Policy & Compliance
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June 02, 2025
Nursing Exec Says DOJ Misapplied Justices' Fraud Ruling
A Nevada nursing home executive convicted of wage-fixing and wire fraud has told a Nevada federal judge that a recent U.S. Supreme Court ruling in a fraud case doesn't preclude his motion for a new trial, contrary to what the U.S. Department of Justice has argued.
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May 30, 2025
$5.2M Generic Drug Price-Fixing MDL Deal Gets Final OK
Apotex Corp. will be paying $5.2 million to settle claims from a class of indirect purchasers alleging the drugmaker was working with other pharmaceutical companies to hike up the price of certain generic medications.
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May 30, 2025
5th Circ. To Rehear No Surprises Act Ruling En Banc
The full Fifth Circuit agreed Friday to reconsider a dispute over provisions for calculating qualifying payments under the 2020 No Surprises Act.
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May 30, 2025
DLA Piper Adds Healthcare Regulatory Atty In DC Office
DLA Piper strengthened its healthcare regulatory resources in Washington, D.C., with the recent addition of an attorney who previously served as acting general counsel for the U.S. Department of Health and Human Services.
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May 29, 2025
AstraZeneca Inks $51.4M Settlement In Pay-For-Delay Case
AstraZeneca Pharmaceuticals LP and Handa Pharmaceuticals LLC have agreed to shell out a combined $51.4 million to put to rest allegations AstraZeneca paid off generic-drug makers, including Handa, to protect its brand antipsychotic drug Seroquel XR, according to a filing Thursday in Delaware federal court.
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May 29, 2025
CMS Seeks Hospital Responses On Gender Dysphoria Care
The Centers for Medicare & Medicaid Services is asking hospitals to produce information on gender dysphoria care provided to children and adolescents, noting in an oversight letter that the U.S. government has "serious concerns" surrounding hormone therapy and other gender-affirming medical interventions.
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May 29, 2025
Ga. BCBS Says Providers Are Gaming Billing Dispute System
Blue Cross Blue Shield of Georgia has accused a healthcare consulting firm and a handful of Peach State providers of systematic abuse of a federal dispute resolution process for surprise medical bills, accusing them of "flooding" the system with bogus dispute claims.
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May 29, 2025
Express Scripts Says Arkansas Can't Ban PBM Pharmacies
Pharmacy benefits manager Express Scripts sued the state of Arkansas in federal court Thursday, alleging that the state's recently enacted law banning PBMs from owning pharmacies in the state violated the U.S. Constitution and ran afoul of federal law governing military employee benefits.
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May 29, 2025
Split 9th Circ. Says Spa's Rule On Certain Trans Women Biased
A divided Ninth Circuit refused to reinstate a Korean spa's constitutional challenge against the Washington State Human Rights Commission and ordered it to rescind its policy denying admission to trans women without gender-affirming surgery, noting Thursday the policy violated state law prohibiting discrimination based on sexual orientation and gender identity.
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May 28, 2025
Elon Musk Is Leaving White House Role, Trump Admin Says
Billionaire Elon Musk is ending his work with President Donald Trump and the federal Department of Government Efficiency, a White House official confirmed Wednesday evening.
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May 28, 2025
Justices Told Del. Expert Law Doesn't Apply In Federal Court
A retired attorney who claims he was negligently injured by healthcare providers urged the U.S. Supreme Court on Tuesday to hold that a Delaware federal court need not apply a state statute requiring an expert affidavit for all medical malpractice suits.
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May 28, 2025
Judge Rejects Johns Hopkins Unit's Claim FCA Suit Is Untimely
A Maine federal judge on Wednesday denied Johns Hopkins Medical Services Corp.'s bid to dismiss a False Claims Act suit as untimely, ruling it must face allegations it failed to report being overpaid for healthcare services for military personnel, retirees and their families.
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May 28, 2025
Feds Urge Supreme Court To Let 10th Circ. PBM Ruling Stand
The federal government urged the U.S. Supreme Court not to take up the state of Oklahoma's challenge to a Tenth Circuit decision that found parts of a law regulating pharmacy benefit managers were preempted by federal benefits and healthcare laws, arguing the case doesn't warrant further review from the justices.
