Policy & Compliance
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May 13, 2025
Express Scripts, FTC Say Defamation Suit 'Should Proceed'
The Federal Trade Commission's new Republican leadership is ready to defend against an Express Scripts defamation lawsuit targeting an agency report excoriating it and other pharmacy benefit managers for allegedly inflating drug costs, the agency and the PBM told a Missouri federal judge Monday.
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May 13, 2025
Canada Drug Import Plan On The Rocks Amid Tension With US
In his first turn through the White House, President Donald Trump said a plan to import cheap prescription drugs from Canada would be a "game-changer." Five years later, the roadblocks to the program have only gotten higher.
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May 12, 2025
W.Va. High Court Declines 4th Circ. Request For Opioid Input
The West Virginia Supreme Court of Appeals on Monday declined the Fourth Circuit's request to answer whether the state's public nuisance law applies to the distribution of opioids, saying disputed facts in litigation between local governments and drug distribution companies must first be resolved.
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May 12, 2025
Pa. Mental Health Rejection Suits Could Rise, Atty Says
The Pennsylvania Supreme Court's recent decision to greenlight a suit accusing two hospitals of negligently rejecting a man seeking mental health treatment who later murdered his girlfriend could spark a rise in such lawsuits, one attorney warned.
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May 12, 2025
Missouri Hit With Sanctions In Generics Price-Fixing Fight
A Connecticut federal judge Monday agreed to sanction and potentially dismiss for good the state of Missouri from antitrust litigation by state enforcers accusing generic-drug makers of conspiring to raise drug prices, finding Missouri violated a court order by ignoring the drugmakers' repeated discovery requests.
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May 12, 2025
Mass. Court Says NIH Grant Disruption Suit Is In The Right Place
A Massachusetts federal court ruled Monday that it has jurisdiction over several states' lawsuit challenging delays and cancellations of federal grant programs linked to issues they say are "disfavored" by the Trump administration, rejecting the federal government's contention that the claims instead belonged in the U.S. Court of Federal Claims.
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May 12, 2025
AGs Call Sandoz Deal's Consumer-Side Benefits 'Illusory'
Dozens of state attorneys general asked a Pennsylvania federal judge to permit intervention into a $275 million settlement resolving generic-drug price-fixing claims from end-payor plaintiffs against Sandoz, arguing the deal threatens relief for consumers and warning that the agreement favors insurers over individuals.
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May 12, 2025
Fla. Pharmacy Beats Novo Nordisk Suit Over Ozempic 'Copies'
A Florida federal judge on Monday granted a compounding pharmacy a win in Novo Nordisk Inc.'s suit claiming it violated a state statute by selling "essentially copies" of Novo Nordisk's blockbuster Ozempic and Wegovy weight loss drugs, ruling that the claims are moot, preempted and nonviable.
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May 12, 2025
20 AGs Suing HHS Move to Halt Cuts At 4 Affected Agencies
States challenging the Trump administration's plans for massive cuts to the U.S. Department of Health and Human Services are asking a Rhode Island federal court to block any planned terminations at four of the department's agencies and programs.
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May 12, 2025
Will Justices Finally Rein In Universal Injunctions?
The U.S. Supreme Court is expected to address for the first time Thursday the propriety of universal injunctions, a tool federal judges have increasingly used to broadly halt presidential orders and policy initiatives, and whose validity has haunted the high court's merits and emergency dockets for more than a decade.
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May 12, 2025
Agencies Win Stay Of Mental Health Parity Rule Suit
A D.C. federal court on Monday agreed to stay a suit from a benefits-focused employer trade group seeking to block a recently finalized mental health parity rule, after the DOL and other federal agencies told the court they plan to rescind or modify the rule.
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May 12, 2025
King & Spalding Taps Fresenius Medical Care Leader In DC
King & Spalding LLP has rehired Patrick Murphy, a life sciences and healthcare regulatory compliance attorney, who told Law360 Pulse in an interview on Monday that he never lost contact with his former colleagues even after spending a quarter-century working as an in-house attorney.
