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Health
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November 20, 2025
NC Judge Halts Medicaid Cuts For Autism Services
A North Carolina state court judge blocked the state's Health and Human Services Department from implementing a 10% cut to Medicaid reimbursement rates for autism therapy after finding children who benefit from that therapy would be irreparably harmed.
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November 20, 2025
Ute 'Healer' Convicted Of Sexual Abuse Over 12 Years
A Colorado tribal member has been convicted of sexually assaulting four women and a child over the past dozen years, the U.S. Department of Justice says, after he allegedly established himself as a traditional Indigenous healer to exploit his victims.
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November 20, 2025
Claims Firms Barred From Misleading Plaintiffs In Pharma MDL
On the same day that a Philadelphia federal judge approved $58 million in settlements as part of an ongoing generic-drug price-fixing multidistrict litigation, she also ordered several claims recovery firms to correct allegedly false and misleading ads used to attract potential clients seeking to make claims on the settlements.
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November 20, 2025
Trump Pardons Nursing Home Owner In $39M Tax Fraud
President Donald Trump granted clemency to a nursing home operator who had been sentenced to three years in prison for a $39 million employment tax fraud scheme involving care centers he owned across the country.
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November 20, 2025
Hospital's Challenge To EEOC Disability Bias Suit Falls Short
A Michigan hospital can't escape a U.S. Equal Employment Opportunity Commission suit claiming it unlawfully refused to transfer a nurse with a metabolic disorder to a less demanding position, with a federal judge saying the hospital hadn't shown the court erred when it sent the case to a jury.
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November 20, 2025
2 Firms Guide Abbott's $23B Deal With Cologuard Maker
Wachtell Lipton Rosen & Katz and Skadden Arps Slate Meagher & Flom LLP are steering Abbott's planned $23 billion acquisition of Exact Sciences, in a deal announced Thursday that will give the medical device maker an immediate foothold in fast-growing U.S. cancer screening markets.
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November 19, 2025
Senior Living Co. Inks $7.2M Deal To End Wash. AG's Probe
Oregon-based senior living provider Bonaventure will invest $7 million in staffing and upgrades and shell out $200,000 in resident credits to resolve allegations of substandard care at 10 Washington state facilities, under a settlement filed Wednesday.
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November 19, 2025
DaVita Reaches Tentative Deal In Patients' Data Breach Suit
DaVita Inc. has reached a settlement in principle with current and former patients of the healthcare company who alleged in Colorado federal court that it did not adequately protect their personal information, resulting in an April data breach.
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November 19, 2025
Fla. Congresswoman Accused Of Stealing $5M In FEMA Funds
A Florida congresswoman was indicted on charges that she stole $5 million in COVID-19 disaster relief funds through her family-run healthcare business and used the money to fund her 2021 campaign, federal prosecutors said on Wednesday.
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November 19, 2025
Med Co. Sellers Urge Del. Justices To Revive Suit
An attorney for former investors in urgent care provider CityMD urged Delaware's Supreme Court on Wednesday to reverse a lower court's dismissal of claims they were coerced into giving up purported rights to the same consideration a private equity controller received in a 2021 merger.
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November 19, 2025
Is 'Red Book' Best For Drug Pricing? Pa. Justices Ask
The Pennsylvania Supreme Court seemed skeptical Wednesday that the state workers' compensation authorities were using the best guide to calculate pharmacy reimbursements for injured workers' prescription drugs, with the justices questioning the fairness of the industry's long-used "red book" method.
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November 19, 2025
11th Circ. Backs Kaiser In Air Ambulance Arbitration Dispute
The Eleventh Circuit on Wednesday declined an air ambulance company's bid to scrap an arbitrator's ruling that Kaiser only owes $24,000 for an emergency helicopter flight, rejecting the emergency medical provider's arguments that the insurer committed fraud by strategically lowballing the arbitrator.
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November 19, 2025
23andMe Seeks OK For Ch. 11 Plan With Release Tweaks
Attorneys for former DNA testing company 23andMe urged a Missouri bankruptcy judge Wednesday to approve its Chapter 11 liquidation plan, which resolved objections from states and the U.S. Trustee tied to claim releases.
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November 19, 2025
Aetna Gets OK For $3.4M Deal In Cancer Treatment Denial Suit
A Florida federal judge has signed off on Aetna's $3.4 million settlement agreement resolving a class action that alleged the insurer unlawfully mischaracterized a proton beam cancer radiation treatment as experimental to deny dozens of claims.
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November 19, 2025
Senate GOP Resists Extending Expanded ACA Tax Premiums
Senate Finance Committee Democrats on Wednesday urged their Republican counterparts to extend the enhanced tax credits for the Affordable Care Act, which is set to expire at the end of the year, but Republicans said they were looking for other options to address rising healthcare costs.
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November 19, 2025
Conn. Dentists Pay $714K To Settle Patient Kickback Claims
Two Connecticut dentists will pay more than $714,000 to the state and federal governments to settle joint allegations that their practices submitted false government benefits claims that contained kickbacks for patient recruiters.
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November 19, 2025
Pa. Health Network's $1.15M 401(k) Suit Deal Gets Initial OK
A healthcare system Wednesday secured initial approval from a Pennsylvania federal court for a $1.15 million settlement agreement that would resolve a proposed class action alleging the company misused forfeited retirement plan funds and allowed the plan's administrative costs to soar.
