Policy & Compliance

  • March 31, 2026

    As FCA Meets 340B, Geyser Of Qui Tam Suits May Erupt

    A Ninth Circuit ruling on the intersection of two of the most contentious laws in healthcare may be a combustible mix that triggers a new wave of fraud litigation.

  • March 31, 2026

    Insurer Says Yale Was 'Misleading' In $4.1M Transplant Claim

    A Liberty Mutual unit accused Yale University's health system of making "serious and material misstatements" about a plan member's bone marrow transplant, the insurer said in its answer and counterclaim for a declaratory judgment that it can continue to deny the $4.1 million claim.

  • March 31, 2026

    Justices Reject Colorado's LGBTQ+ 'Conversion' Ban

    The U.S. Supreme Court ruled Tuesday that a Colorado ban on therapy intended to change a minor's sexual orientation or gender identity amounts to viewpoint discrimination against a Christian therapist, a finding that split the court's liberal wing and crossed ideological lines.

  • March 30, 2026

    Don't Set Special IP Rules For 'Skinny Labels,' Justices Told

    Drugmakers, industry groups, hospitals and scholars have urged the U.S. Supreme Court to uphold a decision letting a patent suit proceed over a generic drug using a so-called skinny label, saying the generics company is seeking unwarranted special protections that would upend patent law.

  • March 30, 2026

    FCA Qui Tams Are Unconstitutional, Eli Lilly Tells Justices

    The False Claims Act's whistleblower provisions are unconstitutional, drugmaker Eli Lilly has told the U.S. Supreme Court, asking it to overturn a Seventh Circuit decision upholding a $183 million trial win for a whistleblower who claimed the drug company hid how much it charged for Medicaid-covered drugs. 

  • March 30, 2026

    FTC Says Anesthesia Group Cheered While Raising Prices

    The Federal Trade Commission pushed back against a bid from U.S. Anesthesia Partners to avoid facing trial on claims that it monopolized the market through a rollup strategy, saying the company celebrated its ability to dramatically increase prices.

  • March 27, 2026

    5th Circ. Won't Revive Ex-Health IT Co. Worker's Bias Suit

    The Fifth Circuit upheld a healthcare information technology provider's win over a Black former manager's lawsuit claiming she was fired for complaining that a white male colleague was treated better, saying she couldn't overcome the company's rationale for letting her go.

  • March 27, 2026

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

    A Pennsylvania federal judge gave the green light to a $1.15 million deal resolving a proposed class action alleging a healthcare system misused workers' forfeited employee retirement plan funds and failed to rein in administrative fees.

  • March 27, 2026

    Insurer Rips Sanctions Bid In Opioid Coverage Dispute

    An insurer asked an Illinois federal court to reject a drug wholesaler's bid for sanctions in a dispute over coverage for underlying opioid litigation, saying the accusations that it intentionally destroyed pertinent evidence are, "at best, based on half-truths and misstatements of fact."

  • March 27, 2026

    Hospital Escapes Ex-Workers' 401(k) Forfeiture, Fund Suit

    A New York federal judge on Friday tossed a proposed class action against a healthcare company alleging mismanagement of an employee 401(k) plan, concluding that ex-workers who sued lacked standing to bring some claims while the remaining allegations weren't sufficiently backed up to state a claim for violating federal benefits law.

  • March 26, 2026

    Elanco Beats Investor Suit Over Dog Drug's Reg Challenges

    A Maryland federal judge Thursday dismissed a proposed securities class action against Elanco Animal Health Inc. that claimed the animal pharmaceuticals company misled investors about the safety of a canine dermatitis treatment it was developing and its timeline for the medication's commercial launch.

  • March 26, 2026

    DOJ Says NY-Presbyterian Blocked Lower-Cost Health Plans

    New York-Presbyterian Hospital is forcing major health insurers to contract with it on an "all-or-nothing" basis, which is driving up healthcare costs in New York City and violates federal antitrust law, the U.S. Department of Justice said in a federal lawsuit filed Thursday. 

  • March 25, 2026

    AbbVie, Novartis Sue Wash. Over New 340B Drug-Pricing Law

    Pharmaceutical giants Novartis and AbbVie say a new Washington state law illegally expands drugmakers' obligations to provide deeply discounted medications under the federal government's 340B Drug Pricing Program, according to a pair of legal challenges launched in federal court on Wednesday.