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May 09, 2025
CFPB's Vought Set To Ditch Dozens Of Guidance Docs
The Consumer Financial Protection Bureau's acting Director Russell Vought is withdrawing dozens of the agency's interpretive rules, policy statements and other guidance documents dating back to 2011, according to a Federal Register draft notice filed Friday.
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May 08, 2025
Panel Says Colo. Hospitals Need Notice Of Retaliation Claims
A Colorado appeals court on Thursday sided with a Denver health system in a precedential ruling, finding healthcare workers who sue public hospitals under a state anti-retaliation statute must warn hospitals about their claims.
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May 08, 2025
Albertsons Says Counties Have 'Paradoxical Status' In MDL
A group of pharmacies led by Albertsons Cos. Inc. have told the Texas Supreme Court that two counties can't assert claims against them in the state's opioid multidistrict litigation while simultaneously denying they qualify as claimants.
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May 08, 2025
3rd Circ. Rejects Challenge To Medicare Drug Price Program
The Third Circuit on Thursday rejected AstraZeneca's challenge to the Medicare drug price negotiation program, ruling that the pharmaceutical giant was unable to show how it is injured by the program's guidance or how it violates its due process rights.
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May 08, 2025
Judge Asks DOJ To Define DEI In Health Grant Case
A Massachusetts federal judge on Thursday ordered U.S. Department of Justice lawyers to provide the Trump administration's definitions of diversity, equity and inclusion, saying he needs to know so he can consider whether that is a valid basis for pausing federal health research grants.
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May 08, 2025
Conn. High Court Snapshot: Rehab Permit And Towing Tiff
The Connecticut Supreme Court, in its upcoming term, will consider whether an existing substance abuse treatment center has the right to challenge the opening of a competitor nearby, and determine if a murder suspect is owed a new trial over an allegedly botched jury poll.
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May 08, 2025
5th Circ. Says Late Filing Dooms Fired Worker's Vax Bias Suit
The Fifth Circuit declined to revive an ex-Texas Children's Hospital worker's bias suit claiming she was fired for seeking a religious exemption to its COVID-19 vaccination requirement, rejecting her argument that a lost password excused missing a deadline to file the case.
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May 07, 2025
Ga. Panel Weighs New Trial In EMT Negligence Suit
The Georgia Court of Appeals on Wednesday considered whether to order a new trial in a man's lawsuit alleging an EMT negligently administered fentanyl to his mother after she fell out of a window, causing her heart to stop.
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May 06, 2025
New Suits Target HHS Cuts, PBM Rates And Med. Device Regs
The Trump administration is facing a wave of new allegations over its restructuring of the Department of Health and Human Services, with state attorneys general, local governments, labor groups and nonprofits alleging in recent days that the cuts exceed executive authority.
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May 06, 2025
Fed Lawmakers Demand Halt On Cuts Affecting Tribal Health
A bipartisan group of U.S. senators is urging U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. to halt any further actions that would affect tribal healthcare and to ensure necessary resources and staffing to fully deliver services for American Indians and Alaska Natives.
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May 06, 2025
What's Ahead For FDA Enforcement: 3 Things To Watch
Companies regulated by the FDA should remain vigilant and expect scrutiny under the new Trump administration, not just from the agency itself but also from DOJ officials, the plaintiffs bar and others, attorneys at a boutique firm say.
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May 06, 2025
Battle Brewing In Michigan Over Nurse Practice Expansion Bill
Facing a doctor shortage, Michigan lawmakers are considering a bill that would allow nurse practitioners to treat patients without oversight from a licensed doctor. The effort is already receiving pushback from the state's medical board.
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May 06, 2025
UBH Can't Escape Residential Treatment Coverage Suit
United Behavioral Health can't dodge a proposed class action claiming it used restrictive guidelines and bundled reimbursement requests to deny claims for residential mental health treatment, with a California federal judge saying plan participants' allegations were detailed enough to stay in court.
Expert Analysis
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Proposed Cannabis Reschedule Sidesteps State Law Effects
The U.S. Department of Justice's recent proposal to move cannabis to Schedule III of the Controlled Substances Act provides certain benefits, but its failure to address how the rescheduling would interact with existing state cannabis laws disappointed industry participants hoping for clarity on this crucial question, says Ian Stewart at Wilson Elser.
