Policy & Compliance
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January 16, 2026
Oversight Head Seeks Help From CMS On NY Medicaid Inquiry
House Oversight and Government Reform Committee Chair James Comer, R-Ky., asked the Centers for Medicare & Medicaid Services on Friday to aid the committee's investigation into whether New York has wrongfully withheld funds for hospitals disproportionately serving Medicaid recipients and uninsured people.
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January 16, 2026
La. State Court Greenlights Challenge To Gender Care Ban
A Louisiana state judge sided with a group of transgender teenagers who argue the state's ban on gender-affirming care for minors is unconstitutional, denying the state's bid to dismiss the case, according to an announcement Friday from the minors' attorneys.
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January 15, 2026
Ex-CEO Of COVID Vax Maker Accused Of Insider Trading
New York Attorney General Letitia James on Thursday sued the former CEO of healthcare contractor Emergent BioSolutions Inc., alleging insider trading amid troubles manufacturing a COVID-19 vaccine, while signing a $900,000 settlement with the company over its approval of an executive trading plan.
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January 15, 2026
5th Circ. Revives Allstate's Fraud Suit Over Car Crash Billing
The Fifth Circuit on Wednesday revived Allstate's racketeering suit alleging doctors and personal injury lawyers unleashed a barrage of unnecessary treatments for car accident patients and caused Allstate to pay $4.7 million in claims, finding the insurer sufficiently pled details about the conspiracy and specifics surrounding each allegedly fake medical billing.
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January 15, 2026
Trump Admin Defies Funding K-12 Mental Health Grants
The Trump administration is fighting an effort by a coalition of U.S. states to preserve at least six months of funding for K-12 mental health grants meant to help students process gun violence, arguing that an earlier court ruling doesn't require the feds to fund the grants.
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January 15, 2026
Colo. Eye Clinics Settle Medicaid Double-Billing Claims
The Colorado attorney general's office announced Thursday that it reached a settlement totaling $520,000 with two eye care clinics that the state claimed were double-billing a Medicaid vision program for more than five years.
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January 15, 2026
NC Attys Can Withdraw From 'Unworkable' Nurses' Pay Row
Two attorneys who said they had "irreconcilable differences" with nurse practitioners who did not meet their contractual financial obligations can withdraw their representation in a minimum wage lawsuit against their employer, a North Carolina federal magistrate judge ruled.
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January 15, 2026
CVS Ducks Antitrust But Not Biz Interference Claim At 5th Circ.
A Fifth Circuit panel has largely sided with CVS Pharmacy and its Caremark affiliate by preserving a district court's dismissal of federal antitrust claims over a Mississippi pharmacy's rejection from participating in the pharmacy benefit manager's network, although the judges did revive state law claims.
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January 14, 2026
Pharmacy Wields Antitrust Law In Challenge To GLP-1 Giants
Eli Lilly & Co. and Novo Nordisk are using their dominant positions in the market for weight loss and diabetes medications to squash potential competitors, including through unlawful exclusivity agreements with telehealth providers, a compounding pharmacy alleged Wednesday in what it calls a landmark antitrust lawsuit.
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January 14, 2026
6th Circ. Skips Rethink, But Still Spars Over Indirect Buyer Bar
A decision by the full Sixth Circuit not to rehear a lawsuit over an alleged allergy testing and treatment provider boycott has turned into an internal dustup about the limits of who can seek damages under federal antitrust law, with one judge calling for U.S. Supreme Court intervention.
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January 14, 2026
NJ Judge Orders Mediation In Merck-Cencora Indemnity Fight
Cencora Inc. can't derail a Merck third-party complaint arguing a prior settlement between the parties requires the drug wholesaler to indemnify Merck in antitrust litigation by Humana, a New Jersey federal court ruled Wednesday, ordering the parties to go to mediation over the dispute.
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January 14, 2026
Vizient Beats Spurned Medical Tape Supplier At 5th Circ.
A Fifth Circuit panel refused to revive an antitrust suit accusing medical supplies group purchasing giant Vizient of locking in hospital customers, agreeing with a district court that a spurned would-be supplier failed at the threshold question of showing a market in which Vizient could be dominant.
