Policy & Compliance

  • May 21, 2026

    PBM Swaps Cravath For WilmerHale In Price-Fixing Suit

    Pharmacy benefit manager Prime Therapeutics LLC has replaced counsel Cravath Swaine & Moore LLP with WilmerHale and another firm in an antitrust case in Michigan federal court brought by the state's attorney general.

  • May 21, 2026

    9th Circ. Told To Reject J&J Unit's $442M Antitrust Appeal

    Cardiac catheter refurbisher Innovative Health urged the Ninth Circuit to reject the appeal from Johnson & Johnson's Biosense Webster unit seeking to upend its $442 million antitrust judgment, saying the lower court rightly found that Biosense forced hospitals to avoid refurbished catheters in favor of its own.

  • May 21, 2026

    FTC's Gender Care Policy Might Not Sink Probe, Judge Says

    A D.C. federal judge wondered Thursday whether it would set a bad precedent for future commissions to label the Federal Trade Commission's investigative demand to the American Academy of Pediatrics as "retaliatory" just because agency officials have issued a policy statement attacking gender-affirming care for minors.

  • May 21, 2026

    Medical Practice Calls $49M Missed Cancer Verdict 'Unjust'

    The Westchester Medical Group PC has asked a Connecticut state judge to find most of a $49 million jury verdict "excessive, unjust, and entirely disproportionate" to claims its staff repeatedly failed to diagnose cancer despite multiple warning signs, calling the award punitive and not supported by the evidence.

  • May 20, 2026

    2nd Circ. Skeptical Of Bid To Boost Drug Royalty Award

    A Second Circuit panel appeared unsympathetic during oral arguments on Wednesday to Acorda Therapeutics Inc.'s assertion that it should be awarded nearly $66 million beyond the $16.5 million it won in a multiple sclerosis drug dispute, with one judge remarking that the company is "kind of in the soup" because it chose arbitration.

  • May 20, 2026

    Refusing Sandoz Parent Dismissal 'Clear Error,' Court Told

    Sandoz's Swiss parent company wants a Pennsylvania federal judge to rethink her decision forcing it to face generic drug price-fixing claims from major employers like General Motors, arguing the court "conflates" Novartis AG with Sandoz AG, which was spun off in 2023.

  • May 20, 2026

    NY Hospital Strikes Deal In Suit Over Retirement Plan Lineup

    A Long Island hospital agreed to settle a proposed class action alleging it cost workers millions of dollars in savings by loading its employee retirement plan with costly and underperforming investment options, according to a filing in New York federal court Wednesday.

  • May 20, 2026

    Va. Will Require Employers To Provide Paid Sick Leave

    Workers in Virginia will soon be entitled to paid sick leave after Gov. Abigail Spanberger signed a bill Wednesday that requires employers to provide five days of paid time off for employees who get sick or have to care for a family member.

  • May 20, 2026

    Pa. AG Aims To Revive Ban On Medicaid-Paid Abortions

    Pennsylvania Attorney General Dave Sunday plans to fight an appellate panel's ruling that Medicaid-funded abortions are a fundamental right to reproductive autonomy in the state.

  • May 20, 2026

    Bass Berry Adds Crowell & Moring Healthcare Atty In DC

    Bass Berry & Sims PLC has hired a former Crowell & Moring LLP partner, who in her last role represented a healthcare insurer against whistleblower claims that it participated in a kickback scheme involving Medicare Advantage customers.

  • May 19, 2026

    New Suits Target Fed. Loan Rule, CVS 340B Rates And More

    Law360 Healthcare Authority looks at new lawsuits targeting a U.S. Department of Education rule limiting loans available to students in nursing and other healthcare programs, CVS reimbursement practices for safety net providers under the federal 340B drug discount program and more.