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A Changing Regulatory Landscape For Weight Loss Drugs
As drugs originally approved to treat diabetes become increasingly popular for weight loss purposes, federal and state regulators and payors are increasing their focus on how these drugs are prescribed, and industry participants should pay close attention to rapidly evolving compliance requirements, say attorneys at Goodwin.
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Opioid Suits Offer Case Study In Abatement Expert Testimony
Settlements in the opioid multidistrict litigation provide useful insight into leveraging expert discovery on abatement in public nuisance cases, and would not have been successful without testimony on the costs necessary to lessen the harms of the opioid crisis, says David Burnett at DiCello Levitt.
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How HHS Discrimination Rule Affects Gender-Affirming Care
The U.S. Department of Health and Human Services' new final rule, which reinterprets the Affordable Care Act's anti-discrimination provision, greatly clarifies protections for gender-affirming care and will require compliance considerations from sponsors and administrators of most group health plans, say attorneys at McDermott.
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FTC Noncompete Rule's Impact On Healthcare Nonprofits
Healthcare entities that are nonprofit or tax-exempt and thus outside of the pending Federal Trade Commission noncompete rule's reach should evaluate a number of potential risk factors and impacts, starting by assessing their own status, say Ben Shook and Tania Archer at Moore & Van Allen.
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Key Takeaways From FDA Final Rule On Lab-Developed Tests
Michele Buenafe and Dennis Gucciardo at Morgan Lewis discuss potential consequences of the U.S. Food and Drug Administration's recently finalized rule regulating lab-developed tests as medical devices, and explain the rule's phaseout policy for enforcement discretion.
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Assessing HHS' Stance On Rare Disease Patient Assistance
The U.S. Department of Health and Human Services' recent advisory opinion, temporarily blessing manufacturer-supported copay funds for rare disease patients, carves a narrow path for single-donor funds, but charities and their donors may require additional assistance to navigate programs for such patients, says Mary Kohler at Kohler Health Law.
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Are Concessions In FDA's Lab-Developed Tests Rule Enough?
Although the U.S. Food and Drug Administration's new policy for laboratory-developed tests included major strategic concessions to help balance patient safety, access and diagnostic innovation, the new rule may well face significant legal challenges in court, say Dominick DiSabatino and Audrey Mercer at Sheppard Mullin.
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8 Questions To Ask Before Final CISA Breach Reporting Rule
The Cybersecurity and Infrastructure Security Agency’s recently proposed cyber incident reporting requirements for critical infrastructure entities represent the overall approach CISA will take in its final rule, so companies should be asking key compliance questions now and preparing for a more complicated reporting regime, say Arianna Evers and Shannon Mercer at WilmerHale.
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Mid-2024 FCA Enforcement And Litigation Trends To Watch
Reviewing notable False Claims Act trends and enforcement efforts in the last year and a half reveals that healthcare is a key enforcement priority for the U.S. Department of Justice, and the road ahead may bring clarification on Anti-Kickback Statute causation and willfulness standards, along with increased focus on private equity, cybersecurity and self-disclosure, say attorneys at Epstein Becker.
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Online Portal Helps Fortify Feds' Unfair Health Practices Fight
The Federal Trade Commission, U.S. Justice Department and the U.S. Department of Health and Human Services recently launched an online portal where the public can report potentially unfair healthcare practices, effectively maximizing enforcers' abilities to police anti-competitive actions that can drive up healthcare costs and chill innovation, say attorneys at Seyfarth.
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McKesson May Change How AKS-Based FCA Claims Are Pled
The Second Circuit’s analysis in U.S. v. McKesson, an Anti-Kickback Statute-based False Claims Act case, provides guidance for both relators and defendants parsing scienter-related allegations, say Li Yu at Dicello Levitt, Ellen London at London & Stout, and Erica Hitchings at Whistleblower Law.
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9th Circ. Ruling Puts Teeth Into Mental Health Parity Claims
In its recent finding that UnitedHealth applied an excessively strict review process for substance use disorder treatment claims, the Ninth Circuit provided guidance on how to plead a Mental Health Parity and Addiction Equity Act violation and took a step toward achieving mental health parity in healthcare, says Mark DeBofsky at DeBofsky Law.