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May 02, 2025
Virginia Accuses Tribe Of Medicaid Billing Fraud
Virginia is fighting a bid by the Nansemond Indian Tribe for an order that would require it to continue processing the tribe's unpaid Medicaid reimbursement claims, telling a federal court that it instead suspended payments and its Medicaid fraud unit is investigating the tribal healthcare entity.
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May 02, 2025
Medical Pot Co. Says Ex-COO Took Patients' Info To Rival
Medical cannabis company MMJ Health Labs LLC is suing a former contractor and chief operating officer in Florida federal court, saying he stole proprietary information, including patient records, and provided them to a competitor.
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May 01, 2025
Planned Parenthood Slams HHS 'Attacks' On Teen Program
Planned Parenthood on Thursday pressed a D.C. federal court to block the U.S. Department of Health and Human Services' "attacks" on a long-running, successful public health initiative aimed at preventing teen pregnancy, claiming that HHS has implemented new, "deeply inconsistent" requirements threatening the program's funding.
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May 01, 2025
DaVita Hit With Class Actions Over Ransomware Attack
DaVita Inc. is facing at least two proposed class actions over a data breach the kidney care provider announced in April, with current and former patients alleging Wednesday in Colorado federal court that data thieves have already engaged in identity theft and fraud while DaVita has yet to offer details.
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May 01, 2025
Aetna And Humana Accused Of Medicare Kickbacks And Bias
The federal government brought a bombshell False Claims Act suit Thursday against Aetna, Elevance and Humana, claiming the insurers paid hundreds of millions of dollars in illegal kickbacks to brokers in exchange for enrollments into their Medicare Advantage plans, with Humana and Aetna also accused of discriminating against disabled beneficiaries.
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May 01, 2025
Fla. Condo Wins Noise Dispute With Autistic Man's Family
A Florida appellate panel ruled in favor of a condominium association in a lawsuit over a noise dispute between a family caring for their autistic son and a neighbor, finding no evidence that the family faced discrimination in violation of housing laws.
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May 01, 2025
HHS Report Finds 'Serious Concerns' On Trans Care For Youth
The U.S. Department of Health and Human Services on Thursday released a report it says raises "serious concerns" about medical interventions used to aid young people in gender transition.
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May 01, 2025
'Fingers Crossed' At FCC As Court's Subsidy Ruling Closes In
There's plenty of hand-wringing at the Federal Communications Commission as a U.S. Supreme Court decision draws near over the legality of the revenue-raising scheme used to pay for more than $9 billion in broadband and phone service subsidies.
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May 01, 2025
Chancery Finds Contract Bars Appeal In Med Co. Merger
Private equity-tilted limited liability company contract terms beat minority investor challenges to the fairness of the $8.9 billion merger in January 2023 that joined Summit Health-CityMD and VillageMD, a Delaware vice chancellor ruled late Wednesday.
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May 01, 2025
Couple's J&J Pelvic Mesh Claims Too Late, 11th Circ. Affirms
The Eleventh Circuit held Thursday that a couple's lawsuit against Johnson & Johnson over injuries allegedly caused by a pelvic mesh device made by the company's med-tech unit was filed too late despite evidence that the woman's doctors had expressed uncertainty for years about whether the mesh was causing her pain.
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May 01, 2025
Publix Can't Slip 'Zero-Market Share' Opioid Claims
Publix Super Markets Inc. can't slip opioid-related claims from nine municipalities in which the supermarket chain alleges it has no pharmacies, an Ohio federal judge overseeing sprawling national opioid litigation ruled.
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May 01, 2025
CFPB, Lenders Float Deal To Vacate Medical Debt Rule
The Consumer Financial Protection Bureau has agreed to a proposed consent judgment that would vacate a Biden-era rule banning an estimated $49 billion in medical debt from credit reports, striking a deal with lender trade groups that sued in Texas federal court to block the rule.
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May 01, 2025
PBMs Tell 6th Circ. Ohio's Pricing Case Belongs In Fed Court
Express Scripts and Prime Therapeutics urged the Sixth Circuit to undo a district court order returning a lawsuit from Ohio's attorney general alleging they drove up prescription drug prices to state court, arguing Wednesday an after-the-fact disclaimer of federal program-based claims isn't enough to sever a federal law connection.
