Policy & Compliance

  • July 23, 2026

    UnitedHealth's $5M Demand Challenged By Wash. Dental Co.

    A dental practice is urging a Washington federal court to stop UnitedHealth from withholding future reimbursements, saying the insurer has failed to fully explain its assertion that it overpaid the practice more than $5 million for past claims, in a lawsuit filed Wednesday.

  • July 23, 2026

    Okla. Chiropractor Convicted Of $30M Medical Fraud Scheme

    A Florida federal jury convicted an Oklahoma chiropractor of attempting to bilk $30 million from federal health insurance programs, finding him guilty of a fraud conspiracy charge after he obtained patient information to produce fake doctors' orders for unnecessary medical equipment, according to the U.S. Department of Justice.

  • July 23, 2026

    Texas Panel Overturns Abortion Injunction Against Midwife

    A Texas appellate court overturned a temporary injunction against a licensed Houston-area midwife accused by state prosecutors of violating Texas' abortion ban, finding Thursday a trial court wrongly admitted probable-cause affidavits from a related criminal case.

  • July 22, 2026

    Late Emails Undercut BCBS Pricing Suit, Walgreens Says

    Walgreen Co. is urging an Illinois federal judge to again sanction a Blue Cross Blue Shield insurer and its subsidiary for allegedly failing to produce key email evidence the pharmacy retailer says "upends" the insurers' 6-year-old claim that it intentionally overcharged them for prescription drugs.

  • July 22, 2026

    Target Beats ERISA Suit Over Tobacco Health Surcharge

    A Minnesota federal judge on Wednesday tossed a proposed class action alleging that a tobacco fee on Target workers' health plan violated nondiscrimination provisions in federal benefits law, agreeing with the retail giant that the suit failed to state a claim.

  • July 22, 2026

    Cambia Health Hit With FCA Suit Over Medicare Fraud Claims

    Cambia Health Solutions Inc. stole millions of dollars from the federal Centers for Medicare & Medicaid Services over more than a decade by submitting fraudulent diagnostic information to the government, according to a whistleblower's False Claims Act lawsuit unsealed by a Seattle federal judge this week.

  • July 22, 2026

    Insurer Sanctioned For Destroying Opioid Coverage Evidence

    An Illinois federal court Wednesday sanctioned an insurer in a drug wholesaler's suit seeking coverage for underlying opioid litigation, finding that the carrier intentionally destroyed key emails and underwriting records in order to deprive the wholesaler of that information.

  • July 22, 2026

    Ex-Players Seek $4M In Legal Fees In NFL Race-Norming Fight

    Ex-NFL players who settled a suit over racially discriminatory assessments made by the league's disability and retirement plans are asking a Maryland federal judge for over $4 million in legal fees.

  • July 22, 2026

    Trump Says 100% Tariff On Generic Drugs Coming In 2028

    Generic drugs imported into the U.S. will be hit with a tariff of 100% in 2028 and 200% in later years in an attempt to drive manufacturing into the country, President Donald Trump said on social media.

  • July 22, 2026

    9th Circ. Won't Reopen Vax Bias Suit Against Wash. Officials

    The Ninth Circuit upheld a Washington state agency's win in a suit alleging it unlawfully fired over a dozen employees rather than accommodate their religious objections to the COVID-19 vaccine, ruling they hadn't shown the agency was purposely hostile toward religion.

  • July 22, 2026

    DOL Proposes E-Delivery Rule For Employer Health Plans

    The U.S. Department of Labor's employee benefits arm unveiled a proposal Wednesday that would provide more opportunities for electronic delivery of employer-provided health plans' mandatory disclosures.

  • July 21, 2026

    DC Circ. Affirms HHS Authority Over 340B Rebate Plans

    The D.C. Circuit on Tuesday upheld a lower court's finding that U.S. Department of Health and Human Services has the authority to block or approve drugmakers' efforts to implement rebates instead of discounts under the 340B drug-pricing program.

  • July 21, 2026

    Economist Concedes Opioid Stats' Limits In Albertsons Trial

    Despite testifying that Albertsons pharmacy records suggest some opioids dispensed in Washington state had "red flags" for potential diversion from legitimate use, an economist for the Evergreen State conceded Tuesday that he can't point to "even a single pill dispensed by Albertsons" that was actually improperly diverted. 