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May 28, 2025
Colorado, Feds Clash Over $6.7M From Collapsed Insurer
A Colorado federal judge pressed the state Wednesday on how its bid to pay out $6.7 million from a defunct health insurer to a Denver Health plan doesn't conflict with the federal government's interests, noting the disbursement would result in less money to a federal risk program.
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May 28, 2025
DOJ Says Justices' Ruling Backs Nursing Exec's Conviction
The U.S. Department of Justice is pointing to a recent U.S. Supreme Court ruling to bolster its fight against a new trial being sought by a convicted Nevada nursing home executive, saying that the new high court decision establishes that economic loss isn't needed to prove wire fraud.
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May 28, 2025
Cooley Adds Ex-FDA Attorney To DC Life Sciences Group
Cooley LLP has hired a former U.S. Food and Drug Administration attorney, who for the majority of her public service career worked as an associate chief counsel, trying civil actions and criminal prosecutions against those accused of violating regulations for a range of products.
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May 27, 2025
Musk, DOGE Fail To Nix States' Suit Against 'Limitless' Power
Fourteen states can proceed in their lawsuit challenging Elon Musk and the Department of Government Efficiency's influence in the federal government after a D.C. federal judge Tuesday refused to toss their suit, rejecting the government's contention that Musk wasn't subject to the U.S. Constitution's appointments clause.
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May 27, 2025
CMS Heightens Medicaid Oversight For Immigrant Care
The Centers for Medicare & Medicaid Services on Tuesday said it is ramping up its financial oversight of states to detect misuse of federal Medicaid dollars, telling states it will seek to recoup federal funds spent on nonemergent care for "illegal aliens."
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May 27, 2025
Healthcare Hires: Wilson Sonsini, BCLP, Proskauer And More
Wilson Sonsini Goodrich & Rosati PC has bolstered its regulatory practice with the addition of a U.S. Department of Health and Human Services attorney who most recently led Crowell & Moring LLP's digital health group.
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May 27, 2025
What The MAHA Report Tells Us About Its Future Agenda
A long-awaited report from a commission tasked with addressing childhood chronic disease in the United States signals key parts of the healthcare system that may soon see policy changes as part of the larger Make America Healthy Again agenda.
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May 27, 2025
The Surgical Pay Gap: How Bias May Hurt Women's Health
Medical and legal professionals warn that systemic sex discrimination in U.S. surgical valuations — in the form of lower pay for procedures on female anatomy — discourages specialization in women's health, leads to delayed care and increased suffering for female patients, and could expose insurers to legal liability.
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May 27, 2025
Feds No Longer Advise COVID Shot For Kids, Pregnant Adults
The nation's public health agency on Tuesday pulled the COVID-19 vaccine from the list of recommended shots for healthy children and pregnant adults, a move that experts say could reduce demand for the vaccine and make it more expensive for some families.
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May 27, 2025
Fla. Judge Pauses Suit Over Baseball Player's Death
A Florida state court judge on Tuesday ordered a temporary halt to a lawsuit alleging medical malpractive against a Minnesota Twins physician over the death of a minor league baseball player, pausing the case while an order denying immunity for the doctor is appealed.
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May 27, 2025
Wilson Sonsini Adds Ex-HHS, Crowell & Moring Leader In DC
A former policy director at the U.S. Department of Health and Human Services who later helped Crowell & Moring LLP launch its healthcare consulting group has joined Wilson Sonsini Goodrich & Rosati PC's Washington, D.C., team, the firm announced Tuesday.
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May 23, 2025
Minn. Patient Sues Over Colorado Limits On Aid-In-Dying Care
A new suit by two Colorado doctors and an out-of-state patient challenges a state restriction barring nonresidents from accessing a form of healthcare legalized in Colorado allowing patients to receive a doctor's help in ending their life.
Expert Analysis
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15 Areas That Would Change Under Health Data Rule Proposal
If finalized, the Office of the National Coordinator for Health Information Technology's proposed rule will significantly progress its efforts to advance interoperability, respond to stakeholder concerns and clarify compliance with the health IT certification program, say attorneys at Ropes & Gray.