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May 01, 2025
Payment Math Dooms Sandoz Price-Fixing Deal With Florida
A Connecticut federal judge on Thursday refused to put a bow on the deal the state of Florida struck with Sandoz AG and related defendants in three generic drug price-fixing lawsuits, ruling from the bench in Hartford that the settlement agreement "as written" would lead to exorbitant supplemental payments in the event that other states also reach deals to release their claims.
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May 01, 2025
Civil Order Stalling Chamber Death Prosecution, Judge Hears
A prosecutor and attorneys for clinic workers charged in connection with the death of a 5-year-old boy in a hyperbaric chamber explosion expressed frustration Wednesday that they cannot get their experts into the building to investigate because of a temporary restraining order they say is interfering with the criminal cases.
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May 01, 2025
Ex-Conn. State Employee Cops To $1.8M Medicaid Scam Role
A former Connecticut government employee admitted to playing a part in a $1.8 million scheme to defraud the Constitution State's Medicaid program by fraudulently billing services for children with autism that her company never provided, acting U.S. Attorney Marc H. Silverman has announced.
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May 01, 2025
Mammogram Provider Facing Wave Of Data Breach Suits
Seven patients of a mobile mammography business have each filed class actions in recent days following the company's disclosure that personal and health information for more than 350,000 patients was impacted by a data breach seven months ago.
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May 01, 2025
IRS Updates Inflation-Adjusted HSA Amounts For 2026
The Internal Revenue Service issued inflation-adjusted amounts Thursday for health savings accounts for 2026, as well as the maximum amount that may be made available for excepted benefit health reimbursement arrangements.
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May 01, 2025
Rehab Center To Pay $19.75M To Resolve FCA Case
A New Jersey drug and alcohol rehabilitation center will pay $19.75 million to resolve claims that it violated the False Claims Act by concealing it had no license from state regulators and billed the Veterans Health Administration and Medicaid for its services.
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April 30, 2025
Judge Keeps Pfizer Foe's COVID Vaccine Patent Case Alive
The chief judge for the Delaware federal court has turned down a bid from Pfizer and BioNTech to invalidate patent claims asserted against their blockbuster COVID-19 vaccine, in a case set to go before a jury later this year.
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April 30, 2025
DOJ Urges 11th Circ. To Restore FCA Whistleblower Provision
The U.S. Department of Justice told the 11th Circuit on Wednesday that a Florida federal judge was wrong to rule that the provision of the False Claims Act that lets whistleblowers bring suits on the government's behalf was unconstitutional, arguing that the judge erred in saying whistleblowers were an unappointed part of the federal workforce.
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April 30, 2025
SuperValu Fights New Trial Bid In Whistleblower Drug Case
SuperValu urged an Illinois federal judge Tuesday not to overturn its defense win on whistleblower claims of systematic prescription overbilling, saying the whistleblowers are now making "kitchen sink arguments" with little basis.
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April 30, 2025
Atlanta Home Health Service Faces Overtime Class Action
An Atlanta home healthcare service was hit with a proposed class action Wednesday over allegations it failed to pay certified nursing assistants proper overtime compensation.
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April 30, 2025
Ga. Panel Backs Benefits For Worker Over COVID Safety
The Georgia Court of Appeals has backed a former salesperson in a long-running fight with the state's Department of Labor over its refusal to pay her unemployment benefits when she quit her job over her company's refusal to follow public health protocols during the pandemic.
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April 30, 2025
Judge Will OK Wellpath's Ch. 11 Plan Over Release Objections
A Texas bankruptcy judge said Wednesday he will confirm prison healthcare company Wellpath's Chapter 11 plan over objections after the debtor achieved a global settlement and agreed to additional changes, saying he was convinced the plan offered the best outcome.
Expert Analysis
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Biden-Era M&A Data Shows Continuity, Not Revolution
While the federal antitrust agencies under former President Joe Biden made broad claims about increasing merger enforcement activity, the data tells a different story, with key claims under Biden coming in at the lowest levels in decades, say attorneys at Covington.
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10 Issues To Watch In Aerospace And Defense Contracting
This year, in addition to evergreen developments driven by national security priorities, disruptive new technologies and competition with rival powers, federal contractors will see significant disruptions driven by the new administration’s efforts to reduce government spending, regulation and the size of the federal workforce, say attorneys at Thompson Hine.
