Policy & Compliance

  • February 23, 2024

    State Farm Alleges Health Co. Violated Deal To Drop 366 Suits

    Two State Farm units are accusing an automobile accident-focused healthcare center of wrongly pursuing 366 lawsuits against the insurer despite a settlement agreement State Farm said requires the facility to drop those suits.

  • February 23, 2024

    Fla. Doctor Says T-Mobile Let Hacker Steal Her SIM Card

    A Tampa, Florida, doctor has sued T-Mobile for allegedly failing to stop a "SIM swap" hacker from transferring her personal phone account and then doing little to address the identity theft that followed, which involved the hacker trying to steal thousands from her retirement account and using her medical credentials to write more than 700 fraudulent prescriptions.

  • February 23, 2024

    Health REIT Hid Halted $375M Equity Stake Deal, Suit Says

    A Medical Properties Trust Inc. shareholder accused the hospital-focused real estate investment trust in Maryland federal court of hiding the California government's halting of a $375 million equity stake transaction with a healthcare management services company.

  • February 23, 2024

    Idaho Blasts 'Abortion Mandate' In High Court State Ban Fight

    The Idaho attorney general has accused the federal government of transforming an emergency medical care law into an "abortion mandate" in a U.S. Supreme Court case pitting the state's criminal ban against the Biden administration's efforts to maintain abortion access post-Dobbs.

  • February 23, 2024

    8th Circ. Says Nursing Home Fraudster Owes Supplier $7.6M

    A nursing home company whose owner pleaded guilty in January to employment tax fraud in a New Jersey federal case must shoulder a $5 million judgment plus interest and fees for bills it failed to pay a medical supply company, an Eighth Circuit panel affirmed Friday.

  • February 23, 2024

    J&J Unit Assails Knee Replacement IP Verdict At Fed. Circ.

    Johnson & Johnson subsidiary DePuy Synthes wants the Federal Circuit to undo a $20 million jury verdict against it for infringing an orthopedic surgeon's knee replacement patent.

  • February 23, 2024

    VA Nixes Trans Vets' Request For Gender-Affirming Surgery

    The Department of Veterans Affairs said Thursday that it had formally rejected an 8-year-old petition for rulemaking by the Transgender American Veterans Association that sought to add gender-affirming surgery as part of VA-covered medical services, urging the Federal Circuit to toss TAVA's mandamus petition as moot.

  • February 23, 2024

    Christian Clinic Says Trans Surgery Suit Bolsters Mich. Fears

    A Michigan clinic fighting to show it can challenge a state civil rights law it claims would force it to care for transgender patients told the Sixth Circuit that a suit targeting a Colorado children's hospital that stopped providing surgeries for transgender patients underscores how it could come under fire as well. 

  • February 23, 2024

    Holland & Knight Product Liability Ace Rejoins Reed Smith

    Reed Smith LLP has rehired a former partner who, in his first stint with the firm, spent a little over nine years representing pharmaceutical and medical device companies in product liability and other litigation, the firm announced Thursday.

  • February 22, 2024

    Wash. AG Seeks $1.2M In Damages For Debt Collector's Errors

    A debt collection company should pay more than $1.2 million after it "didn't even come close to complying with the law" while recovering medical debt payments for a hospital in Washington, the state attorney general's office told a judge during a bench trial Thursday.

  • February 22, 2024

    Justices Urged To Affirm Limits On Mifepristone Access

    The Alliance for Hippocratic Medicine filed a brief in its U.S. Supreme Court case over the abortion medication mifepristone on Thursday, saying the U.S. Food and Drug Administration unlawfully rolled back various safeguards for accessing the pill, such as an in-person doctor's visit requirement.

  • February 22, 2024

    5th Circ. Affirms Medicare Kickback Convictions

    The Fifth Circuit upheld two Texas group-home owners' convictions and sentences for their role in a Medicare kickback scheme, rejecting their argument that a trial court judge wrongly admitted audio recordings at trial and incorrectly calculated the scheme's returns.

  • February 22, 2024

    NYC Doc Charged Over $20M Lab-Fraud Kickback Scheme

    A federal grand jury in New Jersey has returned an indictment charging a medical doctor with receiving kickbacks in exchange for ordering medically unnecessary tests from lab companies that submitted roughly $20.7 million in false Medicare claims, the U.S. Department of Justice announced.

