Policy & Compliance

  • July 17, 2025

    Fla. AG, Sandoz Clash With Other Enforcers Over 'Done' Deal

    Sandoz and Florida's attorney general pressed a Connecticut federal judge Wednesday to let them settle out of sweeping price-fixing litigation against generic-drug makers, contending that federal civil procedure rules give no room for objections from other state enforcers worried the Sunshine State deal interferes with their own ability to negotiate settlements.  

  • July 17, 2025

    4th Circ. Orders New Trial After Doc Acquitted In Fraud Case

    A Fourth Circuit panel ordered a new trial for a doctor who received a judge's acquittal after a jury found him guilty of alleged healthcare fraud, finding that the jury had sufficient evidence to convict, but the case was "close," and the district court was correct in hedging and allowing another shot at the case.

  • July 17, 2025

    PE Firm Is Denied FDA Docs For Defense In Deal Challenge

    An Illinois federal court on Wednesday denied a request from private equity firm GTCR BC Holdings LLC to force the U.S. Food and Drug Administration to produce more than a decade's worth of medical device approval applications as the firm fights a merger challenge from enforcers.

  • July 17, 2025

    6th Circ. Says Axed Expert Reports Doom Hip Implant Suit

    The Sixth Circuit has sided with a medical device maker in a lawsuit brought by a man who alleged a component of his hip implant was faulty due to a manufacturing defect, saying the lower court correctly excluded his experts for their lack of knowledge about the surgery or the company's manufacturing processes.

  • July 16, 2025

    8th Circ. Sends Part Of OptumRx Pricing Fight To Arbitration

    The Eighth Circuit partially reversed a ruling Wednesday that denied pharmacy benefits manager OptumRx's bid to send a drugstore's proposed class action over generics prescription reimbursements to arbitration, finding that OptumRx waived arbitration as to three claims, but an arbitrator must decide the fate of two recently pleaded claims.

  • July 16, 2025

    Pharmacy Benefit Managers Say Ohio Can't Recast Suit

    The state of Ohio can't "recast its complaint on appeal" in order to convince the Sixth Circuit that its enforcement suit accusing two pharmacy benefit managers of working to raise the cost of prescription drugs belongs in state court, those managers have told the appellate court.

  • July 16, 2025

    Maine Clinics Sue Over Medicaid Ban On Abortion Providers

    A Maine family planning organization sued the U.S. Department of Health and Human Services on Wednesday over abortion-related Medicaid restrictions outlined in President Donald Trump's budget act, saying they violate constitutional equal protection rights.

  • July 16, 2025

    Charity Care Is Not Unconstitutional Taking, NJ Justices Rule

    The New Jersey Supreme Court on Wednesday held that a state requirement to treat patients regardless of the patient's ability to pay does not amount to unconstitutional per se or regulatory taking, backing a lower court's decision that dismissed a group of Garden State hospitals' challenge to the requirement.

  • July 15, 2025

    GTCR Seeks Rival's Sales Data To Counter FTC Challenge

    The private equity firm looking to buy medical device coating company Surmodics is seeking Salesforce data from another competitor in the space, saying the information is crucial to showing that the industry will still be competitive if its acquisition is cleared.

  • July 15, 2025

    Trump Admin Seeks Win In Harvard $2B Funding Freeze Case

    The Trump administration urged a Massachusetts federal judge Monday to grant it summary judgment in Harvard University's lawsuit challenging the government's effort to freeze $2.2 billion in funding, arguing the dispute is a contract fight that belongs in the Federal Claims Court and the allegations fail on the merits.

  • July 15, 2025

    Split 4th Circ. Rejects GenBioPro Abortion Ban Challenge

    A split Fourth Circuit panel on Tuesday rejected GenBioPro's challenge to a West Virginia law banning medication abortion with narrow exceptions, with the majority finding the ban does not conflict with federal regulators' statutory authority to impose safety requirements on drug manufacturers.

  • July 15, 2025

    Medicaid Cuts Pose 'Frontal Assault,' Penn Law Prof Says

    Allison K. Hoffman, a health insurance regulation expert at the University of Pennsylvania Carey Law School, talks about the wide-ranging impacts of the cuts coming to Medicaid funding.

  • July 15, 2025

    Decades After Autism Omnibus, CDC Back In Thimerosal Fight

    An unusual legal proceeding two decades ago tested claims that childhood vaccines caused autism. The "omnibus" proceeding found no such link, cutting off the primary legal path for such claims. Today, a CDC advisory panel reconstituted by HHS Secretary Robert F. Kennedy Jr. is reopening the debate.

  • July 15, 2025

    Wash. Court Doubts Hospitals' Bid To Nix $230M Judgment

    A Washington state appellate judge criticized a hospital system's attempt to undo a $230 million loss in a class wage and hour suit on Tuesday, suggesting the employer's arguments about meal break waivers and timekeeping practices are at odds with its own records.  

  • July 15, 2025

    Workers Seek Class Status In United Pricing Scheme Suit

    A group of workers urged a California federal judge to award them class certification in their suit alleging United Behavioral Health and a billing contractor shorted them on coverage for out-of-network substance use disorder treatments, arguing they put forward new detail that clears class status requirements.

  • July 15, 2025

    Amid Budget Woe, New Hampshire Shutters Drug Price Board

    Bucking a trend of state efforts to rein in prescription drug prices, New Hampshire lawmakers have dissolved a state drug affordability board launched just five years ago.

