Policy & Compliance
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July 16, 2025
8th Circ. Sends Part Of OptumRx Pricing Fight To Arbitration
The Eighth Circuit partially reversed a ruling Wednesday that denied pharmacy benefits manager OptumRx's bid to send a drugstore's proposed class action over generics prescription reimbursements to arbitration, finding that OptumRx waived arbitration as to three claims, but an arbitrator must decide the fate of two recently pleaded claims.
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July 16, 2025
Pharmacy Benefit Managers Say Ohio Can't Recast Suit
The state of Ohio can't "recast its complaint on appeal" in order to convince the Sixth Circuit that its enforcement suit accusing two pharmacy benefit managers of working to raise the cost of prescription drugs belongs in state court, those managers have told the appellate court.
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July 16, 2025
Maine Clinics Sue Over Medicaid Ban On Abortion Providers
A Maine family planning organization sued the U.S. Department of Health and Human Services on Wednesday over abortion-related Medicaid restrictions outlined in President Donald Trump's budget act, saying they violate constitutional equal protection rights.
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July 16, 2025
Charity Care Is Not Unconstitutional Taking, NJ Justices Rule
The New Jersey Supreme Court on Wednesday held that a state requirement to treat patients regardless of the patient's ability to pay does not amount to unconstitutional per se or regulatory taking, backing a lower court's decision that dismissed a group of Garden State hospitals' challenge to the requirement.
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July 15, 2025
GTCR Seeks Rival's Sales Data To Counter FTC Challenge
The private equity firm looking to buy medical device coating company Surmodics is seeking Salesforce data from another competitor in the space, saying the information is crucial to showing that the industry will still be competitive if its acquisition is cleared.
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July 15, 2025
Trump Admin Seeks Win In Harvard $2B Funding Freeze Case
The Trump administration urged a Massachusetts federal judge Monday to grant it summary judgment in Harvard University's lawsuit challenging the government's effort to freeze $2.2 billion in funding, arguing the dispute is a contract fight that belongs in the Federal Claims Court and the allegations fail on the merits.
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July 15, 2025
Split 4th Circ. Rejects GenBioPro Abortion Ban Challenge
A split Fourth Circuit panel on Tuesday rejected GenBioPro's challenge to a West Virginia law banning medication abortion with narrow exceptions, with the majority finding the ban does not conflict with federal regulators' statutory authority to impose safety requirements on drug manufacturers.
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July 15, 2025
Medicaid Cuts Pose 'Frontal Assault,' Penn Law Prof Says
Allison K. Hoffman, a health insurance regulation expert at the University of Pennsylvania Carey Law School, talks about the wide-ranging impacts of the cuts coming to Medicaid funding.
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July 15, 2025
Decades After Autism Omnibus, CDC Back In Thimerosal Fight
An unusual legal proceeding two decades ago tested claims that childhood vaccines caused autism. The "omnibus" proceeding found no such link, cutting off the primary legal path for such claims. Today, a CDC advisory panel reconstituted by HHS Secretary Robert F. Kennedy Jr. is reopening the debate.
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July 15, 2025
Wash. Court Doubts Hospitals' Bid To Nix $230M Judgment
A Washington state appellate judge criticized a hospital system's attempt to undo a $230 million loss in a class wage and hour suit on Tuesday, suggesting the employer's arguments about meal break waivers and timekeeping practices are at odds with its own records.
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July 15, 2025
Workers Seek Class Status In United Pricing Scheme Suit
A group of workers urged a California federal judge to award them class certification in their suit alleging United Behavioral Health and a billing contractor shorted them on coverage for out-of-network substance use disorder treatments, arguing they put forward new detail that clears class status requirements.
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July 15, 2025
Amid Budget Woe, New Hampshire Shutters Drug Price Board
Bucking a trend of state efforts to rein in prescription drug prices, New Hampshire lawmakers have dissolved a state drug affordability board launched just five years ago.
