Policy & Compliance

  • September 24, 2025

    4th Circ. Kicks Trans Care Exclusion Suits Back To Trial Court

    A pair of suits challenging health plan coverage exclusions on gender-affirming care for minors are headed to district court after the Fourth Circuit vacated decisions finding those policies discriminatory, in line with a U.S. Supreme Court directive to revisit the cases in light of new precedent.

  • September 24, 2025

    Hall Booth Smith Grows In NJ With Aging Services Expert

    Hall Booth Smith PC built out its aging services practice this week with the hire of a Paramus, New Jersey-based of counsel attorney specializing in litigation and risk management for clients in the acute care and post-acute care fields.

  • September 24, 2025

    States Say Ed Dept. Must Face Suit Over Mental Health Cuts

    A group of 16 states led by Washington has asked a federal judge not to let the U.S. Department of Education escape the states' claims that the agency violated federal law by discontinuing mental health grants given to public schools to help students cope with school shootings.

  • September 24, 2025

    Amtrak Beats Retired Worker's Suit Over Benefits Reversal

    A Rhode Island federal judge dismissed an ex-Amtrak employee's suit claiming the company illegally rolled back medical care reimbursement benefits that the rail service said it mistakenly granted him in retirement, finding he wasn't entitled to the extra credits under the plan's terms.

  • September 23, 2025

    Fed. Vaccine Panel Prompts Legal, Health Confusion

    It's been days since a Centers for Disease Control and Prevention committee updated recommendations for a common childhood vaccine and the COVID-19 booster. But healthcare and legal experts are still trying to understand the implications of the meeting and the votes that came out of it.

  • September 23, 2025

    Kansas Abortion Mandates On Trial: What You Need to Know

    The largest provider of reproductive healthcare in Kansas will face off with state officials this week at a long-awaited trial focused on a 24-hour abortion waiting period, among other state requirements.

  • September 23, 2025

    Tylenol MDL In Spotlight After Trump Blasts Use In Pregnancy

    The Trump administration's attack on the use of acetaminophen during pregnancy drew on the work of a Harvard expert whose analysis is central to a legal clash now before a federal appeals court. The president's broadside promises to energize plaintiffs.

  • September 23, 2025

    State Medicaid Cuts Mean 'Financial Squeeze' For Providers

    Law360 Healthcare Authority talks with Gayland Hethcoat of ArentFox Schiff LLP about the rationale behind major cuts coming to Medicaid state-directed payments and what they will mean for providers and patients.

  • September 23, 2025

    NC Sens. Vote To Cut Planned Parenthood's Medicaid Funds

    Republican state senators in North Carolina have greenlit a bill that would revoke Medicaid funding for Planned Parenthood, aligning the Tar Heel state with the president's "One Big Beautiful Bill," which prohibits Medicaid funding for nonprofit groups that provide abortion services.

  • September 23, 2025

    Long Time Limits In Trans Care Laws Expand Doctors' Liability

    State lawmakers are including lengthy statutes of limitations — some of them decades-long — in new bans on transgender care for minors. Advocates say long time frames for prosecutions or civil suits make sense when a child is involved. Others see a "chilling" effect for providers.

  • September 23, 2025

    EX-CTA Worker's $425K Vaccine Bias Award Capped At $300K

    An Illinois federal judge lowered a former Chicago Transit Authority employee's $425,000 jury award to $300,000 Tuesday for the ex-worker's claim that he was wrongly fired for refusing the COVID-19 vaccine, entering a judgment the judge said he'll later amend with awards that include back and front pay.

  • September 23, 2025

    Two Longtime HHS Attys Depart Posts For Crowell & Moring

    Two prominent U.S. Department of Health and Human Services attorneys have left their posts for Crowell & Moring LLP after more than two decades in the federal government.

  • September 23, 2025

    Burns White Launches Correctional Healthcare Practice Group

    Pittsburgh-based Mid-Law firm Burns White LLC has launched a practice group focused on helping clients navigate liability risk from providing healthcare in prisons and other correctional settings.

  • September 23, 2025

    Pa. Health Network To Pay $1.15M In 401(k) Forfeiture Suit

    A Pennsylvania health system agreed to pay workers $1.15 million to resolve a federal suit alleging it unlawfully used forfeited retirement plan funds to satisfy its contribution obligations and allowed workers to be overcharged for plan administrative fees.