  • July 15, 2025

    Wisconsin Health Co. Faces Trimmed 403(b) Fee Suit

    A federal judge agreed to trim a federal benefits lawsuit against a Wisconsin health system from a proposed class of employees who said their 403(b) retirement plan was mismanaged, refusing to dismiss recordkeeping fee claims but agreeing to toss allegations of excessive investment management fees.

  • July 15, 2025

    A Legal 'Green Light' For FDA Abortion Drug Review

    A case brought by Democratic attorneys general led to a "green light" federal court decision for the Trump administration as it considers new regulations on the abortion drug mifepristone.

  • July 14, 2025

    BCBS Defends $2.8B Provider Antitrust Deal Amid Objections

    Blue Cross Blue Shield asked an Alabama federal judge on Friday to approve a $2.8 billion antitrust settlement with hospitals and other healthcare providers over its territorial policies, arguing that recent objections to the deal's release provision are meritless and the settlement preserves "key, procompetitive features" of the insurance system.

  • July 14, 2025

    CFPB Deal To Put Medical Debt Back On Reports OK'd

    A Texas federal court has reversed a Biden-era rule that kept an estimated $49 billion in medical debt from credit reports after the Consumer Financial Protection Bureau and lender trade groups struck a deal to axe the rule.

  • July 14, 2025

    DOJ Drops Vax Card Case Against Plastic Surgeon Mid-Trial

    The Justice Department dismissed charges against a Utah plastic surgeon accused of leading a conspiracy to forge COVID-19 vaccination cards for over 1,500 people, ending the case less than a week after trial began in Salt Lake City federal court.

  • July 14, 2025

    Cigna Denies Responsibility For Alleged Health Data Breach

    Cigna has asked a Pennsylvania federal judge to throw out class claims by health plan members alleging it failed to protect their private data, arguing they didn't show how their sensitive information was intercepted from the insurer's websites.

  • July 14, 2025

    Court Says Insider Trading Rules Unscathed By Loper Bright

    A U.S. Supreme Court ruling that curtailed deference to agency interpretations of law did not undermine the U.S. Securities and Exchange Commission's rules against insider trading, a Pennsylvania federal court ruled Friday.

  • July 14, 2025

    Judge Says Med Device 401(k) Fee Suit Should Get A Trim

    A Massachusetts federal magistrate judge recommended narrowing a proposed class action claiming a medical technology company saddled its retirement plan with excessive fees and abused forfeited funds, ruling the workers failed to show the business violated the plan's terms.

  • July 14, 2025

    UnitedHealth Settling Fraud Case Over Fake Invoice Scheme

    UnitedHealth Group Inc. and a subsidiary are not going to trial in Colorado state court this week after the company reached a settlement with a defunct Colorado investment company that claimed UnitedHealth should have been liable for the "multi-million dollar fraudulent scheme" executed by a former employee, counsel for the plaintiff told Law360.

Expert Analysis

  • Why DOJ's Whistleblower Program May Have Limited Impact

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    The U.S. Department of Justice’s new whistleblower pilot program aims to incentivize individuals to report corporate misconduct, but the program's effectiveness may be undercut by its differences from other federal agencies’ whistleblower programs and its interplay with other DOJ policies, say attorneys at Milbank.

  • How Cos. With Chinese Suppliers Should Prep For Biotech Bill

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    A proposed bill to prohibit government-affiliated life sciences companies from contracting with Chinese biotech companies of concern may necessitate switching to other sources for research and supplies, meaning they should begin evaluating supply chains now due to the long lead times of drug development, say John O'Loughlin and Christina Carone at Weil Gotshal.

  • FTC's Drug Middlemen Probe Highlights Ongoing Scrutiny

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    The Federal Trade Commission's interim staff report on its inquiry into pharmacy benefit managers suggests that the industry will remain under an enforcement microscope for the foreseeable future due to concerns about how PBMs affect drug costs and accessibility, say attorneys at Arnold & Porter.

  • What Cos. Should Note In DOJ's New Whistleblower Pilot

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    After the U.S. Department of Justice unveiled a new whistleblower pilot program last week — continuing its efforts to incentivize individual reporting of misconduct — companies should review the eligibility criteria, update their compliance programs and consider the risks and benefits of making their own self-disclosures, say attorneys at Skadden.

  • Motion To Transfer Venue Considerations For FCA Cases

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    Several recent decisions highlight the importance for practitioners of analyzing as early as possible whether a False Claims Act case warrants a change of venue, and understanding how courts weigh certain factors for defendants versus whistleblowers, say Ellen London at London & Stout, and Li Yu and Corey Lipton at DiCello Levitt.

  • A Primer On EU's Updated Human Substance Regulations

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    The European Union's updated standards regarding quality and safety of substances of human origin meant for human application carry significant implications for companies that work with cells and tissues, and U.S. companies active in the EU market should pay particular attention to the import and export rules, say Geneviève Michaux and Georgios Symeonidis at King & Spalding.

  • CFPB's Medical Debt Proposal May Have Side Effects

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    The Consumer Financial Protection Bureau’s recent proposal to prevent medical debt information from appearing on consumer reports and creditors from basing lending decisions on such information may have initial benefits for some consumers, but there are potential negative consequences that should also be considered, say attorneys at Cooley.

  • 15 Areas That Would Change Under Health Data Rule Proposal

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    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.

  • 3 Healthcare FCA Deals Provide Self-Disclosure Takeaways

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    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.

  • Takeaways From High Court's Tribal Health Admin Cost Ruling

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    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.

  • FTC Focus: Private Equity Investments In Healthcare

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    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.

  • High Court's Expert Ruling May Help Health Fraud Defendants

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    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.

  • Unpacking HHS' Opinion On Cell Therapy Refund Programs

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    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.