  • February 22, 2024

    Mass. Medical Regulator Seeks Pregnancy Center Records

    A group of pregnancy crisis centers in Massachusetts and their medical director have been hit with a civil investigative demand by the state's medical board, which says it is looking into allegations the clinics "may be engaging in deceptive practices" and allowing unlicensed employees to perform ultrasounds and other procedures.

  • February 22, 2024

    Lawmakers Urge Biden To Nix March-In Plan Over Drug Prices

    Twenty-eight members of Congress have written a letter urging President Joe Biden to reconsider a National Institute of Standards proposal to use march-in rights under the Bayh-Dole Act to reduce prescription drug prices, arguing the draft guidance won't achieve lower drug costs and will "hamstring" U.S. innovation.

  • February 22, 2024

    Texas Pharmacists Paid Doctors Kickbacks, Prosecutors Say

    Dallas federal prosecutors have accused about a dozen doctors and pharmacists of a patient referral scheme, saying in an indictment entered Thursday that the pharmacists gave the doctors kickbacks in exchange for expensive prescriptions fillable at specific pharmacies.

  • February 22, 2024

    Esformes Gets Time Served In Plea Deal With Gov't

    The yearslong prosecution against Miami nursing home mogul Philip Esformes ended Thursday when he pled guilty to one of the pending healthcare fraud charges against him and was sentenced to time served.

  • February 21, 2024

    Texas Panel Unsure Hospital Should Escape $6M MedMal Suit

    A Texas state appellate panel on Wednesday wondered why Harris Hospital should duck liability for a contractor's critical error that left a woman with severe brain damage, with one justice saying the rules that govern Medicaid are "good enough for Texas."

  • February 21, 2024

    39 AGs Call For Federal Pharmacy Benefit Manager Reform

    The list of critics of pharmacy benefit managers continues to grow as nearly 40 attorneys general have thrown their weight behind a trio of federal bills they say would force more transparency into an "opaque" industry that has "been a cause of rising drug prices."

  • February 21, 2024

    FDA Let Pharma Co. 'Sidestep' Application Rules, Court Told

    The Food and Drug Administration has been hit with a suit alleging it wrongly allowed a drugmaker to expand the scope of its application to market a generic version of a blockbuster pulmonary hypertension drug.

  • February 21, 2024

    Idaho Asks High Court For Stay In Gender Care Ban Dispute

    The state of Idaho has asked the U.S. Supreme Court to issue an emergency stay against a district court's injunction temporarily blocking the state from enforcing a law banning gender-affirming care for minors while the case plays out in the Ninth Circuit.

  • February 21, 2024

    Scammer Freed By Trump Indicted On New Charges

    A previously convicted scammer whose sentence was commuted by former President Donald Trump has been indicted by a grand jury on new charges that he began running multiple rackets, including a fraudulent aid-for-Ukraine scheme, shortly after leaving prison, New Jersey's top federal prosecutor said.

  • February 20, 2024

    High Court Blocks Bid By 3 States To Join Abortion Drug Case

    Republican attorneys general of three states on Tuesday lost in their attempt to join the U.S. Supreme Court case challenging approval of the abortion medication mifepristone, a potential blow to their efforts to ensure the case isn't dismissed for lack of standing.

  • February 20, 2024

    Ala. Justices Deem Frozen Embryos Children Under State Law

    The Alabama Supreme Court ruled that frozen embryos count as children in a first-of-its-kind decision bemoaned by advocates and a dissenting judge as potentially ruinous for in vitro fertilization services in the state. 

  • February 20, 2024

    Ga. Justices Clarify Official's Role In Hospital Expansion Law

    The Supreme Court of Georgia has vacated the judgment of the Georgia Court of Appeals in a case concerning the standard that the state's community health commissioner must apply when reviewing a hearing officer's decision over an application to establish a new health service.

Expert Analysis

  • Lessons From Rare Post-Verdict Healthcare Fraud Acquittal

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    A Maryland federal court recently overturned a jury verdict that found a doctor guilty of healthcare fraud related to billing levels for COVID-19 tests, providing defense attorneys with potential strategies for obtaining acquittals in similar prosecutions, says attorney Andrew Feldman.