  • September 22, 2025

    2nd Circ. Undoes $25M Restitution In Horse-Doping Case

    A veterinarian convicted of conspiracy in a sprawling horse-doping scheme has escaped $25 million in restitution and is also off the hook for the $10.3 million forfeiture of funds tied to the sale of undetectable, performance-enhancement drugs, the Second Circuit said Monday.

  • September 22, 2025

    Family Sues For $100M In Child's Hyperbaric Chamber Death

    The family of a 5-year-old boy who died in a hyperbaric chamber explosion in January sued the center that was treating the child and the manufacturer of the chamber for more than $100 million in damages Monday, alleging the Michigan clinic concealed the dangers of using the chamber. 

  • September 22, 2025

    Anthem's $12.9M ERISA Deal Clears First Hurdle

    A New York federal judge has granted preliminary approval to a nearly $12.9 million settlement resolving claims that Anthem wrongfully denied coverage for residential behavioral health treatment under employer-sponsored health plans.

  • September 22, 2025

    Mayo Clinic Can't Fully Nix Suit Over Withheld Benefits Info

    The Mayo Clinic and its benefits administrator can't entirely escape a worker's suit claiming they pushed her to work with pricey out-of-network providers and wouldn't provide reimbursement estimates, after a Minnesota federal judge said she supported some federal benefits law claims with enough detail to remain in court.

  • September 19, 2025

    Ga. Providers Seek Exit From 'Conspiratorial' BCBS Fraud Suit

    Healthcare consulting firm HaloMD and several providers urged a federal judge Friday to toss a lawsuit from Blue Cross Blue Shield of Georgia accusing them of abusing a federal dispute resolution process for surprise medical bills, arguing the insurer's suit offers little more than "inflammatory, conspiratorial rhetoric."

  • September 19, 2025

    CDC Panel Urges Caution On COVID Vax, Punts On Hep B

    A panel of advisers at the Centers for Disease Control and Prevention on Friday voted unanimously to recommend that people receiving the COVID-19 vaccine this season do so only after discussing it with their health providers.

  • September 18, 2025

    Brothers Blame Associate For $90M HIV Drug Fraud Scheme

    Two Maryland brothers accused of selling $90 million worth of mislabeled HIV drugs told a Florida federal jury on Thursday that their charges stem from an associate hired for his pharmaceutical industry connections, but who instead lied about the medication's black market origins and told them it was purchased legitimately.

  • September 18, 2025

    Mich. Top Court To Weigh Medicare's Role In No-Fault Cases

    Michigan's highest court will weigh whether an injured driver who opted out of personal injury protection due to his Medicare coverage must offset his damages by billing the insurance program for accident-related medical expenses in a no-fault dispute. 

  • September 18, 2025

    HHS Shutters Miami Organ Donor Org. For 'Unsafe' Practices

    Federal health officials have decertified a Miami-based organ procurement organization that arranges organ donations after an investigation found a pattern of "unsafe" practices, marking the first time the federal government has revoked the certification of such a group, according to an announcement Thursday from Health Secretary Robert F. Kennedy Jr. 

  • September 18, 2025

    Elevance Won't Cover Zepbound To Treat Apnea, Patient Says

    Elevance Health, formerly known as Anthem Inc., arbitrarily excludes coverage of FDA-approved Zepbound to treat moderate to severe obstructive sleep apnea and refuses to consider requests for exceptions by maintaining that the medication is for weight loss, alleges a proposed class action filed by an enrollee in Indiana federal court Tuesday.

  • September 18, 2025

    Senate Confirms Trump's Pick To Lead DOL Benefits Arm

    The Senate confirmed fiduciary liability insurance expert Daniel Aronowitz on Thursday to lead the U.S. Department of Labor's employee benefits division, which oversees regulation and enforcement of employer-provided health and retirement plans.

Expert Analysis

  • A New Way Forward For COVID Vaccine Lawsuit Immunity

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    As Public Readiness and Emergency Preparedness Act protections for COVID-19 vaccines wane, adding those vaccines to coverage by the National Vaccine Injury Compensation Program would bolster defenses for administrators and manufacturers while also providing stronger remedies for those injured by vaccines, says Altom Maglio at MCT Law.

  • 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.