  • March 25, 2026

    3rd Circ. Probes Free Speech Impact Of NJ Telemedicine Law

    A Third Circuit panel on Wednesday examined whether New Jersey can bar out-of-state doctors from consulting with Garden State patients via phone or video without a state license, pressing both sides on where to draw the line between protected speech and the regulated practice of medicine.

  • March 25, 2026

    Insurers, Brokers Can't Exit Medicare Advantage Steering Suit

    A Massachusetts federal judge on Wednesday largely rejected a bid by insurers and brokers to toss claims that they colluded in a kickback scheme to steer Medicare Advantage customers to certain companies and to push away disabled individuals.

  • March 25, 2026

    PBMs Say Mich. Price-Fixing Suit Lacks Specifics

    For the second time, pharmacy benefit managers Express Scripts Inc. and Prime Therapeutics LLC asked a Michigan federal judge on Monday to toss a price-fixing suit filed by Michigan Attorney General Dana Nessel, arguing that the state has no standing to file the suit.

  • March 25, 2026

    Judge Trims SEC Fraud Case Over Cancer Drug Claims

    A Massachusetts federal judge greenlighted U.S. Securities and Exchange Commission claims against two of three former pharmaceutical executives accused of concealing from investors the U.S. Food and Drug Administration's "harsh critiques" about a cancer drug.

  • March 25, 2026

    Foreign Aides' RICO Labor Suit Against PruittHealth Hits NC

    A Tennessee federal judge has agreed to transfer to North Carolina a year-old class action in which foreign workers say a healthcare system and recruiter trapped them in punitive contracts and buried them in grueling labor, after a judge said the action could have been filed in the Tar Heel State in the first place.

  • March 24, 2026

    Nicotine Pouch Maker To Refile FDA Suit In DC After Transfer

    The maker and seller of Zone nicotine pouches on Tuesday dismissed its own lawsuit accusing the U.S. Food and Drug Administration of unfairly holding up a market application for its product, promising to refile in D.C. federal court after a Texas federal court transferred it to South Carolina federal court.

  • March 24, 2026

    Biz Services Co. Faces ERISA Suit Over 'Tobacco Surcharge'

    Business services company Conduent unlawfully imposes health insurance surcharges on employees who use tobacco products, forcing them to pay more for coverage the company provides, a former employee and plan participant said in a proposed class action in New Jersey federal court.

  • March 24, 2026

    $5.7M Cigna Ghost Network Deal Receives Final Go-Ahead

    An Illinois federal judge gave his final sign-off Tuesday to a $5.7 million settlement in what he called an "interesting" case accusing Cigna of improperly advertising out-of-network providers as though they're in-network for certain benefit plans it administered.

  • March 24, 2026

    Health Co. Escapes Workers' 401(k) Forfeiture Suit In La.

    A Louisiana federal judge agreed to toss a federal benefits lawsuit against a health company from workers who alleged the company misspent forfeitures from their employee 401(k) plan, rejecting the workers' argument that funds should have gone toward defraying expenses instead of lowering employer-side contribution obligations.

  • March 24, 2026

    Utah Hospitals To Track Violence As States Step Up Reporting

    Under a new law, Utah hospitals will join a national effort to better understand the risks facing healthcare workers.

  • March 24, 2026

    Ohio Justices Likely Split On Trans Care Restrictions

    The Ohio Supreme Court appeared split Tuesday as to whether a new state law banning gender-affirming care for minors trumps a decade-old healthcare freedom provision passed by voters that says state laws can't block a patient from obtaining healthcare. 

  • March 24, 2026

    Fraud Task Force May Boost White Collar Defense Work

    A new federal anti-fraud task force involving at least a dozen federal agencies could soon expose more state and local governments, contractors, companies and others to compliance risks, particularly in healthcare fraud and False Claims Act cases, experts say.

Expert Analysis

  • Predicting Actual Impact From CDC's New Vaccine Guidance

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    Recent federal changes to the childhood immunization schedule, reducing the number of vaccine recommendations from 18 to 11, do not automatically create enforceable obligations for parents, schools or healthcare providers, but may spur litigation and other downstream effects on school policies and state guidelines, says Mehdi Sinaki at Michelman & Robinson.

