Policy & Compliance

  • 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."

  • May 15, 2026

    Minn. Twins Doctor Can't Claim Immunity In Player Death Suit

    A doctor employed by the Minnesota Twins can't claim immunity in a lawsuit alleging he failed to diagnose a heart condition in a ballplayer that led to his death, a Florida appeals panel ruled on Friday.

  • May 15, 2026

    4th Circ. Hands Express Scripts Jury Trial In W.Va. Opioid Suit

    The Fourth Circuit on Friday issued a writ of mandamus backing Express Scripts Inc.'s right to a jury trial in litigation over the pharmacy benefit manager's alleged role in contributing to the opioid crisis in West Virginia.

  • May 15, 2026

    Texas Justices Revive Anti-SLAPP Bid In Abortion Fund Suit

    The Texas Supreme Court on Friday revived a woman's anti-SLAPP bid in an abortion fund's suit against her, holding that the suit was filed in response to the woman's earlier attempt to investigate the fund's deputy director for potential violations of state abortion law.

  • May 15, 2026

    NC Social Worker Wants Resentencing In Medicaid Fraud Suit

    A clinical social worker in North Carolina serving more than 11 years in prison on healthcare fraud charges is challenging her sentence in the Fourth Circuit, saying Thursday that a lower court used overly generalized findings to apply a vulnerable victim sentence enhancement.

  • May 14, 2026

    NJ Doctor Prescribed Medical Marijuana To Kids, AG Says

    A New Jersey doctor had his medical license temporarily suspended by a state board, which found there is good reason to believe he is "a grave danger" to his patients after prosecutors accused him of repeatedly prescribing marijuana to adults and children without complying with state law.

  • May 14, 2026

    NC Republicans Want Fetal Personhood Question On '26 Ballot

    Two Republicans in the North Carolina House who have a history of advancing so-called fetal personhood bills have made another attempt to put a constitutional amendment to voters in November to decide if life begins at fertilization.

  • May 14, 2026

    Pa. Psych Hospital Faces Multiple Abuse Lawsuits

    A Pittsburgh-area psychiatric hospital has been hit with five state court lawsuits alleging it allowed patients as young as 10 years old to be physically and sexually abused by staff members and other patients, despite multiple investigations and warnings.

  • May 14, 2026

    Moda Health Settles Wilderness Therapy Coverage Suit

    Health insurance provider Moda Health has agreed to settle a lawsuit alleging it unlawfully denied a family's claims for their daughter's stays at two wilderness therapy programs and left them with thousands of dollars in medical bills, according to a filing in Oregon federal court.

  • May 14, 2026

    Albertsons Not Covered In Opioid Litigation, Del. Judge Says

    Albertsons isn't entitled to defense or indemnity for more than 100 suits accusing the pharmacy and grocery chain of fueling the opioid epidemic, a Delaware state court ruled, tracking the state high court's rulings in nearly identical disputes involving Rite Aid and CVS.

  • May 14, 2026

    High Court Maintains Abortion Pill Access Amid Circuit Appeal

    The U.S. Supreme Court on Thursday extended a stay preserving telehealth access to the abortion medication mifepristone while the Fifth Circuit weighs a challenge to the mail-order distribution of the pill.

  • May 14, 2026

    NC Healthcare Workers Get Final Nod On $1.5M Wage Deal

    A federal judge has given final approval to a $1.56 million settlement with the owners of several North Carolina hospitals and healthcare facilities accused of manipulating workers' time sheets to skirt overtime requirements.

  • May 14, 2026

    Time For Trial, Judge Says, Nixing DQ Appeal In Generics MDL

    A Pennsylvania federal judge has refused to let generic-drug makers seek Third Circuit intervention in their bid to disqualify the lead counsel for insurers Humana and Molina, concluding the fight would only further delay the long-running case ahead of its first trial in the price-fixing multidistrict litigation.

  • May 13, 2026

    CMS To Keep $1.3B From Calif., Halt New Hospice Enrollment

    The federal government on Wednesday announced it will defer more than $1.3 billion in Medicaid funds from California and halt new Medicare enrollments for hospices and home health agencies, saying it was part of an effort to crack down on fraudulent activity.

