Policy & Compliance

  • April 07, 2026

    Calif. Dialysis Bill Violates 1st Amendment, 9th Circ. Says

    The Ninth Circuit on Tuesday struck down provisions of a California law that aims to restrict dialysis providers' ability to profit from patients receiving health insurance premium assistance from nonprofit charities, ruling in a published opinion that the provisions violated nonprofit American Kidney Fund's and dialysis providers' First Amendment rights.

  • April 07, 2026

    Pa. Hospitals Accuse Aetna Of Underpaying Medicare Claims

    Two Pennsylvania hospital operators have sued Aetna Health Inc. in federal court, alleging the insurer has been improperly denying Medicare Advantage claims for inpatient services, or underpaying, under a new policy.

  • April 07, 2026

    Insurer Premera Accuses Clinic Of Misusing No Surprises Act

    Premera Blue Cross sued a weight loss clinic on Monday in Washington federal court saying it abused a federal law aimed at safeguarding patients from unexpected medical bills in order to shake down the insurer for exorbitant amounts of money — as much as 10 times what Premera pays in-network providers.

  • April 07, 2026

    Acadia Still On Hook For $9M Rehab Death Negligence Verdict

    A California state appeals court on Tuesday affirmed a more than $9 million jury verdict against Acadia Healthcare Co. Inc. in a suit stemming from the death of a patient at one of its addiction treatment centers, saying there was substantial evidence that the Marin County facility was negligently understaffed.

  • April 07, 2026

    HHS Must Face States' Suit Over RFK's 'Dramatic Overhaul'

    A Rhode Island federal judge rejected Tuesday the government's bid to toss a group of states' lawsuit challenging Robert F. Kennedy Jr.'s "dramatic overhaul" of the U.S. Department of Health and Human Services, criticizing the government for rehashing jurisdictional arguments the court already rejected and finding the states' claims are plausible.

  • April 07, 2026

    Minn. Can't Unfreeze $243M In Medicaid Funds, Judge Says

    A Minnesota federal judge on Monday denied the state's preliminary injunction request to release $243 million in Medicaid funds deferred by the federal government during a fraud investigation, holding that the "unprecedented" size and scope of the deferral action doesn't mean the Centers for Medicare & Medicaid Services isn't legally cleared to pursue the action.

  • April 07, 2026

    3 Healthcare Decisions You May Have Missed This Week

    A proposed class of HIV and AIDS patients is dropping their disability bias lawsuit, the Third Circuit on a COVID-era fraudster sentence, and Aetna escapes a testing payment lawsuit. Law360 Healthcare Authority looks at three decisions you may have missed.

  • April 07, 2026

    Judge Questions FTC's Motive In Gender-Care Probe

    A federal judge in Washington said Tuesday he would have to balance any legitimate concerns about parents and children being misled on the issue of gender-affirming care with what appeared to be retaliatory motives behind Federal Trade Commission investigative demands to a pair of nonprofits.

  • April 07, 2026

    HHS Staff Changes Likely To Lead To Uncertain 2026

    Healthcare experts are keeping a close eye on personnel changes at the U.S. Department of Health and Human Services. Law360 Healthcare Authority looks at how they could affect key agency policies.

  • April 07, 2026

    Mich. AG Says PBMs Can't Stall Discovery In Drug-Pricing Suit

    Michigan's attorney general is urging a federal court to reject a renewed bid by pharmacy benefit managers to pause discovery in an antitrust case accusing them of price-fixing reimbursement rates, claiming the companies are relying on exaggerated burden claims and an ordinary motion to dismiss that is unlikely to succeed.

  • April 07, 2026

    DC Circ. Skeptical Ex-Steward CEO Could Skip Senate Hearing

    A D.C. Circuit judge told the attorney for the embattled former CEO of Steward Health Care on Tuesday that she couldn't comprehend how his client could invoke his Fifth Amendment rights without showing up to his scheduled appearance before a Senate committee.

  • April 07, 2026

    High Court Ruling Won't End 'Conversion Therapy' Battles

    The U.S. Supreme Court's rejection of Colorado's ban on what is commonly known as gay conversion therapy may have rendered dozens of similar laws toothless, but don't expect it to be the end of legal challenges in this arena.

  • April 07, 2026

    Jury Awards $39.5M Over Discharged Psych Patient's Victims

    A Philadelphia jury on Tuesday hit a healthcare management company and a Pennsylvania hospital with a $39.5 million verdict, finding them liable for the deaths of four people who were murdered by a family member who was discharged from a psychiatric unit that failed to submit paperwork that would have prevented him from purchasing the gun he used to kill them.

  • April 06, 2026

    RFK Jr. Tweaks HHS Vaccine Policy Panel Membership Criteria

    U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. is making changes to a key federal vaccine advisory panel's charter, according to a renewal notice the agency published Monday, after a Massachusetts federal judge last month declared Kennedy's committee picks "appear distinctly unqualified."