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July 15, 2025
Wisconsin Health Co. Faces Trimmed 403(b) Fee Suit
A federal judge agreed to trim a federal benefits lawsuit against a Wisconsin health system from a proposed class of employees who said their 403(b) retirement plan was mismanaged, refusing to dismiss recordkeeping fee claims but agreeing to toss allegations of excessive investment management fees.
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July 15, 2025
A Legal 'Green Light' For FDA Abortion Drug Review
A case brought by Democratic attorneys general led to a "green light" federal court decision for the Trump administration as it considers new regulations on the abortion drug mifepristone.
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July 14, 2025
BCBS Defends $2.8B Provider Antitrust Deal Amid Objections
Blue Cross Blue Shield asked an Alabama federal judge on Friday to approve a $2.8 billion antitrust settlement with hospitals and other healthcare providers over its territorial policies, arguing that recent objections to the deal's release provision are meritless and the settlement preserves "key, procompetitive features" of the insurance system.
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July 14, 2025
CFPB Deal To Put Medical Debt Back On Reports OK'd
A Texas federal court has reversed a Biden-era rule that kept an estimated $49 billion in medical debt from credit reports after the Consumer Financial Protection Bureau and lender trade groups struck a deal to axe the rule.
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July 14, 2025
DOJ Drops Vax Card Case Against Plastic Surgeon Mid-Trial
The Justice Department dismissed charges against a Utah plastic surgeon accused of leading a conspiracy to forge COVID-19 vaccination cards for over 1,500 people, ending the case less than a week after trial began in Salt Lake City federal court.
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July 14, 2025
Cigna Denies Responsibility For Alleged Health Data Breach
Cigna has asked a Pennsylvania federal judge to throw out class claims by health plan members alleging it failed to protect their private data, arguing they didn't show how their sensitive information was intercepted from the insurer's websites.
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July 14, 2025
Court Says Insider Trading Rules Unscathed By Loper Bright
A U.S. Supreme Court ruling that curtailed deference to agency interpretations of law did not undermine the U.S. Securities and Exchange Commission's rules against insider trading, a Pennsylvania federal court ruled Friday.
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July 14, 2025
Judge Says Med Device 401(k) Fee Suit Should Get A Trim
A Massachusetts federal magistrate judge recommended narrowing a proposed class action claiming a medical technology company saddled its retirement plan with excessive fees and abused forfeited funds, ruling the workers failed to show the business violated the plan's terms.
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July 14, 2025
UnitedHealth Settling Fraud Case Over Fake Invoice Scheme
UnitedHealth Group Inc. and a subsidiary are not going to trial in Colorado state court this week after the company reached a settlement with a defunct Colorado investment company that claimed UnitedHealth should have been liable for the "multi-million dollar fraudulent scheme" executed by a former employee, counsel for the plaintiff told Law360.
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July 14, 2025
Ga. County Wants 11th Circ. To Nix Trans Deputy's Health Win
A Georgia county urged the Eleventh Circuit to reverse a transgender sheriff's deputy's trial court win on claims that denying coverage for a vaginoplasty constituted discrimination in violation of Title VII, arguing the U.S. Supreme Court's recent decision upholding a Tennessee state ban on gender-affirming care for minors supported its appeal.
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July 14, 2025
Fla. Says High Court Rulings Back Trans Care Medicaid Ban
Florida told the Eleventh Circuit that recent U.S. Supreme Court rulings affirm the legality of a state law banning Medicaid payments for gender-affirming medical care, arguing its restrictions mirror a similar Tennessee law upheld by the justices because it centers on gender dysphoria diagnoses, not one's sex.
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July 14, 2025
Mich. Jury Sides With Red Cross In COVID Vax Refusal Suit
A Michigan federal jury on Monday found that a former American Red Cross nurse's request for an exemption from the organization's COVID-19 vaccine mandate wasn't based on a sincere religious belief that barred her from getting the injection, rejecting the worker's request for more than $6 million in damages for her firing.
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July 14, 2025
Masimo Corp. Settles Investor Suit Over Revenue Disclosures
Masimo Corp. has settled proposed class claims alleging the health technology firm misrepresented the company's finances and plans to investors, according to a filing in Southern California federal court.
