Policy & Compliance

  • February 11, 2026

    AbbVie Sues Medicaid, HHS Over Botox Fair Price Controls

    AbbVie Inc. on Wednesday asked a D.C. federal court to block the Centers for Medicare and Medicaid Services from controlling the price of Botox under the Inflation Reduction Act, arguing the cosmetic drug and migraine treatment should be excluded from the controls because it's a "plasma-derived" product.

  • February 11, 2026

    Ex-Lt. Col. Sues Hegseth Over Son's Benefits Denial

    A former U.S. Army lieutenant colonel sued Defense Secretary Pete Hegseth and the Defense Health Agency on Wednesday, alleging his son was wrongfully denied health care coverage for continued inpatient mental health treatment, leaving in limbo more than $270,000 in costs. 

  • February 11, 2026

    Anesthesia Group Looks To End FTC Rollup Suit

    U.S. Anesthesia Partners has urged a Texas federal court to end the Federal Trade Commission's case accusing the group of buying competing practices through a so-called rollup strategy, asserting that enforcers have no evidence of any harm to competition.

  • February 11, 2026

    Judge Won't Review Tossed ERISA Claim In Benefits Dispute

    An Ohio federal court refused Wednesday to reconsider a recent decision dismissing a woman's Employee Retirement Income Security Act claims against her husband's employer and several UnitedHealth Group Inc. companies that administered the couple's employee health benefits.

  • February 11, 2026

    HHS Says RFK Jr. Trans Care Policy View Not Legally Binding

    Health and Human Services Secretary Robert F. Kennedy Jr.'s declaration supporting the Trump administration's move to cut funding to hospitals that provide gender-affirming care is a nonbinding policy view, his agency told an Oregon federal court, and doesn't trigger provider exclusions from federal health programs.

  • February 11, 2026

    Organ Donor Network Must Face Veteran's Waitlist Bias Suit

    A Black veteran who alleges his kidney transplant timeline was delayed because the United Network for Organ Sharing artificially inflated his kidney function scores can proceed with his Title VI lawsuit, a Georgia federal judge ruled, denying the network's bid to have the suit tossed.

  • February 11, 2026

    Trans Health And Pediatric Groups Challenge FTC Subpoenas

    A major transgender medical group and a pediatric healthcare organization are seeking to end what they call "unlawful" consumer protection investigations from the Federal Trade Commission that want information pertaining to the medical groups' claims made in their marketing and advertising for gender-affirming care for minors. 

  • February 11, 2026

    Mass. AG Charges Medical Transport Co. With Billing Fraud

    A nonemergency medical transportation provider and its former owner are facing criminal charges for allegedly billing Massachusetts' Medicaid program for tens of thousands of fake rides and laundering the proceeds to accounts in Uganda, according to a Wednesday announcement.

  • February 11, 2026

    Kaiser Will Pay $30M To End DOL Mental Health Investigations

    Kaiser Permanente has agreed to fork over at least $30 million and change its practices to end multiple U.S. Department of Labor investigations into the adequacy of the healthcare organization's mental health and substance use disorder treatment networks in California, the DOL said.

  • February 10, 2026

    US Says Abbott Lied, Must Repay Funds Spent On Formula

    Abbott Laboratories must face the federal government's lawsuit over the 2022 infant formula crisis caused by the discovery of potentially deadly bacteria in a facility that made baby formula, prosecutors told a Michigan federal court, saying the company "repeatedly lied" about the cleanliness of its plant.

  • February 10, 2026

    Ex-DOJ Fraud Prosecutors Launch DC White Collar Boutique

    Two former U.S. Department of Justice fraud prosecutors are opening their own Washington, D.C., boutique firm to represent clients in complex fraud and white collar cases, they said Tuesday.

  • February 10, 2026

    PBMs Enter New Era Of Legal Scrutiny

    The recent government funding bill includes extensive reforms for the embattled pharmacy benefit manager industry. It may presage a new wave of agency scrutiny, regulatory action and lawsuits, including from PBMs.

