Policy & Compliance

  • January 27, 2026

    Long Road For Kaiser Whistleblowers Ends In Historic Payout

    The whistleblowers behind a massive Medicare Advantage "upcoding" case spent years in isolation before a historic settlement was finally reached.

  • January 27, 2026

    Clinic Workers' Vax Bias Suit Needs 2nd Look, 3rd Circ. Says

    A split Third Circuit panel reinstated a religious bias suit claiming Geisinger Medical Center illegally required workers who opposed its COVID-19 vaccine mandate to undergo nasal testing, saying the employees should have been allowed to explore whether a chemical in the nasal swabs made that accommodation unreasonable.

  • January 27, 2026

    Divisions Emerge At 2nd Circ. Over Reproductive Rights Law

    A Second Circuit panel appeared split Tuesday on whether an anti-abortion group challenging a New York state law that bars employers from penalizing workers based on their reproductive health decisions has standing to challenge the law as unconstitutional.

  • January 26, 2026

    Generics Makers Fight Cert. In Cholesterol Drug Pricing MDL

    Generic-drug makers sought to defeat a bid to certify proposed classes comprising thousands of pharmacies that indirectly purchased and resold generics at the center of sprawling price-fixing litigation, telling a Pennsylvania federal court Monday that certification would result in an "unmanageable trial."

  • January 27, 2026

    Record FCA Haul Sends 'Loud' Message On Federal Priorities

    Aggressive enforcement by President Donald Trump's administration and the qui tam bar's success prosecuting fraud even without government intervention helped fuel the explosion in recoveries under the False Claims Act last year, experts say.

  • January 26, 2026

    Anthem Seeks Dismissal Of 'Ghost Network' Class Action

    A proposed class action's allegations that Anthem Health Plans maintains inaccurate mental health directories known as ghost provider networks aren't true and are "legally deficient," the insurer and its parent company, Elevance Health Inc., argued while urging a Connecticut federal court to toss the suit.

  • January 26, 2026

    3rd Circ. Finds NJ Officials Shielded From COVID Deaths Suit

    A proposed class action on behalf of the families of roughly 10,000 nursing home residents who died early in the COVID-19 pandemic cannot proceed against New Jersey officials over their response, the Third Circuit has ruled, finding the officials are protected through qualified immunity.

  • January 26, 2026

    Novo Nordisk Faces Class Claims Over GLP-1 Patent Tactics

    A South Carolina drug company has launched a proposed class action against major pharmaceutical company Novo Nordisk, alleging it engaged in anticompetitive behavior to prolong its monopoly against generic competition for the GLP-1 drug Victoza.

  • January 23, 2026

    Providers Oppose Credit Bureaus' Medical Debt Appeal

    A proposed class of medical providers and collection agencies accusing Equifax, Experian and TransUnion of colluding to exclude medical debt under $500 from consumer credit reports is opposing a bid by the credit bureaus to expedite an appeal of a ruling that denied dismissal of the claims.

  • January 23, 2026

    High Court's Med Mal Ruling Won't Spark Rise In Suits

    The U.S. Supreme Court's recent ruling that a Delaware medical malpractice statute can't be enforced in federal court won't cause a noticeable rise in cases, experts said, but it could lay the groundwork for other cases involving conflicting procedural state laws.

  • January 23, 2026

    $200M Sun, Taro Generics Deal Gets Final OK

    A Pennsylvania federal judge granted final approval Friday for a $200 million deal resolving employee benefits plans' claims against Sun Pharmaceutical and Taro Pharmaceuticals in the sprawling price-fixing litigation against generic-drug makers, while again ensuring the claims from dozens of state attorneys general remain untouched by the settlement.

  • January 22, 2026

    DC Circ. Presses Feds To Justify Military Trans Ban

    A D.C. Circuit judge pressed the government on Thursday to justify a policy that effectively bars transgender people from serving in the military, questioning why Secretary of Defense Pete Hegseth imposed a more stringent policy than the first Trump administration did. 

