Policy & Compliance

  • November 20, 2025

    Pharma Cos. Seek Early Win In States' Price-Fixing Lawsuit

    A collection of states failed to prove an overarching conspiracy among 25 separate pharmaceutical companies to fix the prices of generic drugs, most of them dermatology formulations, the drugmakers argued Wednesday in support of a bid for an early win on one element of dozens of antitrust claims.

  • November 20, 2025

    5th Circ. Seeks Interpretation Of Miss. Health Decisions Law

    A Fifth Circuit panel asked the Mississippi Supreme Court on Thursday to clarify an "ambiguous" state law that sets out which family members can act as surrogates and make healthcare decisions for relatives without the capacity to decide for themselves.

  • November 20, 2025

    Ala. County Must Face Inmate Death Claim, 11th Circ. Rules

    An Eleventh Circuit panel ruled Thursday that no Alabama state law prevents a county from facing liability for an incarcerated person's death after substandard healthcare from a third-party medical provider the county hired. 

  • November 20, 2025

    Blue Shield Of California, Magellan Sued Over 'Ghost Network'

    Blue Shield of California and Magellan Health maintain a "ghost network" directory of mental health providers who don't exist or don't accept new patients, leading customers to hit a dead end or desperately resort to expensive out-of-network providers, according to a proposed class action filed Wednesday in California federal court. 

  • November 20, 2025

    10th Circ. Weighs Colo. Law On Healthcare Sharing Plans

    A Tenth Circuit panel grappled Thursday with how the court should interpret a Colorado law requiring entities not authorized to offer insurance in the state to report certain information about their healthcare sharing plans, in an appeal by a religious trade group challenging the law's constitutionality.

  • November 20, 2025

    Claims Firms Barred From Misleading Plaintiffs In Pharma MDL

    On the same day that a Philadelphia federal judge approved $58 million in settlements as part of an ongoing generic-drug price-fixing multidistrict litigation, she also ordered several claims recovery firms to correct allegedly false and misleading ads used to attract potential clients seeking to make claims on the settlements.

  • November 19, 2025

    Senior Living Co. Inks $7.2M Deal To End Wash. AG's Probe

    Oregon-based senior living provider Bonaventure will invest $7 million in staffing and upgrades and shell out $200,000 in resident credits to resolve allegations of substandard care at 10 Washington state facilities, under a settlement filed Wednesday.

  • November 19, 2025

    Is 'Red Book' Best For Drug Pricing? Pa. Justices Ask

    The Pennsylvania Supreme Court seemed skeptical Wednesday that the state workers' compensation authorities were using the best guide to calculate pharmacy reimbursements for injured workers' prescription drugs, with the justices questioning the fairness of the industry's long-used "red book" method.

  • November 19, 2025

    11th Circ. Backs Kaiser In Air Ambulance Arbitration Dispute

    The Eleventh Circuit on Wednesday declined an air ambulance company's bid to scrap an arbitrator's ruling that Kaiser only owes $24,000 for an emergency helicopter flight, rejecting the emergency medical provider's arguments that the insurer committed fraud by strategically lowballing the arbitrator.

  • November 19, 2025

    Aetna Gets OK For $3.4M Deal In Cancer Treatment Denial Suit

    A Florida federal judge has signed off on Aetna's $3.4 million settlement agreement resolving a class action that alleged the insurer unlawfully mischaracterized a proton beam cancer radiation treatment as experimental to deny dozens of claims.

  • November 19, 2025

    Senate GOP Resists Extending Expanded ACA Tax Premiums

    Senate Finance Committee Democrats on Wednesday urged their Republican counterparts to extend the enhanced tax credits for the Affordable Care Act, which is set to expire at the end of the year, but Republicans said they were looking for other options to address rising healthcare costs.

  • November 19, 2025

    Conn. Dentists Pay $714K To Settle Patient Kickback Claims

    Two Connecticut dentists will pay more than $714,000 to the state and federal governments to settle joint allegations that their practices submitted false government benefits claims that contained kickbacks for patient recruiters.

  • November 19, 2025

    Pa. Health Network's $1.15M 401(k) Suit Deal Gets Initial OK

    A healthcare system Wednesday secured initial approval from a Pennsylvania federal court for a $1.15 million settlement agreement that would resolve a proposed class action alleging the company misused forfeited retirement plan funds and allowed the plan's administrative costs to soar.

  • November 19, 2025

    Whoop Blood Pressure Tracker Hit With False Ad Suit

    A consumer on Tuesday hit health and wellness wearable tech company Whoop Inc. with a proposed class action in California federal court alleging that its boasting of the blood pressure features of its fitness tracker duped consumers and prompted a warning from health regulators.

  • November 19, 2025

    Hospice Co. Should Face Tobacco Fee Suit, Judge Says

    A hospice and home healthcare provider shouldn't escape a proposed class action challenging a tobacco surcharge in its employee health plan, a Pennsylvania federal judge recommended, finding that allegations sufficiently backed up that a wellness program implementing the fee didn't meet all regulatory requirements.

  • November 19, 2025

    Doctor, Husband Admit $16M Healthcare Fraud, Tax Evasion

    A physician and her husband admitted to committing more than $16 million in healthcare fraud and tax evasion as part of a scheme that injected sick patients with the wrong medications or dosages, according to their plea agreements in Alaska federal court.

