Policy & Compliance
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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 it "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
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.
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November 17, 2025
9th Circ. Strikes Down Trans Patients' Win In ACA Bias Case
The Ninth Circuit upended a win Monday for patients who challenged Blue Cross Blue Shield of Illinois' administration of their employer-provided health plans containing gender-affirming care exclusions, ordering a lower court to reexamine the case in light of intervening authority from the U.S. Supreme Court.
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November 17, 2025
Corporate Pilot Fired For Flagging Safety Concerns, Suit Says
The former head of aviation for an oral surgery management services company in North Carolina says he was canned because of his age and hearing disability and for allegedly reporting flight scheduling practices that he said flouted federal safety laws.
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November 17, 2025
No High Court Review For FDA Fast-Track Denial
The U.S. Supreme Court on Monday said it would not consider whether federal drug regulators went astray in denying fast-track review for a digestive disorder medication being developed by Vanda Pharmaceuticals.
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November 14, 2025
Texas Judge Rejects Bid To Block Kenvue's $398M Dividend
Texas can't stop the makers of Tylenol from marketing the drug as safe for children and pregnant women or halt a nearly $400 million payment to shareholders, a state court ruled on Friday, rejecting arguments by Attorney General Ken Paxton's motion.
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November 14, 2025
Fla. Pharmacy To Pay $17M To Settle COVID False Claims Case
A Tampa, Florida, pharmacy has agreed to pay over $17 million to settle allegations that it knowingly filed false Medicare claims for over-the-counter COVID-19 tests that hadn't gone out to recipients.
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November 14, 2025
Drug Buyers Defend Class Cert. In 3rd Circ. Generics Case
Direct purchasers and end-payers in the sprawling multidistrict litigation over alleged price-fixing of generic drugs are fighting requests from Actavis and Mylan to undo class certification in the cases, arguing to the Third Circuit that the litigation is a classic example of a class action matter.
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November 14, 2025
10th Circ. Sides With Rehab Facility In Bias, Retaliation Suit
The Tenth Circuit refused Friday to reopen an occupational therapist's lawsuit claiming she was unceremoniously let go by a Kansas rehabilitation clinic for reporting a colleague's inappropriate behavior toward women, saying she couldn't revive her suit using arguments the trial court never considered.
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November 14, 2025
Horizon BCBS To Pay $100M To End NJ AG's Overcharge Suit
Horizon Blue Cross Blue Shield of New Jersey has agreed to pay the state $100 million to resolve allegations that it fraudulently secured a multibillion-dollar contract to administer public employee health plans and then systematically overcharged taxpayers for years, Attorney General Matthew J. Platkin announced Friday.
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November 13, 2025
NC Biz Court Bulletin: Rulings Spotlight Coverage Clashes
The North Carolina Business Court plowed into the fourth quarter with two big decisions in insurance disputes that involved $50 million in COVID-19-related losses at a chain of outlet malls, and an industrial accident at a Nucor Corp. iron plant in Louisiana.
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November 13, 2025
Donor Info Subpoena Chills Speech, Anti-Abortion Org Says
An organization that operates anti-abortion pregnancy centers told the U.S. Supreme Court on Thursday that New Jersey is undermining its own subpoena power in a bid to avoid constitutional review of its request for information about the group's donors.
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.
A New Mental Health Rx? FDA Braces For AI Chatbots
Patients suffering from depression may someday soon get an unusual kind of prescription that doesn’t involve a pill or an injection: Download a chatbot. Law360 Healthcare Authority has the key takeaways from an FDA meeting focused on regulating AI-powered mental health chatbots.
Gov't Subpoena Powers Face Reckoning In Healthcare Battles
The judicial deference given to the government's power to issue investigative subpoenas is facing an unprecedented challenge in transgender care cases. Willingness by judges to question motives could lead to more subpoena challenges or impede worthy government investigations.
Expert Analysis
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Surveying The Healthcare Policy Landscape Post-Shutdown
With last week's agreement to reopen the federal government, at least through the end of January, key healthcare legislation that has been in limbo since a December 2024 spending bill fell apart may recapture the attention of Congress, say attorneys at Faegre Drinker.