  • February 10, 2026

    Abortion Rules, Vaccine Recommendations And More In Court

    Abortion restrictions in Arizona are facing a new legal challenge, and an interstate clash over abortion pills is heating up. Here, Law360 Healthcare Authority takes a look at the week's top healthcare news.

  • February 10, 2026

    Wash. Panel Says Healthcare Cost-Share Group Is An Insurer

    A Utah-based healthcare cost-sharing nonprofit operates as and must register as an insurer under Washington state law, a state appeals panel ruled, upholding a $50,000 fine from the state's insurance commissioner that found the nonprofit ran afoul of Washington insurance law. 

  • February 10, 2026

    Pa. Emerges As Battleground Over State False Claims Laws

    Momentum is growing to pass a False Claims Act law in Pennsylvania, the most populous U.S. jurisdiction without one already on the books. It's also reigniting debate over the value of anti-fraud statutes around the country.

  • February 10, 2026

    Hospitals Face 'Perfect Storm' Of Fed. Cuts, Revenue Strains

    Facing federal budget cuts, soaring labor costs and a rising tide of uninsured patients, U.S. hospitals are approaching a financial cliff that could trigger a wave of closures nationwide.

  • February 10, 2026

    Fresenius Can't Knock Out 401(k) Forfeiture Suit

    A Massachusetts federal judge narrowed but declined to dismiss a suit claiming dialysis company Fresenius violated federal benefits law by using forfeited 401(k) funds to pay for match contributions instead of plan fees, ruling the workers behind the suit adequately explained that the move may have flouted their interests.

  • February 09, 2026

    Anti-Abortion Groups Say Mich. Law Impedes 1st Amendment

    Two Michigan-based anti-abortion organizations are suing several officials, alleging recent amendments to Michigan's civil rights law will force them to hire employees and volunteers who do not share or may openly oppose their religious beliefs and stance on abortion.

  • February 09, 2026

    Medical Equipment Co. Nets Tentative Deal In Overbilling Suit

    Medical supply giant AdaptHealth Corp. has tentatively settled an overbilling suit brought by a proposed class of patients who claim they were overcharged for home healthcare equipment, according to a North Carolina court order pausing upcoming deadlines in the case.

  • February 06, 2026

    Ga. Panel Backs Sperm Bank Win In 'Wrongful Birth' Case

    A Georgia appeals court backed a win for sperm bank Xytex Corp. in consolidated litigation alleging the company sold sperm under false pretenses about the medical, psychological and social history of the donors.

  • February 06, 2026

    'Very Bizarre': Trump's Funding Freeze Appeal Vexes DC Circ.

    D.C. Circuit judges struggled Friday with whether to unblock a federal funding freeze carrying multitrillion-dollar implications, as a Trump administration lawyer disclaimed interest in a vast spending halt but also dodged opportunities to rule it out unequivocally.

  • February 06, 2026

    Arizona Abortion Restrictions Found Unconstitutional

    An Arizona state court permanently struck down a slew of restrictions on abortion care in the state, including an ultrasound mandate and a ban on the mailing of abortion pills, finding that the restrictions violate the right to abortion enshrined in the state's constitution.

  • February 06, 2026

    Hospital Pays $595K To End Ex-Workers' Retirement Suit

    A Cambridge hospital system agreed to pay $595,000 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.

  • February 06, 2026

    HHS Ends 340B Drug Rebate Pilot After Legal Challenge

    The U.S. Department of Health and Human Services has ended a proposed rebate program that would have altered how hospitals receive payments for participating in the federal 340B drug discount program, which provides discounted prescription drugs for low-income Americans, after facing a lawsuit from a major hospital association.

  • February 05, 2026

    TikTok Urges NC Justices To Toss State's Addictive App Suit

    The North Carolina attorney general can't haul California-based TikTok Inc. and its now-minority Chinese owner ByteDance Inc. into state court to hash out addictive app and deceptive marketing claims solely because the online platform can be accessed in the Tar Heel State, the companies have told North Carolina's highest court.

Expert Analysis

  • Top 5 Antitrust Issues For In-House Counsel To Watch In 2026

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    With Trump administration enforcement policy having largely taken shape last year, antitrust issues that in-house counsel should have on the radar range from scrutiny of technology-assisted pricing to the return of merger remedies, say attorneys at Squire Patton.