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January 14, 2026
GOP Senators Say Patients Must See Docs For Abortion Meds
Republicans on a Senate health panel Wednesday called for the U.S. Food and Drug Administration to reinstate a requirement that pregnant women seeking an abortion via medication must have the drug administered in a doctor's office, not through telehealth or remotely.
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January 13, 2026
Ark. Official Urges 7th Circ. Not To Revive Pharma Rule Fight
An Illinois federal judge correctly upheld an Arkansas insurance regulation designed to protect local pharmacies, the state's insurance commissioner told the Seventh Circuit on Monday, asking the court to toss a Teamsters healthcare plan's bid to renew its challenge to the regulation.
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January 13, 2026
EEOC Disability Bias Win Stands, But Damages Shrink
A Florida federal judge declined a senior living facility's bid for a new trial in a U.S. Equal Employment Opportunity Commission disability bias suit claiming it wouldn't hire a veteran who has PTSD, but cut a $400,000 jury verdict to $50,000 in line with a damages cap.
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January 13, 2026
La. Moves To Extradite Calif. Doc Over Abortion Pill Trafficking
Louisiana Gov. Jeff Landry on Tuesday said he would authorize an extradition request for a California doctor accused of illegally mailing abortion pills to a Louisiana resident, further escalating a legal battle over the reach of state bans in the post-Roe era.
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January 13, 2026
Oak Street Exec's Ex-Partner Must Forfeit $617K In Assets
Federal authorities can delve into the assets of a man who made illegal insider trades of CVS stock based on information from his domestic partner so that they can recover $617,000 he agreed to forfeit as part of a plea deal, a Pennsylvania federal judge said Tuesday.
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January 13, 2026
Healthcare Litigation Week In Review
Law360 Healthcare Authority looks at the past week's top healthcare news.
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January 13, 2026
Workers Seek $126M In Seattle Hospital System Wage Row
Seattle-area hospital system Swedish Health Services should shell out about $126 million to settle wage violations, after a state court found that the system failed to provide a second meal break on longer shifts and that its rounding practices led to unpaid wages, the workers said.
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January 13, 2026
Blue States Say HHS Conditions Funding On Anti-Trans Bias
A dozen Democratic state attorneys general sued the U.S. Department of Health and Human Services on Tuesday, claiming the agency's threat to withhold billions of dollars in funding from states that don't hew to an executive order declaring that gender is immutable conflicts with antidiscrimination law.
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January 13, 2026
Gov't Didn't Allege Formula Was Contaminated, Abbott Says
Abbott Laboratories has urged a Michigan federal judge to throw out a suit brought by the federal government over the 2022 infant formula shortage, saying the government is trying to recoup a "belated windfall" and no tainted formula left its plant's doors.
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January 13, 2026
Federal Drug Pricing Policies Irk Biotech Insiders
As the federal government targets drug and other healthcare costs, biotech insiders say they're getting exasperated.
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January 13, 2026
Justices Seem Poised To Greenlight Transgender Athlete Bans
The conservative wing of the U.S. Supreme Court voiced skepticism of allowing transgender athletes to compete in women's and girls' sports Tuesday, while also signaling a willingness to keep its ruling narrowly tailored.
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January 13, 2026
Blip Or Trend? FDA Guidance Fell Off Steeply In 2025
The U.S. Food and Drug Administration issued far less industry guidance last year after President Donald Trump returned to office. The change has pharmaceutical attorneys bracing for more unpredictability.
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January 12, 2026
The Curious, Very Long Delay In A Pioneering Drug Prices Suit
When Merck & Co. launched a fiery challenge to Medicare's landmark drug price negotiations, it blazed a trail for many similar suits. But 31 months later, the challenge is stalled where it started as Merck begs for a ruling, other suits speed along the path it created and huge costs now seem unavoidable.
Expert Analysis
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AG Watch: Illinois A Key Player In State-Level Enforcement
Illinois Attorney General Kwame Raoul has systematically strengthened his office to fill federal enforcement gaps, oppose Trump administration mandates and advance state policy objectives, particularly by aggressively pursuing labor-related issues, say attorneys at Troutman.