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November 19, 2025
Alkermes, Avadel Bump Deal To $2.37B After Alternate Bid
Alkermes PLC said on Wednesday that its agreement to purchase Avadel Pharmaceuticals PLC has been increased to as much as $2.37 billion after a third party threw an alternate bid into the mix.
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November 19, 2025
8th Circ. Hears PBMs' Bid To Pause FTC Insulin Pricing Case
An Eighth Circuit panel had only a handful of questions on Wednesday for the pharmacy benefit managers accused of inflating insulin prices, though one of the judges expressed skepticism about pausing the Federal Trade Commission's in-house enforcement action on constitutional grounds.
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November 19, 2025
Gilead Sciences' GC Will Leave Co. Next Month
Gilead Sciences Inc. announced Wednesday that Deborah H. Telman will no longer serve as its executive vice president for corporate affairs and general counsel as of Dec. 5, 2025.
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November 19, 2025
Hospice Co. Should Face Tobacco Fee Suit, Judge Says
A hospice and home healthcare provider shouldn't escape a proposed class action challenging a tobacco surcharge in its employee health plan, a Pennsylvania federal judge recommended, finding that allegations sufficiently backed up that a wellness program implementing the fee didn't meet all regulatory requirements.
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November 19, 2025
Doctor, Husband Admit $16M Healthcare Fraud, Tax Evasion
A physician and her husband admitted to committing more than $16 million in healthcare fraud and tax evasion as part of a scheme that injected sick patients with the wrong medications or dosages, according to their plea agreements in Alaska federal court.
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November 19, 2025
Pfizer To Pay $41.5M To Settle Adulterated ADHD Drug Claims
Pfizer Inc. and Tris Pharma Inc. agreed Wednesday to cough up $41.5 million to settle claims brought by Texas that it gave adulterated ADHD drugs to children, ending a lawsuit alleging the companies violated a state healthcare fraud law.
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November 19, 2025
Doc Takes Plea, Avoids Prison In Novel Opioid Death Case
A retired Massachusetts doctor pled guilty and was sentenced to five years of probation in a first-of-its-kind involuntary manslaughter case over a patient's 2016 opioid overdose death, the state attorney general's office announced.
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November 18, 2025
Health Co. Execs Convicted In $100M Adderall Sales Scheme
A San Francisco federal jury weighing a first-of-its-kind case on Tuesday convicted two digital healthcare company executives of scheming to sell Adderall through deceptive advertising, allegedly bringing in $100 million in illicit profits.
Expert Analysis
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Opinion
Expert Reports Can't Replace Facts In Securities Fraud Cases
The Ninth Circuit's 2023 decision in Nvidia v. Ohman Fonder — and the U.S. Supreme Court's punt on the case in 2024 — could invite the meritless securities litigation the Private Securities Litigation Reform Act was designed to prevent by substituting expert opinions for facts to substantiate complaint assertions, say attorneys at A&O Shearman.
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Opinion
High Court, Not A Single Justice, Should Decide On Recusal
As public trust in the U.S. Supreme Court continues to decline, the court should adopt a collegial framework in which all justices decide questions of recusal together — a reform that respects both judicial independence and due process for litigants, say Michael Broyde at Emory University and Hayden Hall at the U.S. Bankruptcy Court for the District of Delaware.
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Series
Traveling Solo Makes Me A Better Lawyer
Traveling by myself has taught me to assess risk, understand tone and stay calm in high-pressure situations, which are not only useful life skills, but the foundation of how I support my clients, says Lacey Gutierrez at Group Five Legal.
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Opinion
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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Series
Law School's Missed Lessons: Client Service
Law school teaches you how to interpret the law, but it doesn't teach you some of the key ways to keeping clients satisfied, lessons that I've learned in the most unexpected of places: a book on how to be a butler, says Gregory Ramos at Armstrong Teasdale.
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How Occasional Activists Have Reshaped Proxy Fights
The sophistication and breadth of first-time activist engagement continue to shape corporate governance and strategic outcomes, as evidenced across corporate annual meetings this summer, meaning advisers should anticipate continued innovation in tactics, increased regulatory complexity, and a persistent focus on board accountability, say attorneys at MoFo.
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Bid Protest Spotlight: Documentation, Overrides, Eligibility
Recent decisions by the U.S. Court of Federal Claims and the U.S. Government Accountability Office illustrate the importance of contemporaneous documentation in proposal evaluations, the standards for an agency’s override of a Competition in Contracting Act stay, and the regulatory requirements for small business joint ventures, says Cody Fisher at MoFo.
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Shutdown Imperils Telehealth Access For Medicare Patients
The federal government shutdown that commenced on Oct. 1 coincided with the expiration of certain telehealth flexibilities that had preserved expansive access to telehealth services for Medicare beneficiaries following COVID-19, creating significant legal and financial uncertainty for healthcare providers and patients, say attorneys at Robinson & Cole.
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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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Why Justices Seem Inclined To Curtail Del. Affidavit Statute
After recent oral argument before the U.S. Supreme Court in Berk v. Choy — asking whether Delaware's affidavit-of-merit statute applies in federal diversity actions, or whether the Federal Rules of Civil Procedure displace the state requirement — it appears the court is poised to simplify the standard approach, says Eric Weitz of The Weitz Law Firm.
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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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Series
Adapting To Private Practice: 3 Tips On Finding The Right Job
After 23 years as a state and federal prosecutor, when I contemplated moving to a law firm, practicing solo or going in-house, I found there's a critical first step — deep self-reflection on what you truly want to do and where your strengths lie, says Rachael Jones at McKool Smith.
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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.