  • July 21, 2026

    $152M Health Marketing Ban, $62M Drug MDL Deal And More

    Law360 Healthcare Authority looks at the Federal Trade Commission's $152 million deal resolving allegations against a pair of health insurance marketers, a $62 million deal releasing Pfizer Inc. and other drugmakers from multidistrict litigation over generic-drug prices, and other key resolutions in healthcare litigation over the last week.

  • July 21, 2026

    Air Ambulance Co. Fights To Keep 'No Surprises' Suit Alive

    An air ambulance service looking to collect unpaid transport bills from Blue Cross Blue Shield's parent company argued Tuesday that its lawsuit should proceed because court enforcement is its only hope for combating the insurer's practice of ignoring the No Surprises Act's otherwise tight payment deadlines.

  • July 21, 2026

    Chamber Asks 2nd Circ. To Back Toss Of Pepsi Smoking Suit

    A New York federal judge rightly tossed allegations that Pepsi violated federal benefits law by making employees who smoke pay more for health insurance, the nation's largest business lobby argued in an amicus brief, urging the Second Circuit to affirm dismissal of the suit.

  • July 21, 2026

    What To Know: FDA Compounding Panel Weighs Peptides

    A panel advising the U.S. Food and Drug Administration will weigh in this week on a push to expand legal access to seven peptides that are touted by wellness influencers to treat injuries and other conditions.

  • July 21, 2026

    Class Cert. In Avandia MDL Undone For Lacking Stats

    The Third Circuit undid class certification for a group of health plans claiming GlaxoSmithKline deceptively marketed its diabetes drug Avandia, with a panel majority ruling Tuesday the plans needed stronger statistical analysis to show links between the marketing, the revelation of side effects and a drop in sales.

  • July 21, 2026

    States Dispute Drugmakers' Bid To Toss GLP-1 Antitrust Case

    The attorneys general of Texas and Louisiana pushed back on Tuesday against a bid from Novo Nordisk and Eli Lilly to duck a specialty pharmacy's antitrust case accusing the companies of blocking competition for GLP-1 medications.

  • July 21, 2026

    Novo's False Ad Suit Against Eli Lilly Ramps Up GLP-1 Rivalry

    Pharmaceutical giant Novo Nordisk Inc. slapped rival Eli Lilly & Co. with a false advertising suit in New Jersey federal court Tuesday, calling a marketing campaign for the rival's weight loss drugs "deceptive" for "withholding critical scientific evidence" about newer GLP-1 formulations.

  • July 21, 2026

    Imaging Co. Faces Consolidated Data Breach Cases In NC

    A North Carolina federal judge consolidated three proposed class actions against diagnostic imaging provider Lumexa Imaging Inc. over an alleged patient data breach earlier this year, tapping attorneys from Kopelowitz Ostrow PA and Milberg PLLC to serve as interim co-lead counsel.

  • July 21, 2026

    Hospitals Say Saul Ewing Atty's Board Role Taints FCA Suit

    A Saul Ewing LLP attorney should be disqualified from leading a whistleblower suit over a nurse's alleged diversion of prescription narcotics, as the former Heritage Valley Health System in western Pennsylvania said he was previously a member of its board of directors.

  • July 21, 2026

    CMS Withholds $1B In Medicaid From Calif., Minn., Citing Fraud

    The Centers for Medicare & Medicaid Services is withholding more than $1 billion in Medicaid dollars from California and Minnesota because the agency suspects healthcare fraud in those states, officials announced Tuesday.

  • July 21, 2026

    Research Or Crime? Feds Eye Scientists Crossing Borders

    At U.S. airports and border crossings, scientists returning from trips abroad are getting a closer look from law enforcement agents. More smuggling and paperwork violations that might once have been overlooked are turning into criminal cases.

  • July 21, 2026

    2nd Circ. Tylenol Expert Call Sows Admissibility Confusion

    A circuit court decision on expert admissibility in a dispute over an alleged link between Tylenol and autism is raising legal experts' concerns that the panel will sow confusion among judges trying to weed out unreliable medical opinions.

Expert Analysis

  • 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.

  • 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.