  • May 13, 2026

    3 NJ Employers Accused Of Pregnancy Discrimination

    A New Jersey hospital system, a laboratory company and a cleaning business must answer to allegations that they engaged in pregnancy discrimination in the workplace, state enforcers said this week.

  • May 13, 2026

    Washington Hits Providence Health With Pregnancy Bias Suit

    Washington slapped Providence Health & Services with a lawsuit Wednesday claiming the health system routinely rejected accommodation requests from pregnant employees, denying them spaces to pump breast milk, seating and schedule flexibility to attend doctor appointments.

  • May 13, 2026

    DOJ Fraud Division Set To Shake Up White-Collar Enforcement

    President Donald Trump's administration created the U.S. Department of Justice's National Fraud Enforcement Division with a narrow focus on combating government program fraud, but a move to retain federal prosecutors focused on other types of fraud could signal a wider scope with potential ripple effects across white-collar enforcement.

  • May 13, 2026

    Becton Hernia Mesh Antitrust Case Survives Dismissal

    A Pennsylvania federal court has refused to toss an antitrust case from Tela Bio Inc. accusing Becton Dickinson & Co. of abusing its dominant position in the hernia mesh market to block competing products.

  • May 13, 2026

    Provider Says NY Is On The Hook For $3.3M Medicaid Shortfall

    The New York State Department of Health's refusal to enforce payment obligations by Medicaid managed care organizations has cost a Queens-based safety net provider at least $3.3 million in underpayments for behavioral health services, according to a suit filed in New York federal court.

  • May 12, 2026

    Trans Care In Court: Gov't Probes, Forum Concerns And More

    Law360 Healthcare Authority looks at developments over the past week in legal challenges to probes by the Justice Department and Federal Trade Commission concerning the provision of gender-affirming care for transgender minors.

  • May 12, 2026

    Cigna Says HIPAA Doesn't Save Website Privacy Suit

    A proposed group of Cigna health plan participants can't cite HIPAA to keep up their claims that the insurer improperly tracked their private information through its websites, since the privacy law doesn't cover the kind of information the company collected, the insurer told a Pennsylvania federal court.

  • May 12, 2026

    DOJ Playing 'Dirty Pool' With Hospital In Trans Care Subpoena

    A Rhode Island federal judge indicated Tuesday she's likely to quash a subpoena from the U.S. Department of Justice seeking to obtain gender-affirming care medical records from Rhode Island Hospital, saying the DOJ was playing "dirty pool" by filing a motion to enforce the subpoena in another jurisdiction.

Expert Analysis

  • Prison Body Cams Raise Health Privacy Compliance Issues

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    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.

  • Employer Considerations After 11th Circ. Gender Care Ruling

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    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.

  • How Healthcare Practices Can Prepare For ICE Visits

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    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.

  • Adapting To Calif.'s Enhanced Regulation Of PE In Healthcare

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    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.

  • Lessons From 7th Circ. Decision Affirming $183M FCA Verdict

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    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.

  • Calif. Justices Continued Anti-Arbitration Trend This Term

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    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.

  • Steps For Healthcare Providers After Cigna ERISA Settlement

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    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.

  • What's New In FDA's Latest Cell And Gene Therapy Guidance

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    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.

  • Adapting To Enforcement Focus On Wound Care Fraud

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    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.

  • AG Watch: Illinois A Key Player In State-Level Enforcement

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    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.

  • Organ Transplant System Reforms Mark Regulatory Overhaul

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    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.

  • Federal Grantees May Soon Face More Limitations On Speech

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    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.

  • HHS Wound Care Report Highlights Need For Payment Reform

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    The U.S. Department of Health and Human Services' recent report on potential abuse in Medicare Part B payments for skin substitutes highlights specific fraud schemes, but more importantly emphasizes that broader changes are needed for the wound care sector's fundamentally flawed payment system, say attorneys at Paul Hastings.