  • May 19, 2026

    Cigna Can't Knock Out 401(k) Forfeiture, Fund Suit

    Cigna can't escape a proposed class action alleging that underperforming investment offerings and misallocated forfeitures in its employee 401(k) plan cost workers millions, after a Pennsylvania federal judge ruled Tuesday that alleged violations of federal benefits law were sufficiently backed up to reach discovery.

  • May 19, 2026

    Justice Alito Calls Out Slow Pace Of FDA Mifepristone Study

    The Trump administration’s slow-paced review of the abortion medication mifepristone has the attention of a U.S. Supreme Court justice, not just anti-abortion activists.

  • May 19, 2026

    9th Circ. Reopens Ex-Transit Manager's Vaccine Bias Suit

    The Ninth Circuit breathed new life into a Washington transit system manager's lawsuit alleging she was fired for requesting a religious exemption from a county's COVID-19 vaccine requirement, ruling Tuesday that she should be given a chance to revise her complaint.

  • May 19, 2026

    3 Things To Know As Distributors Test Conn. Drug Price Law

    The Second Circuit will hear arguments in a suit filed by a wholesale drug distributor group seeking to take down —​​​​​​​ or at least hold up —​​​​​​​ a Connecticut law tying price increases for generics to inflation.

  • May 19, 2026

    States Sue Over Student Loan Limits On Professional Degrees

    A coalition of 24 attorneys general and two governors are challenging a rule recently promulgated by the U.S. Department of Education, alleging in a complaint in Maryland federal court Tuesday that it unlawfully limits access to federal student loans for those pursuing professional degree programs.

  • May 19, 2026

    Mich. Hospitals Say CVS Diverted $66M In 340B Drug Savings

    CVS Health Corp. and several affiliates implemented a pricing scheme to divert to themselves savings from the federal 340B Drug Pricing Program, two University of Michigan hospital operators told a federal court, saying the scheme has resulted in more than $66 million in lost revenue over six years.

  • May 19, 2026

    Anthem Inks $3.6M Settlement In Proton Beam Therapy Suit

    Anthem and its affiliates have agreed to fork over approximately $3.6 million to end a proposed class action from employee health plan participants who challenged coverage denials for proton beam therapy to treat cancer, according to Tuesday filings in Tennessee federal court.

  • May 18, 2026

    PBMs Tell Mich. Court They're Not To Blame For Opioid Abuse

    Pharmacy benefit managers told a Michigan federal court on Monday they are not responsible for opioid abuse because they do not control prescription drugs once they are sold to patients, as Evernorth Health, Express Scripts and other companies seek an exit from the state attorney general's public nuisance suit.

  • May 18, 2026

    Aetna Denied A Freeze On Trans Facial Surgery Order

    A Connecticut federal judge ordered Aetna to comply with a preliminary injunction requiring it to reconsider coverage denials affecting two transgender health plan participants who sought gender-affirming facial surgery, refusing to stay the insurer's compliance obligations during its pending appeal in the proposed class action.  

  • May 18, 2026

    Morgan & Morgan Atty Barred From Harvard Suit Over AI Error

    A Massachusetts judge on Monday said a Morgan & Morgan PA attorney may not appear before him in a suit against Harvard University over the theft of body parts donated to its medical school, saying the lawyer did not learn his lesson after signing off on briefs in another case with fake case law generated by artificial intelligence.

  • May 18, 2026

    Justices Deny Eli Lilly's Qui Tam Constitutional Challenge

    The U.S. Supreme Court on Monday declined to review Eli Lilly's $183 million trial loss to a whistleblower who claimed the drugmaker knowingly defrauded the government by underpaying Medicaid drug rebates.

  • May 18, 2026

    Colo. Justices Tell Hospital To Resume Gender-Affirming Care

    The Colorado Supreme Court ordered Children's Hospital Colorado on Monday to resume its provision of gender-affirming care for transgender youth patients, finding the patients demonstrated actual harm from the denial of care.

