • March 05, 2026

    9th Circ. Judge 'Frustrated' At DOJ Position On Anti-Trans EOs

    A Ninth Circuit judge said Thursday he's "very frustrated" with the Trump administration's argument that a district court judge acted prematurely by partly blocking executive orders to end funding for gender-affirming care, saying it's "pretty clear" the government was poised to do exactly that.

  • March 05, 2026

    BCBS Can't Nix NC Plan Member From Cancer Treatment Row

    A North Carolina federal judge ruled a Blue Cross Blue Shield unit must face proposed class action claims over its administration of a state employee health plan from a participant alleging it arbitrarily characterized a proton beam cancer radiation treatment as experimental to deny coverage.

Expert Analysis

  • 3 Key Takeaways From Planned Rescheduling Of Cannabis

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    An executive order reviving cannabis rescheduling represents a monumental change for the industry and, while the substance will remain illegal at the federal level, introduces several benefits, including improving state-legal cannabis operators' tax treatment, lowering the industry's legal risk profile, and leaving state-regulated markets largely intact, say attorneys at Dentons.

  • 6 Issues That May Follow The 340B Rebate Pilot Challenge

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    Though the Health Resources and Services Administration withdrew a pending case to reconsider the controversial 340B rebate pilot program, a number of crucial considerations remain, including the likelihood of a rework and questions about what that rework might look like, say attorneys at Spencer Fane.

  • 2026 State AI Bills That Could Expand Liability, Insurance Risk

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    State bills legislating artificial intelligence that are expected to pass in 2026 will reshape the liability landscape for all companies incorporating AI solutions into their business operations, as any novel private rights of action authorized under AI-related statutes signal expanding exposures, say attorneys at Wiley.

  • How 11th Circ.'s Zafirov Decision Could Upend Qui Tam Cases

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    Oral argument before the Eleventh Circuit last month in U.S. ex rel. Zafirov v. Florida Medical Associates suggests that the court may affirm a lower court's opinion that the qui tam provisions of the False Claims Act are unconstitutional — which could wreak havoc on pending and future qui tam cases, say attorneys at Morgan Lewis.

  • Key Trends For Life Sciences Cos. To Watch In 2026

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    Following a year of drastic change at the U.S. Food and Drug Administration, two themes are likely to drive the coming year — a commitment to lowering the cost of drugs and an inherent tension between the priorities of the health agencies and the broader administration, say attorneys at Sheppard Mullin.

  • The Next Pressure Point In Digital Health: Informed Consent

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    Two new federal digital health initiatives will usher in a new era where virtual care, software-enabled devices and home-based monitoring are integrated into care and reimbursement models, with the impact of shifting rules and opportunities felt most immediately in the context of informed consent, says Kimberly Chew at Husch Blackwell.

  • 4 Trends Shaping Drug And Medical Device Law For 2026

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    2025 saw some significant legal developments with potential impact for drug and device manufacturers, ranging from growing skepticism in science and regulatory entities to new regulation of artificial intelligence, say attorneys at Faegre Drinker.

  • Preparing For Congressional Investigations In A Midterm Year

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    2026 will be a consequential year for congressional oversight as the upcoming midterm elections may yield bolder investigations and more aggressive state attorneys general coalitions, so companies should consider adopting risk management measures to get ahead of potential changes, say attorneys at Morgan Lewis.

  • A Meaningful Shift In FDA's Biosimilarity Analysis

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    The U.S. Food and Drug Administration's potential pivot away from routinely requiring comparative efficacy studies for interchangeable biosimilar applications would not lower regulatory standards, but instead allow applicants to allocate resources toward establishing more probative evidence, says Theodore Thompson at Stinson.

  • Top 5 Antitrust Issues For In-House Counsel To Watch In 2026

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    With Trump administration enforcement policy having largely taken shape last year, antitrust issues that in-house counsel should have on the radar range from scrutiny of technology-assisted pricing to the return of merger remedies, say attorneys at Squire Patton.

  • 2025 Legal Milestones That Will Shape Psychedelics Sector

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    As 2025 draws to a close, psychedelic drug development stands at an inflection point, experiencing unprecedented momentum through recent sweeping regulatory changes and landmark clinical milestones, amid rapidly evolving regulatory expectations, say Odette Hauke at Odette Alina LLC and Kimberly Chew at Husch Blackwell.

  • 2025 State AI Laws Expand Liability, Raise Insurance Risks

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    As 2025 nears its end, claims professionals should be aware of trends in state legislation addressing artificial intelligence use, as insurance claims based on some of these liability-expanding statutes are a certainty, say attorneys at Wiley.

  • Learning From 2025 FCA Trends Targeting PE In Healthcare

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    False Claims Act enforcement trends and legislative developments from this year signal intensifying state and federal scrutiny of private equity's growing footprint in healthcare, and the urgency of compliance, says Lisa Re at Arnold & Porter.