  • January 22, 2026

    6th Circ. Revives Law Firm Worker's Anthem Coverage Fight

    Anthem Blue Cross Blue Shield's decision denying coverage for a law firm employee's son to continue receiving residential mental health treatment was arbitrary and capricious, the Sixth Circuit ruled Thursday, saying the insurer needs to carry out a "full and fair review of the requested coverage."

  • January 22, 2026

    Yale Hospital Wants Infant Death Verdict Reduced By $30M

    Yale University and Yale New Haven Hospital on Thursday asked a Connecticut judge to reduce a $32 million infant death verdict to just $2 million, saying damages for the loss of enjoyment of life cannot be awarded in addition to damages for the infant's death itself.

  • January 22, 2026

    Docs Ask NJ Justices To Send Allstate RICO Case To Arbitration

    Medical providers facing a racketeering suit from Allstate units pressed the New Jersey Supreme Court on Thursday to compel the insurers to arbitrate even large-scale fraud and racketeering claims tied to personal injury protection benefits under the state's no-fault statute, as the justices questioned whether that was feasible.

  • January 22, 2026

    FDA Action Shouldn't Halt Amazon Labeling Suit, Plaintiffs Say

    Shoppers accusing Amazon of failing to make required disclosures on dietary supplement product pages told a Washington federal judge there's no need to pause their proposed class action amid possible rulemaking by the U.S. Food and Drug Administration, arguing that the supposed rule change wouldn't negate the suit's claims under California law.

  • January 22, 2026

    As Lawmakers Scrutinize Costs, Insurers Point To Hospitals

    Facing a barrage of questions from lawmakers on Capitol Hill about rising costs, the heads of the biggest health insurance companies in the U.S. sought to blame providers and other parts of a complex industry.

  • January 22, 2026

    Arnall Golden Starts Gender-Affirming Care Defense Team

    Arnall Golden Gregory LLP has started a team to defend healthcare providers and others who are facing federal investigations and enforcement actions over gender-affirming care.

  • January 22, 2026

    Ex-Surgeon Prevails Over Insurers In Lifetime Disability Fight

    A Michigan federal judge handed a disabled surgeon a win against two insurance companies Thursday in his suit seeking total disability benefits for life, siding with the ex-worker's argument that the insurers erred in determining that his condition was caused by sickness instead of injury and cutting off benefits.

  • January 22, 2026

    Investors Drop LA Law Firm From Bioscience Fraud Suit

    A group of investors including a "Toy Story" screenwriter pursuing an $87 million fraud suit against a bioscience company in California state court has agreed to drop claims against a California law firm and its name partner, with the firm in turn withdrawing an anti-SLAPP motion it filed in the suit.

  • January 21, 2026

    CVS, UnitedHealth, Express Scripts Duck PBM Antitrust Suit

    A Missouri federal judge has thrown out a proposed class action accusing the country's three largest pharmacy benefit managers — owned by CVS, UnitedHealth Group and Cigna Group — of inflating prescription costs through their rebating practices.

  • January 21, 2026

    Midwives Challenge Miss. Practice Limits In Antitrust Suit

    The American College of Nurse-Midwives launched a suit seeking to permanently block Mississippi rules requiring certified nurse-midwives to obtain collaboration agreements with physicians, arguing the rules unlawfully restrict competition and exacerbate public health challenges in the state.

  • January 21, 2026

    BCBS Says Bankrupt Hospital Can't Leave $3B Antitrust Deal

    Blue Cross Blue Shield is opposing a bankrupt Alabama hospital's bid to opt out of a $2.8 billion antitrust class action settlement to pursue its own claims in bankruptcy court, arguing the hospital has no excuse for missing the deadline.