  • May 18, 2026

    High Court Spurns Pharma Challenges To IRA Drug Price Talks

    The U.S. Supreme Court rejected six petitions Monday from pharmaceutical giants seeking to bring down the Medicare drug price negotiations established as part of the Inflation Reduction Act three years ago.

  • May 15, 2026

    Texas Hospital Creates 'De-Transition Clinic' After Settlement

    The Texas attorney general announced a settlement with Texas Children's Hospital that will see the creation of a detransition clinic, saying Friday that the hospital will pay $10 million for billing Texas Medicaid for "illegal 'gender-transition' interventions."

Expert Analysis

  • How To Engage With Gov't's Direct-To-Consumer Drug Policy

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    The U.S. Department of Health and Human Services' recent request for industry input on manufacturers' direct-to-consumer drug sales reflects the government's caution in this arena, and allows stakeholders a rare opportunity to help shape policy, says Mary Kohler at Kohler Health Law.

  • When Fraud Involvement Disqualifies FCA Whistleblowers

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    A Massachusetts federal court's recent dismissal of a False Claims Act relator in U.S. ex rel. Perry v. First Psychiatric Planners provides instructive insight into when whistleblowers may be denied their share of settlement proceeds, even if their involvement in the underlying fraud is a step removed, say attorneys at Holland & Knight.

  • Lessons From Justices' Split On Major Questions Doctrine

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    The justices' varied opinions in Learning Resources v. Trump, which held the International Emergency Economy Powers Act did not confer the power to impose tariffs, offer a meaningful window into the U.S. Supreme Court's perspective on the major questions doctrine that will likely shape lower courts' approach to executive action challenges, say attorneys at Venable.

  • Drug Wholesaler's DPA Shows Imperfect Efforts Still Count

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    Atlantic Biologicals’ recent deferred prosecution agreement with federal prosecutors for allegedly distributing controlled substances to pill mill pharmacies demonstrates that even subpar cooperation, when combined with genuine remediation and strategic advocacy, can yield outcomes that protect a company's long-term interests, says Jonathan Porter at Husch Blackwell.

  • Key Takeaways As HRSA Aims To Revive 340B Rebate Pilot

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    The U.S. Department of Health and Human Services' recent request for feedback on the 340B Rebate Model Pilot Program demonstrates that it intends to correct the model's procedural defects, which is positive news for participating manufacturers, but a setback for covered entities, say attorneys at Manatt.

  • Unique Issues Facing Brand-Compounder Patent Litigation

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    Recent litigation and potential enforcement action against Hims & Hers Health raise questions about how compounders and branded pharmaceuticals companies would be positioned in patent litigation as compared to generics companies, which would require strategies different from those that would be used in traditional Hatch-Waxman Act litigation, say attorneys at Morgan Lewis.

  • Pros And Cons Of FDA's Push For Nonprescription Drugs

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    The U.S. Food and Drug Administration's recent moves to shift more prescription drugs to over-the-counter status could increase access to important medications, but also bring potential safety risks and other trade-offs for drug companies, say attorneys at Hogan Lovells.

  • Prepping For The Future Of No Surprises Act Enforcement

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    This year is expected to be a transition point for the No Surprises Act framework from regulatory delay to operational enforcement, so stakeholders should use this time to stress-test systems, clean up processes and prepare for enforcement, say attorneys at Akerman.

  • High Court's 'Skinny Label' Case May Tackle Wider Questions

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    The U.S. Supreme Court's upcoming decision in Hikma v. Amarin will have important ramifications for broader debates over what defines a generic version of a drug, and the pending case is already altering patent practice, say attorneys at Taft.

  • Unpacking Key Themes From NY's New Healthcare Strategy

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    New York Gov. Kathy Hochul's 2026 State of the State agenda, read together with the state's fiscal year 2027 executive budget, reflect a clear framework to utilize Medicaid as the state's operating platform for healthcare reform, say attorneys at Sheppard.

  • 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.