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Prison Body Cams Raise Health Privacy Compliance Issues
The increasing use of prison staff body cameras to enhance transparency and safety presents correctional healthcare partners with new risk management questions where they must carefully reconcile the benefits of surveillance with the imperative to protect patient privacy, say attorneys at Gordon Rees.
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Employer Considerations After 11th Circ. Gender Care Ruling
The Eleventh Circuit's en banc decision in Lange v. Houston County, Georgia, finding that a health plan did not violate Title VII by excluding coverage for gender-affirming care, shows that plans must be increasingly cognizant of federal and state liability as states pass varying mandates, say attorneys at Miller & Chevalier.
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How Healthcare Practices Can Prepare For ICE Visits
Healthcare providers that may face encounters with immigration enforcement should familiarize themselves with compliance obligations beyond ensuring employment authorization, and mitigate risk by establishing clear policies and specific procedures that safeguard patient rights and manage staff interactions with agents, say attorneys at Roetzel & Andress.
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Adapting To Calif.'s Enhanced Regulation Of PE In Healthcare
New California legislation enhances oversight on the role of private equity groups and hedge funds in healthcare transactions, featuring both a highly targeted nature and vague language that will require organizations to carefully evaluate existing practices, says Andrew Demetriou at Husch Blackwell.
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Lessons From 7th Circ. Decision Affirming $183M FCA Verdict
The Seventh Circuit's decision to uphold a $183 million False Claims Act award against Eli Lilly engages substantively with recurring materiality and scienter questions and provides insights into appellate review of complex trial court judgments, say Ellen London at London & Naor, Li Yu at Bernstein Litowitz and Kimberly Friday at Osborn Maledon.
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Calif. Justices Continued Anti-Arbitration Trend This Term
In the 2024-2025 term, the California Supreme Court justices continued to narrow arbitration's reach under state law, despite state courts' extreme caseload backlog and even as they embraced contractual autonomy in other contexts, says Josephine Petrick at The Norton Law Firm.
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Steps For Healthcare Providers After Cigna ERISA Settlement
Following the Cigna class action's settlement, where Employee Retirement Income Security Act violations arose from Cigna's online provider directory advertising providers as in-network who were actually out-of-network, providers should routinely audit their contract status and directory listings, and proactively coordinate with plans and payor partners, say attorneys at ArentFox Schiff.
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What's New In FDA's Latest Cell And Gene Therapy Guidance
New draft guidance from the U.S. Food and Drug Administration, along with other recent initiatives, come together to promote cell and gene therapy product development by streamlining development and review pathways, say attorneys at Holland & Knight.
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Adapting To Enforcement Focus On Wound Care Fraud
As federal agencies target wound care industry fraud as a top enforcement priority, attorneys advising industry stakeholders should evaluate business relationships for Anti-Kickback Statute violations, emphasize appropriate product use and documentation, and use internal data analytics to monitor billing patterns, say David Tarras at Tarras Defense and Jay McCormack at Verrill Dana.
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AG Watch: Illinois A Key Player In State-Level Enforcement
Illinois Attorney General Kwame Raoul has systematically strengthened his office to fill federal enforcement gaps, oppose Trump administration mandates and advance state policy objectives, particularly by aggressively pursuing labor-related issues, say attorneys at Troutman.
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Organ Transplant System Reforms Mark Regulatory Overhaul
Recent oversight, enforcement and operational developments in the U.S. organ procurement and transplantation system, alongside challenges like the federal shutdown, highlight heightened regulatory scrutiny and the need for compliance to maintain public trust, say attorneys at Hall Render.
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Federal Grantees May Soon Face More Limitations On Speech
If courts accept the administration’s new interpretation of preexisting case law, which attempts to graft onto grant recipients the existing limitations on government contractors' free speech, a more deferential standard may soon apply in determining whether an agency’s refusal or termination of a grant was in violation of the First Amendment, say attorneys at Venable.