  • ChristianaCare Settlement Reveals FCA Pitfalls For Hospitals

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    ChristianaCare's False Claims Act settlement in December is the first one based on a hospital allegedly providing private physicians with free services in the form of hospital-employed clinicians and provides important compliance lessons as the government ramps up scrutiny of compensation arrangements, say attorneys at Sheppard Mullin.

  • Patent Waiver For COVID Meds Would Harm US Biopharma

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    If the Biden administration backs the World Trade Organization in waiving patent rights on COVID-19 treatments, it would negatively affect the U.S. biopharmaceutical industry and help foreign competitors, without necessarily expanding global access to COVID-19 care, says clinical pathologist Wolfgang Klietmann.

  • New CMS Rule Will Change Nursing Facility Disclosures

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    A new rule from the Centers for Medicare & Medicaid Services significantly expands disclosure requirements for nursing facilities backed by private equity companies or real estate investment trusts, likely foreshadowing increased oversight that could include more targeted audits, say Janice Davis and Christopher Ronne at Morgan Lewis.

  • Skirting Anti-Kickback Causation Standard Amid Circuit Split

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    Amid the federal circuit court split over the causation standard applicable to False Claims Act cases involving Anti-Kickback Statute violations, which the First Circuit will soon consider in U.S. v. Regeneron, litigators aiming to circumvent the heightened standard should contemplate certain strategies, say Matthew Modafferi and Terence Park at Frier Levitt.

  • Gilead Ruling Signals That Innovating Can Lead To Liability

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    A California appeals court's ruling last month in Gilead Life Sciences v. Superior Court of San Francisco that a drug manufacturer can be held liable for delaying the introduction of an improved version of its medication raises concerns about the chilling effects that expansive product liability claims may have on innovation, says Gary Myers at the University of Missouri School of Law.

  • Health Policy Legislative Landscape May Remain Frozen

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    With Congress again delaying the full resolution of fiscal year 2024 federal spending legislation, there is now an additional window in which Congress could work through several priority issues for healthcare stakeholders, though these issues are unlikely to be resolved in time, say attorneys at Faegre Drinker.

  • Despite HHS Opinion, Gift Card Giveaways Require Caution

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    Though the U.S. Department of Health and Human Services' Office of Inspector General recently determined that a healthcare consulting firm's gift card plans do not violate the Anti-Kickback Statute, the opinion does not suggest blanket approval for providing gift cards in exchange for referrals, say Ragini Acharya and Matthew Deutsch at Husch Blackwell.

  • DOJ's Biopharma Settlement Raises Anti-Kickback Questions

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    In the aftermath of the U.S. Department of Justice's settlement with Ultragenyx over genetic testing programs, it may be prudent to reevaluate genetic tests through the lens of the Anti-Kickback Statute and reconsider whether it is proper for free testing programs to be treated like patient assistance programs, says Mary Kohler at Kohler Health Law.

  • Where Justices Stand On Chevron Doctrine Post-Argument

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    Following recent oral argument at the U.S. Supreme Court, at least four justices appear to be in favor of overturning the long-standing Chevron deference, and three justices seem ready to uphold it, which means the ultimate decision may rest on Chief Justice John Roberts' vote, say Wayne D'Angelo and Zachary Lee at Kelley Drye.

  • Bracing For Calif.'s New Health Transaction Framework

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    As California's new cost and market impact review regulations' April 1 date for its updated notice and review process approaches, healthcare entities should ready themselves for dramatic changes to the state's regulatory landscape and prepare for potentially substantial transaction delays, say Jordan Grushkin and Matthew Goldman at Sheppard Mullin.

  • Uncharted Waters Ahead For FCA Litigation In 2024

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    Following a year of significant court decisions, settlements, recoveries and proposed amendments, 2024 promises to be a lively year for False Claims Act actions and litigation, and one that will hopefully provide more clarity as FCA jurisprudence evolves, say attorneys at Crowell & Moring.

  • OIG Report Has Clues For 2024 Healthcare Fraud Enforcement

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    A recent report from the Health Department's Office of the Inspector General reveals healthcare fraud and abuse enforcement trends that will continue in 2024, from increased telehealth oversight to enhanced policing of managed care, say attorneys at Sheppard Mullin.