  • What Rescheduling Means For Cannabis Labels, Marketing

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    The proposed reclassification of cannabis is expected to bring heightened scrutiny of labeling, advertising and marketing from the U.S. Food and Drug Administration and the Federal Trade Commission, but the brands that tighten evidence, standardize operations and professionalize marketing controls now will see fewer surprises and better outcomes, say attorneys at Wilson Elser.

  • What's At Stake In Possible Circuit Split On Medicaid Rule

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    A recent Eleventh Circuit decision, reviving Florida's lawsuit against a federal rule that reduces Medicaid funding based on agreements between hospitals, sets up a potential circuit split with the Fifth Circuit, with important ramifications for states looking to private administrators to run provider tax programs, say Liz Goodman, Karuna Seshasai and Rebecca Pitt at FTI Consulting.

  • Courts' Rare Quash Of DOJ Subpoenas Has Lessons For Cos.

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    In a rare move, three federal courts recently quashed or partially quashed expansive U.S. Department of Justice administrative subpoenas issued to providers of gender-affirming care, demonstrating that courts will scrutinize purpose, cabin statutory authority and acknowledge the profound privacy burdens of overbroad government demands for sensitive records, say attorneys at ArentFox Schiff.

  • Remote Patient Monitoring Is At Regulatory Inflection Point

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    With remote patient monitoring at the center of new federal pilot programs and a recent report from the U.S. Department of Health and Human Services' Office of Inspector General examining Medicare billing for those services, it is clear that balancing innovation and risk will be a central challenge ahead for digital health stakeholders, say attorneys at Morgan Lewis.

  • Utah's AI Prescription Renewal Pilot Could Inform Policy

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    Utah recently became the first state to approve an artificial intelligence system for autonomously renewing certain prescription medicines, providing a test case for how regulators may be able to draw boundaries between administrative automation and medical judgment, say Jashaswi Ghosh at Holon Law Partners and Bryant Godfrey at Foley Hoag.

  • Ramped Up Psychedelic Production Carries Opportunity, Risk

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    Kimberly Chew at Husch Blackwell discusses the key legal implications of the U.S. Drug Enforcement Administration's recent dramatic increases in the production quotas for a range of psychedelic substances, offering guidance on compliance, risk management and strategic opportunities for practitioners navigating this rapidly evolving landscape.

  • New Biotech Nat'l Security Controls May Have Blunted Impact

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    While the newly enacted federal prohibition against contracting with certain biotechnology providers associated with countries of concern may have consequences on U.S. companies' ability to develop drugs, the restrictions may prove to be less problematic for the industry than the significant publicity around their passage would suggest, say attorneys at Wilson Sonsini.

  • Takeaways From The DOJ Fraud Section's 2025 Year In Review

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    Former acting Principal Deputy Chief Sean Tonolli of the U.S. Department of Justice's Fraud Section, now at Cahill Gordon, analyzes key findings from the section’s annual report — including the changes implemented to adapt to the new administration’s priorities — and lays out what to watch for this year.

  • Traditional FCA Enforcement Surges Amid Shifting Priorities

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    The U.S. Department of Justice’s January report on False Claims Act enforcement in fiscal year 2025 reveals that while the administration signaled its intent to expand FCA enforcement into new areas such as tariffs, for now the greatest exposure remains in traditional areas like healthcare — in which the risk is growing, say attorneys at Debevoise.

  • 3 Key Ohio Financial Services Developments From 2025

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    Ohio's banking and financial services sector saw particularly notable developments in 2025, including a significant Ohio Supreme Court decision on creditor disclosure duties to guarantors in Huntington National Bank v. Schneider, and some major proposed changes to the state's Homebuyer Plus program, says Alex Durst at Durst Kerridge.

  • Rescheduling Cannabis Marks New Tax Era For Operators

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    As the attorney general takes steps to move cannabis from Schedule I to Schedule III of the Controlled Substances Act, operators and advisers should prepare by considering the significant changes this will bring from tax, state, industry and market perspectives, says Michael Harlow at CohnReznick.

  • Justices' Med Mal Ruling May Spur Huge Shift For Litigators

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    The U.S. Supreme Court’s recent decision in the medical malpractice suit Berk v. Choy, holding that a Florida procedural requirement does not apply to medical malpractice claims filed in federal court, is likely to encourage eligible parties to file claims in federal court, speed the adjudicatory process and create both opportunities and challenges for litigators, says Thomas Kroeger at Colson Hicks.