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Organ Transplant System Reforms Mark Regulatory Overhaul
Recent oversight, enforcement and operational developments in the U.S. organ procurement and transplantation system, alongside challenges like the federal shutdown, highlight heightened regulatory scrutiny and the need for compliance to maintain public trust, say attorneys at Hall Render.
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Federal Grantees May Soon Face More Limitations On Speech
If courts accept the administration’s new interpretation of preexisting case law, which attempts to graft onto grant recipients the existing limitations on government contractors' free speech, a more deferential standard may soon apply in determining whether an agency’s refusal or termination of a grant was in violation of the First Amendment, say attorneys at Venable.
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HHS Wound Care Report Highlights Need For Payment Reform
The U.S. Department of Health and Human Services' recent report on potential abuse in Medicare Part B payments for skin substitutes highlights specific fraud schemes, but more importantly emphasizes that broader changes are needed for the wound care sector's fundamentally flawed payment system, say attorneys at Paul Hastings.
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Assessing The Future Of The HIPAA Reproductive Health Rule
In light of a Texas federal court's recent decision to strike down a U.S. Department of Health and Human Services rule aimed to protect the privacy of patients seeking abortions and gender-affirming care, entities are at least temporarily relieved from compliance obligations, but tensions are likely to continue for the foreseeable future, says Liz Heddleston at Woods Rogers.
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DOJ's Tracing Rule For Pandemic Loan Fraud Is Untenable
In conducting investigations related to COVID-19 relief fraud, the government's assertion that loan proceeds are nonfungible and had to have been segregated from other funds is unsupported by underlying legislation, precedent or the language establishing similar federal relief programs, say Sharon McCarthy, Jay Nanavati and Lasya Ravulapati at Kostelanetz.
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New Health AI Guidance Features A Provider-Centric Approach
New guidance from the Joint Commission and Coalition for Health AI regarding the responsible use of artificial intelligence in healthcare deviates from preexisting guidance by recommending a comprehensive framework for using AI tools, focusing on healthcare provider organizations rather than on AI developers, say attorneys at Ropes & Gray.
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Mass. Ruling May Pave New Avenue To Target Subpoenas
A Massachusetts federal court’s recent decision to quash a subpoena seeking information on gender-affirming care at Boston Children’s Hospital is a significant departure from courts' deferential approach to subpoena enforcement, and may open a new pathway for practitioners challenging investigative tools in the future, say attorneys at Gibson Dunn.
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What To Expect After FDA Warnings To GLP-1 Compounders
The U.S. Food and Drug Administration's recent warning letters to companies advertising compounded versions of GLP-1 medications raise questions not just about the enforcement outlook for marketing such products, but also about the future of drug compounding as a whole, say attorneys at Spencer Fane.
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How Financial Cos. Can Prep As NYDFS Cyber Changes Loom
Financial institutions supervised by the New York State Department of Financial Services can prepare for two critical cybersecurity requirements relating to multifactor authentication and asset inventories, effective Nov. 1, by conducting gap analyses and allocating resources to high-risk assets, among other steps, say attorneys at Pillsbury.
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How Courts May Interpret Data-Driven Healthcare Fraud Suits
As the U.S. Department of Justice and other agencies increasingly turn to data mining as an enforcement tool, courts will have to determine how far data alone can take a fraud case, and sound theory, clinical expertise and institutional context will play an important role, say Jaime Jones at Sidley and Andrée-Anne Fournier and Atang Gilika at Analysis Group.
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How Gov't Shutdown Will Affect Federal Health Agencies
Federal health agencies' contingency plans indicate that many major programs will remain insulated from disruption during the ongoing government shutdown, but significant policy proposals will likely be delayed and the Trump administration's emphasis on reduction-in-force plans distinguishes this shutdown from past lapses, says Miranda Franco at Holland & Knight.
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Assessing Legal, Regulatory Hurdles Of Healthcare Offshoring
The offshoring of administrative, nonclinical functions has emerged as an increasingly attractive option for healthcare companies seeking to reduce costs, but this presents challenges in navigating the web of state restrictions on the access or storage of patient data outside the U.S., say attorneys at McDermott.