  • January 21, 2026

    Feds Say Medicare Steering Case Meets FCA Legal Bar

    The government said Wednesday that its False Claims Act complaint accusing insurers and brokers of participating in a kickback scheme to steer customers to Medicare Advantage plans doesn't conflict with a First Circuit decision last year setting out the standard for such cases.  

  • January 21, 2026

    Whole Foods Can't Escape Workers' Tobacco Fee Suit

    A Texas federal judge refused to toss a proposed class action against Whole Foods from employee health plan participants who challenged a surcharge on workers who used tobacco, ruling allegations should proceed to discovery that the fees violated multiple provisions of federal benefits law.

Expert Analysis

  • Rethinking 'No Comment' For Clients Facing Public Crises

    Author Photo

    “No comment” is no longer a cost-free or even a viable public communications strategy for companies in crisis, and counsel must tailor their guidance based on a variety of competing factors to help clients emerge successfully, says Robert Bowers at Moore & Van Allen.

  • High Court Must Acknowledge US History Of Anti-Trans Laws

    Author Photo

    Despite Justice Amy Coney Barrett's claim to the contrary during oral arguments in U.S. v. Skrmetti, U.S. governments at every level have systematically discriminated against transgender people, and the U.S. Supreme Court must consider this historical context in upcoming cases about transgender issues, says Paisley Currah at the City University of New York.

  • The Fate Of Biden-Era Clinical Study Guidance Under Trump

    Author Photo

    Draft guidance about the study of sex and gender differences in medical product development issued by the outgoing Biden administration currently faces significant uncertainty and litigation potential due to the Trump administration's executive orders and other actions, say attorneys at Arnold & Porter.

  • 10 Issues To Watch In Aerospace And Defense Contracting

    Author Photo

    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.

  • Dispelling 10 Myths About Health Provider-Based Compliance

    Author Photo

    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.

  • A Look At HHS' New Opinion On Patient Assistance Programs

    Author Photo

    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.

  • 2 Anti-Kickback Developments Hold Lessons For Biopharma

    Author Photo

    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.

  • Tips For Pharma-Biotech Overlap Reporting In New HSR Form

    Author Photo

    While there’s no secret recipe for reporting overlaps to the Federal Trade Commission in the new Hart-Scott-Rodino Act form, there are several layers of considerations for all pharma-biotech companies and counsel to reflect on internally before reporting on any deal, say attorneys at A&O Shearman.

  • A Look At Drug Price Negotiation Program's Ongoing Impact

    Author Photo

    More than two years after the passage of the Inflation Reduction Act and the rapid implementation of the drug price negotiation program, attorneys at Ropes & Gray discuss how the IRA has influenced licensing strategies, and how maximum fair prices under the law have economically affected certain drugs.

  • Preparing For A Possible End To The Subminimum Wage

    Author Photo

    The U.S. Department of Labor's proposed rule to end the subminimum wage for employees with disabilities may significantly affect the community-based rehabilitation and training programs that employ these workers, so certified programs should be especially vigilant about compliance during this period of evaluation and scrutiny, say attorneys at Jackson Lewis.

  • Drug Pricing Policy Trends To Expect In 2025 And Beyond

    Author Photo

    Though 2025 may bring more of the same in the realm of drug pricing policy, business as usual entails a sustained, high level of legal and policy developments across at least six major areas, say attorneys at Ropes & Gray.

  • Top 10 Healthcare And Life Sciences Issues To Watch In 2025

    Author Photo

    Under the new Trump administration, this coming year may benefit some healthcare and life sciences stakeholders, while creating new challenges for others amid an increasingly complex regulatory environment, say attorneys at Debevoise.

  • 4 Keys To Litigating In An Active Regulatory Environment

    Author Photo

    For companies facing litigation influenced by government regulatory action — a recent trend that a politically charged atmosphere will exacerbate — there are a few principles that can help to align litigation strategy with broader public positioning in the regulatory and oversight context, say attorneys at Jenner & Block.