Expert Analysis
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4th Circ. Health Data Ruling Opens Door To State Law Claims
In Real Time Medical v. PointClickCare, the Fourth Circuit recently clarified that state law claims can rest in part on violations of a federal law that prohibits electronic health information blocking, expanding legal risks for health IT companies and potentially creating exposure to a range of competitive implications, say attorneys at BCLP.
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Unpacking Trump Admin Plans For Value-Based Care
Recent developments from the Center for Medicare and Medicaid Innovation suggest the Trump administration intends to put its own stamp on value-based care, emphasizing cost savings assessment in particular, with its recent cancellation of several payment models that had supported primary care, says Miranda Franco at Holland & Knight.
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What To Expect For Stem Cell Regulation Under Trump Admin
The new administration's push for deregulation, plus the post-Chevron legal landscape, and momentum from key political and industry players to facilitate stem cell innovation may create an opportune backdrop for a significant reduction in the U.S. Food and Drug Administration's regulatory framework for stem cells, say attorneys at Sheppard Mullin.
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How Importers Can Minimize FCA Risks Of Tariff Mitigation
False Claims Act risks are inherent in many tariff mitigation strategies, making it important for importers to implement best practices to identify and report potential violations of import regulations before they escalate, says Samuel Finkelstein at LMD Trade Law.
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10 Practical Takeaways From FDA's Biopharma AI Guidance
Recent guidance from the U.S. Food and Drug Administration provides much-needed insight on the usage of artificial intelligence in producing information to support regulatory decision-making regarding drug safety, with implications ranging from life cycle maintenance to AI tool acquisition, say attorneys at Covington.
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Lawmakers Shouldn't Overlook Rare Disease Therapies' Value
As the ORPHAN Cures Act is pending in Congress, policymakers assessing the value of certain drugs for price regulation should consider data beyond what is collected in clinical trials, say Alice Chen at the University of Southern California, and Molly Frean and Yao Lu at Analysis Group.
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What Trump's Order Means For The Legal Status Of IVF
An executive order signed by President Donald Trump last month signals the administration's potential intention to increase protections for in vitro fertilization services, though more concrete actions would be needed to resolve the current uncertainty around IVF access or bring about a binding legal change, says Jeanne Vance at Weintraub Tobin.
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Mitigating Tariff Risks For Healthcare In US And Canada
Healthcare stakeholders should take steps to evaluate the impact of cross-border tariffs, as the historically strong ties between Canada and the U.S. demonstrate the potential for real disruption and harm to the healthcare industry in both countries, say attorneys at Norton Rose.
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What's At Stake In High Court Transgender Care Suit
The outcome of U.S. v. Skrmetti will have critical implications for the rights of transgender youth and their access to gender-affirming care, and will likely affect other areas of law and policy involving transgender individuals, including education, employment, healthcare and civil rights, say attorneys at ArentFox Schiff.
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6 Laws Transforming Calif.'s Health Regulatory Framework
Attorneys at Hooper Lundy discuss a number of new California laws that raise pressing issues for independent physicians and small practice groups, ranging from the use of artificial intelligence to wage standards for healthcare employees.
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Anticipating Calif. Oversight Of PE Participation In Healthcare
A new bill recently introduced in the California Senate revives last year's attempt to increase oversight of healthcare transactions involving private equity groups and hedge funds, meaning that attorneys may soon need to assess the compliance status of existing management relationships and consider modifying contract terms, says Andrew Demetriou at Husch Blackwell.
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Considering The Future Of AI Regulation On Health Sector
As Texas looks to become the next state to pass a comprehensive law regulating artificial intelligence, the healthcare industry should consider how AI regulation will continue to evolve in the U.S. and how industry members can keep up with compliance considerations, say attorneys at Kirkland & Ellis.
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What To Expect From 'Make America Healthy Again' Actions
The Make America Healthy Again Commission recently established by President Donald Trump and chaired by Robert F. Kennedy Jr. will potentially bring energy and attention to important public health topics, and stakeholders should be aware of pathways for sharing their input and proactively informing proceedings, says Nicholas Manetto at Faegre Drinker.