  • April 06, 2026

    Anthem Owes $2.1M For No Surprises Act Awards, Court Told

    Two medical providers said Anthem Blue Cross and Blue Shield owes them a combined $2.1 million for medically necessary services rendered to its insured members, telling a Colorado state court that the carrier is wrongfully withholding payment despite losing multiple federal arbitration proceedings.

  • April 06, 2026

    Biz Groups Urge 4th Circ. To End Allergan Overcharge Suit

    Major pharmaceutical and business associations urged the Fourth Circuit to reconsider a panel decision that revived a whistleblower lawsuit accusing an Allergan Sales LLC predecessor of overcharging Medicaid, warning it threatens to become a road map for False Claims Act abuses.

  • April 06, 2026

    Splenda Loses Bid To End Scientist's Libel Counterclaim

    The maker of Splenda lost its bid for a pretrial win on a scientist's counterclaims for libel after a North Carolina federal judge on Monday ruled they weren't filed too late because the counterclaims are directly linked to the company's defamation suit challenging her statements linking Splenda to cancer-causing chemicals.

  • April 06, 2026

    1st Circ. Suggests It May Resurrect AdTech Wiretap Case

    A panel of the First Circuit appeared receptive Monday to reinstating federal wiretap claims leveled against a Massachusetts healthcare system over its use of online tracking tools, despite arguments that such a ruling could cripple the industry amid an influx of similar cases nationwide.

  • April 06, 2026

    Cleary FCA Task Force Head On Enforcement Trends To Watch

    Former U.S. Attorney for the Eastern District of New York Breon Peace, who now leads a False Claims Act task force at Cleary Gottlieb Steen & Hamilton LLP, is predicting a continued surge in enforcement as the Trump administration wields the law in new ways.

  • April 06, 2026

    Mass. Justices Hint Insurer Owes Defense In Doc's Discipline

    An allegation that a Massachusetts doctor prescribed addictive medications to manipulate a patient into a sexual relationship could be enough to trigger a malpractice insurer's duty to defend him in a disciplinary proceeding launched years later over other alleged misconduct, justices on the state's highest court hinted Monday.

  • April 06, 2026

    WilmerHale Adds Regulatory Atty From Mayer Brown In DC

    WilmerHale announced Monday it has hired a veteran U.S. Food and Drug Administration and life sciences regulatory attorney from Mayer Brown LLP.

  • April 03, 2026

    Case-By-Case Guide As Justices Eye Landmark Pharma Law

    Drugmakers and prominent allies are inundating the U.S. Supreme Court with calls to scrutinize Medicare's new power to slash payments by tens of billions of dollars, and the justices look poised to take up or turn down a fistful of legal challenges in one fell swoop.

  • April 03, 2026

    Wash. DOC Inks Deal Over Trans Treatment In Facilities

    The Washington State Department of Corrections will start improving conditions for transgender, intersex and nonbinary people in its facilities and submit to yearly monitoring, according to a settlement agreement between the agency and a nonprofit in the state.

  • April 03, 2026

    SEC Moves To Set Up $40M Investor Fund In Cassava Case

    The U.S. Securities and Exchange Commission asked a Texas federal court on Friday to establish a $40 million fund to potentially compensate investors harmed by a Texas biopharmaceutical company and two former executives' alleged misstatements about an Alzheimer's drug, following the company's 2024 settlement with the regulator.

  • April 03, 2026

    Northwestern Can't Escape ERISA Fight Over Health Offerings

    An Illinois federal court refused to toss a proposed class action against Northwestern University alleging excessive employee healthcare costs violated federal benefits law, concluding ex-workers had sufficiently backed up their allegations that an expensive plan option breached fiduciary duties.

Expert Analysis

  • How Plan Sponsors Can Mitigate Risk In PBM Contracts

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    A recent lawsuit in New York federal court alleges that JPMorgan caused exorbitant prescription costs by mishandling the pharmacy benefit manager arrangement, adding to a growing body of Employee Retirement Income Security Act fiduciary breach litigation and affirming that fiduciaries must proactively manage their healthcare plan vendors, say attorneys at Hall Benefits Law.

  • 4th Circ. Health Data Ruling Opens Door To State Law Claims

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    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.

  • Unpacking Trump Admin Plans For Value-Based Care

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    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.

  • What To Expect For Stem Cell Regulation Under Trump Admin

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    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.

  • How Importers Can Minimize FCA Risks Of Tariff Mitigation

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    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.

  • 10 Practical Takeaways From FDA's Biopharma AI Guidance

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    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.

  • Lawmakers Shouldn't Overlook Rare Disease Therapies' Value

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    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.

  • What Trump's Order Means For The Legal Status Of IVF

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    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.

  • Mitigating Tariff Risks For Healthcare In US And Canada

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    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.

  • What's At Stake In High Court Transgender Care Suit

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    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.

  • 6 Laws Transforming Calif.'s Health Regulatory Framework

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    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.

  • Anticipating Calif. Oversight Of PE Participation In Healthcare

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    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.

  • Considering The Future Of AI Regulation On Health Sector

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    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.