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3 Healthcare FCA Deals Provide Self-Disclosure Takeaways
Several civil False Claims Act settlements of alleged healthcare fraud violations over the past year demonstrate that healthcare providers may benefit substantially from voluntarily disclosing potential misconduct to both the U.S. Department of Justice and the U.S. Department of Health and Human Services, say Brian Albritton and Raquel Ramirez Jefferson at Phelps Dunbar.
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Takeaways From High Court's Tribal Health Admin Cost Ruling
The U.S. Supreme Court's recent determination that the government must reimburse two Native American tribes for administrative healthcare costs will help tribes maintain equal footing with the Indian Health Service when administering programs, and continues a pattern of how the current court aligns on tribal concerns, say attorneys at Lewis Roca.
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FTC Focus: Private Equity Investments In Healthcare
As the Federal Trade Commission is tightening its scrutiny of private equity investment in healthcare, the agency is finding novel grounds to challenge key focus areas, including rollup acquisitions, the flip-and-strip approach and minority investments in rival providers, say attorneys at Proskauer.
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High Court's Expert Ruling May Help Health Fraud Defendants
The U.S. Supreme Court's decision in Diaz v. U.S. appears to give the government a powerful new tool in calling its own agents as expert witnesses, but it could also benefit defense counsel in criminal healthcare fraud and other white collar criminal cases that arise in complex legal or regulatory environments, say attorneys at Holland & Knight.
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Unpacking HHS' Opinion On Cell Therapy Refund Programs
A recent advisory opinion from the U.S. Department of Health and Human Services, determining that a biopharma company's refund program for its cell therapy will not be penalized, indicates an encouraging willingness to engage, but the regulator's assumptions about the program's limited term warrant a closer look, says Mary Kohler at Kohler Health.
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DOJ Innovasis Settlement Offers Lessons On Self-Disclosure
The recent $12 million settlement with Innovasis and two of its executives demonstrates the U.S. Department of Justice's continued prioritization of Anti-Kickback Statute enforcement amid the growing circuit split over causation, and illustrates important nuances surrounding self-disclosure, say Denise Barnes and Scott Gallisdorfer at Bass Berry.
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How Orange Book Antitrust Scrutiny Is Intensifying
Pharmaceutical patent holders should be reviewing Orange Book listing practices, as the Federal Trade Commission takes a more aggressive antitrust approach with actions such as the Teva listing probe, and the U.S. Food and Drug Administration calls attention to potentially improper listings, say attorneys at McDermott.
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After Chevron: Slowing Down AI In Medical Research
The U.S. Supreme Court's recent decision overturning the Chevron doctrine may inhibit agencies' regulatory efforts, potentially slowing down the approval and implementation of artificial intelligence-driven methodologies in medical research, as well as regulators' responses to public health emergencies, say Ragini Acharya and Matthew Deutsch at Husch Blackwell.
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FDA's Multifaceted Role On Display In MDMA Therapy Scrutiny
Ongoing deliberations at the U.S. Food and Drug Administration regarding MDMA-assisted therapy for post-traumatic stress disorder serves as a window into the intricate balance of scientific innovation and patient safety oversight, and offers crucial insights into regulatory nuances, say Kimberly Chew at Husch Blackwell and Kevin Lanzo at Pharmaka Clinical Consulting.
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Analyzing FDA Draft Guidance On Clinical Trial Diversity
In light of the U.S. Food and Drug Administration's draft guidance on clinical trial diversity action plans, there are several important considerations for sponsors and clinical researchers to keep in mind to prevent delay in a drug or device application, say attorneys at Crowell & Moring.
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In The CFPB Playbook: Making Good On Bold Promises
The U.S. Supreme Court's decision upholding the Consumer Financial Protection Bureau's funding structure in the second quarter cleared the way for the bureau to resume a number of high-priority initiatives, and it appears poised to charge ahead in working toward its aggressive preelection agenda, say Andrew Arculin and Paula Vigo Marqués at Blank Rome.
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Critical Questions Remain After High Court's Abortion Rulings
The U.S. Supreme Court's decisions in two major abortion-related cases this term largely preserve the status quo for now, but leave federal preemption, the Comstock Act and in vitro fertilization in limbo, say attorneys at Jenner & Block.