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Compliance Pointers For DOJ's Sweeping Data Security Rule
A new Justice Department rule broadly restricts many common data transactions with the goal of preventing access by countries of concern, and with an effective date of April 8, U.S. companies must quickly assess practices related to employee, customer and vendor data, says Sam Castic at Hintze Law.
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Class Actions At The Circuit Courts: February Lessons
In this month's review of class action appeals, Mitchell Engel at Shook Hardy discusses five federal appellate court class certification decisions and identifies practice tips from cases involving breach of life insurance contracts, constitutional violations of inmates and more.
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Series
Competitive Weightlifting Makes Me A Better Lawyer
The parallels between the core principles required for competitive weightlifting and practicing law have helped me to excel in both endeavors, with each holding important lessons about discipline, dedication, drive and failure, says Damien Bielli at VF Law.
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Axed ALJ Removal Protections Mark Big Shift For NLRB
A D.C. federal court's recent decision in VHS Acquisition Subsidiary No. 7 v. National Labor Relations Board removed long-standing tenure protections for administrative law judges by finding they must be removable at will by the NLRB, marking a significant shift in the agency's ability to prosecute and adjudicate cases, say attorneys at Proskauer.
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11th Circ. TCPA Ruling Signals Erosion Of Judicial Deference
The U.S. Court of Appeals for the Eleventh Circuit recently came to the rescue of the lead generation industry, striking down new regulations that were set to go into effect on Jan. 27, a decision consistent with federal courts' recent willingness to review administrative decisions, say attorneys at Troutman.
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The Case For Compliance During The Trump Administration
Given the Trump administration’s shifting white collar enforcement priorities, C-suite executives may have the natural instinct to pare back compliance initiatives, but there are several good reasons for companies to at least stay the course on their compliance programs, if not enhance them, say attorneys at Riley Safer.
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Opinion
Undoing An American Ideal Of Fairness
President Donald Trump’s orders attacking birthright citizenship, civil rights education, and diversity, equity and inclusion programs threaten hard-won constitutional civil rights protections and decades of efforts to undo bias in the law — undermining what Chief Justice Earl Warren called "our American ideal of fairness," says Reuben Guttman at Guttman Buschner.
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Dispelling 10 Myths About Health Provider-Based Compliance
Congress appears intent on requiring hospitals to submit provider-based attestations for all off-campus outpatient hospital locations, so now is the time for hospitals to prepare for this change by understanding common misconceptions about provider-based status and proactively correct noncompliance, say attorneys at McDermott.
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A Look At HHS' New Opinion On Patient Assistance Programs
A recent advisory opinion from the U.S. Department of Health and Human Services' Office of Inspector General follows a recent trend of blessing patient assistance program arrangements that implicate the Anti-Kickback Statute, as long as they are structured with appropriate safeguards to minimize the risk of fraud and abuse, say attorneys at Sheppard Mullin.
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How Ill. Ruling Could Influence Future Data Breach Cases
The Illinois Supreme Court's recent decision in Petta v. Christie Business Holding, which was based solely on standing, establishes an important benchmark for the viability of Illinois-based lawsuits arising out of data security incidents that defendants can cite in future cases, say attorneys at Wilson Elser.
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Opinion
Inconsistent Injury-In-Fact Rules Hinder Federal Practice
A recent Third Circuit decision, contradicting a previous ruling about whether consumers of contaminated products have suffered an injury in fact, illustrates the deep confusion this U.S. Supreme Court standard creates among federal judges and practitioners, who deserve a simpler method of determining which cases have federal standing, says Eric Dwoskin at Dwoskin Wasdin.
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Virginia AI Bills Could Serve As Nationwide Model
If signed into law, two Virginia bills focused on regulating the use of high-risk AI systems in the private and public sectors have the potential to influence similar legislation in other states, as well as the compliance strategies of companies operating in the commonwealth and across the U.S., say attorneys at Woods Rogers.
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2 Anti-Kickback Developments Hold Lessons For Biopharma
The U.S. Department of Justice's Anti-Kickback Statute settlement with QOL Medical and a favorable advisory opinion from the U.S. Department of Health and Human Services provide a study in contrasts, but there are tips for biopharma manufacturers trying to navigate the vast compliance space between them, says Mary Kohler at Kohler Health Law.