  • November 19, 2025

    COVID-19 Testing Co. Settles Wage Suit With Testers, Drivers

    A COVID-19 mobile testing company told a New York federal court that it has reached a settlement with a group of testers and drivers who claimed they were not paid full wages and overtime.

  • November 19, 2025

    Doc Takes Plea, Avoids Prison In Novel Opioid Death Case

    A retired Massachusetts doctor pled guilty and was sentenced to five years of probation in a first-of-its-kind involuntary manslaughter case over a patient's 2016 opioid overdose death, the state attorney general's office announced.

  • November 18, 2025

    Health Co. Execs Convicted In $100M Adderall Sales Scheme

    A San Francisco federal jury weighing a first-of-its-kind case on Tuesday convicted two digital healthcare company executives of scheming to sell Adderall through deceptive advertising, allegedly bringing in $100 million in illicit profits.

  • 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.

  • 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.

  • 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 they "proudly" stood by what defense attorneys for the supplement manufacturer and distributor previously derided as a "paper case."

  • 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.

  • 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.

  • 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.

Expert Analysis

  • 10 Noteworthy CFPB Developments From 2024

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    In a banner year for consumer finance regulation, the Consumer Financial Protection Bureau made significant strides in its efforts to rein in Big Tech and nonbank financial firms, including via rules regarding open banking, credit card late fees, and buy now, pay later products, say attorneys at Wiley.

  • The Future Of GLP-1 Policy After Drug Shortage Ends

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    If and when the U.S. Food and Drug Administration determines that GLP-1 RA drugs are no longer in short supply, regulators will face questions of how to balance access to GLP-1 RAs with statutory and policy considerations applicable to compounded drugs, say attorneys at Skadden.

  • Top 10 Whistleblowing And Retaliation Events Of 2024

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    From a Florida federal court’s ruling that the False Claims Act’s qui tam provision is unconstitutional to a record-breaking number of whistleblower tips filed with the U.S. Commodity Futures Trading Commission, employers saw significant developments in the federal and state whistleblower landscapes this year, say attorneys at Proskauer.

  • How White Collar Defense Attys Can Use Summary Witnesses

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    Few criminal defense attorneys have successfully utilized summary witnesses in the past, but several recent success stories show that it can be a worthwhile trial tactic to help juries understand the complex decision-making at issue, says Jonathan Porter at Husch Blackwell.

  • Nutraceutical Patent Insights As Market Heats Up

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    Companies entering the expanding nutraceutical market and seeking patents to protect their innovations should evaluate successful nutraceutical claim language and common patent challenges in this field, say attorneys at Sterne Kessler.

  • How White Collar Attys Can Use Mythic Archetypes At Trial

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    A careful reading of a classic screenwriting guide shows that fairy tales and white collar trials actually have a lot in common, and defense attorneys would do well to tell a hero’s journey at trial, relying on universal character archetypes to connect with the jury, says Jack Sharman at Lightfoot Franklin.

  • What 2024 Election Means For Drugs, Medicare And Medicaid

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    With Republicans running the White House, U.S. House of Representatives and U.S. Senate, the incoming administration is likely to provide pathways — through new initiatives and others returning from Trump's previous presidency — for a range of potential changes to drug pricing, Medicare and Medicaid, say attorneys at Morgan Lewis.

  • Justices Mull Sex-Based Classification In Trans Law Case

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    After the U.S. Supreme Court heard oral argument in U.S. v. Skrmetti this week, it appears that the fate of the Tennessee law at the center of the case — a law banning gender-affirming healthcare for transgender adolescents — will hinge on whether the majority read the statute as imposing a sex-based classification, says Alexandra Crandall at Dickinson Wright.

  • Key Takeaways From FDA's Latest Social Media Warnings

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    The U.S. Food and Drug Administration's latest untitled letter concerning a drug company's social media promotion provides lessons for how companies should navigate risk presentation, FDA labeling requirements and superiority claims, say attorneys at Sheppard Mullin.

  • Rank-And-File DOJ Attorneys Will Keep Calm And Carry On

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    Career prosecutors at the U.S. Department of Justice often pride themselves on their ability to remain apolitical in order to ensure consistency and keep the department’s mission afloat, and the incoming Trump administration is unlikely to upend this tradition, says Michael Landman at Bird Marella.

  • Unpacking Arguments From High Court's Rural Hospital Case

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    During oral arguments in Advocate v. Becerra, the U.S. Supreme Court justices focused questions on the meaning of being "entitled to" supplementary security income assistance, and there's reason for optimism that the likely split decision will break in favor of hospitals, say attorneys at King & Spalding.

  • Health Policy Predictions For Trump's Second Administration

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    As President-elect Donald Trump's nominations for health policy and enforcement heads work their way through the confirmation process, healthcare organizations can look at nominee backgrounds, campaign statements and actions from Trump's previous presidency to predict incoming priorities, say attorneys at McDermott.

  • What Trump's Next Term May Mean For Biz Immigration

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    Leonard D'Arrigo at Harris Beach discusses the employment-based immigration policies businesses can potentially expect during President-elect Donald Trump’s second term, based on policies enacted during his first administration, statements made during his campaign and proposals in Project 2025.