  • 2025 Legal Milestones That Will Shape Psychedelics Sector

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    As 2025 draws to a close, psychedelic drug development stands at an inflection point, experiencing unprecedented momentum through recent sweeping regulatory changes and landmark clinical milestones, amid rapidly evolving regulatory expectations, say Odette Hauke at Odette Alina LLC and Kimberly Chew at Husch Blackwell.

  • 2025 State AI Laws Expand Liability, Raise Insurance Risks

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    As 2025 nears its end, claims professionals should be aware of trends in state legislation addressing artificial intelligence use, as insurance claims based on some of these liability-expanding statutes are a certainty, say attorneys at Wiley.

  • Learning From 2025 FCA Trends Targeting PE In Healthcare

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    False Claims Act enforcement trends and legislative developments from this year signal intensifying state and federal scrutiny of private equity's growing footprint in healthcare, and the urgency of compliance, says Lisa Re at Arnold & Porter.

  • How 11th Circ.'s Qui Tam Review Could Affect FCA Litigation

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    On Dec. 12, the Eleventh Circuit will hear arguments in U.S. ex rel. Zafirov v. Florida Medical Associates, setting the stage for a decision that could drastically reduce enforcement under the False Claims Act, and presenting an opportunity to seek U.S. Supreme Court review of the act's whistleblower provisions, say attorneys at Epstein Becker.

  • How MAHA Is Taking Shape At The State Level

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    The national spotlight on the federal government's Make America Healthy Again movement is bolstering state-level actions regarding potential health impacts of certain food ingredients, increasing the difficulty and importance of maintaining effective compliance programs, say attorneys at Cooley.

  • A Look At Middlemen Fees In 340B Drug Discount Program

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    A U.S. Senate committee's recent hearing on the Section 340B drug discount program, along with statistical analysis of payment amounts, contribute to a growing consensus that middlemen fees are too high, say William Sarraille at the University of Maryland, and Shanyue Zeng and Rory Martin at IQVIA.

  • Nursing Home Abuse Cases Face 3 Barriers That Need Reform

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    Recent headlines reveal persistent gaps in oversight and protection for vulnerable residents in long-term care, but prosecution of these cases is often stymied by numerous challenges that will require a comprehensive overhaul of regulatory, legal and financial structures to address, says Veronica Finkelstein at Wilmington University.

  • Mulling Differing Circuit Rulings On Gender-Affirming Care

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    Despite the Eleventh Circuit's recent holding in Lange v. Houston County that a health plan's exclusion for gender-affirming surgery did not violate Title VII, employers should be mindful of other court decisions suggesting that different legal challenges may still apply to blanket exclusions for such care, say attorneys at Smith Gambrell.

  • State AGs May Extend Their Reach To Nat'l Security Concerns

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    Companies with foreign supply-chain risk exposure need a comprehensive risk-management strategy to address a growing trend in which state attorneys general use broadly written state laws to target conduct that may not violate federal regulations, but arguably constitutes a national security threat, say attorneys at Wiley.

  • Unique Aspects Of Texas' Approach To AI Regulation

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    The Texas Responsible AI Governance Act — which will soon be the sole comprehensive artificial intelligence law in the U.S. — pulls threads from EU and Colorado laws but introduces more targeted rules with fewer obligations on commercial entities, say attorneys at MVA Law.

  • Surveying The Healthcare Policy Landscape Post-Shutdown

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    With last week's agreement to reopen the federal government, at least through the end of January, key healthcare legislation that has been in limbo since a December 2024 spending bill fell apart may recapture the attention of Congress, say attorneys at Faegre Drinker.

  • FDA Biosimilar Guidance Should Ease Biologics Development

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    New draft guidance from the U.S. Food and Drug Administration, indicating that the agency may no longer routinely require comparative efficacy studies when other evidence provides sufficient assurance of biosimilarity, underscores the FDA's trust in analytical technology as a driver of biologics access, say attorneys at Hogan Lovells.