Policy & Compliance
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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."
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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April 03, 2026
Law360 Announces The Members Of Its 2026 Editorial Boards
Law360 is pleased to announce the formation of its 2026 Editorial Advisory Boards.
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April 03, 2026
Ga. Urology Network To Pay $14M To Resolve FCA Case
An Atlanta urology network and its founder will pay $14 million to settle allegations that they billed Medicare and Medicaid for medically unnecessary procedures, ranging from ultrasounds to endoscopic exams, according to an announcement by federal and Georgia state prosecutors.
Expert Analysis
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Key Takeaways As HRSA Aims To Revive 340B Rebate Pilot
The U.S. Department of Health and Human Services' recent request for feedback on the 340B Rebate Model Pilot Program demonstrates that it intends to correct the model's procedural defects, which is positive news for participating manufacturers, but a setback for covered entities, say attorneys at Manatt.
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Unique Issues Facing Brand-Compounder Patent Litigation
Recent litigation and potential enforcement action against Hims & Hers Health raise questions about how compounders and branded pharmaceuticals companies would be positioned in patent litigation as compared to generics companies, which would require strategies different from those that would be used in traditional Hatch-Waxman Act litigation, say attorneys at Morgan Lewis.
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Pros And Cons Of FDA's Push For Nonprescription Drugs
The U.S. Food and Drug Administration's recent moves to shift more prescription drugs to over-the-counter status could increase access to important medications, but also bring potential safety risks and other trade-offs for drug companies, say attorneys at Hogan Lovells.
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Prepping For The Future Of No Surprises Act Enforcement
This year is expected to be a transition point for the No Surprises Act framework from regulatory delay to operational enforcement, so stakeholders should use this time to stress-test systems, clean up processes and prepare for enforcement, say attorneys at Akerman.
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High Court's 'Skinny Label' Case May Tackle Wider Questions
The U.S. Supreme Court's upcoming decision in Hikma v. Amarin will have important ramifications for broader debates over what defines a generic version of a drug, and the pending case is already altering patent practice, say attorneys at Taft.
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Unpacking Key Themes From NY's New Healthcare Strategy
New York Gov. Kathy Hochul's 2026 State of the State agenda, read together with the state's fiscal year 2027 executive budget, reflect a clear framework to utilize Medicaid as the state's operating platform for healthcare reform, say attorneys at Sheppard.
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Trans Care Enforcement Landscape Is Evolving Quickly
The recent coordinated federal effort to reshape pediatric gender-affirming care through enforcement and funding pressure has created a rapidly evolving regulatory environment marked by shifting risk assessments and potential downstream market effects for healthcare institutions and life sciences companies, say attorneys at Arnall Golden.
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11th Circ. May Bring Tectonic Shift To FCA Qui Tam Actions
The Eleventh Circuit's upcoming decision in Zafirov v. Florida Medical Associates, assessing whether the False Claims Act permits ordinary citizens to stand as officers of the federal government, could significantly limit private relators' ability to bring FCA actions, say attorneys at Saul Ewing.
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To Survive FCA Actions, Small Cos. Must Take Offensive Steps
A fumbled response to False Claims Act allegations can doom lower-middle-market businesses, and with FCA enforcement hitting record levels for two years, smaller companies must have offensive strategies ready that focus their limited resources on defeating civil qui tam and federal criminal actions, says Derrelle Janey at Olshan Frome.
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Record FCA Recoveries Signal Intensified Healthcare Focus
In its recently released False Claims Act statistics, the U.S. government's emphasis on record healthcare recoveries and government-initiated healthcare matters last year indicates robust enforcement ahead, though the administration's focus on current policy objectives also extends beyond the healthcare sector, say attorneys at Epstein Becker.
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A Potential Shift In FDA's Approach To Drug Trial Design
Recent guidance released by the U.S. Food and Drug Administration clarifying how Bayesian approaches — which combine prior knowledge with new data — may be used in clinical trials reflects the agency's continued interest in innovative trial designs that may accelerate drug approvals, say attorneys at Alston & Bird.
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What FDA Guidance Means For Future Of Health Software
Two significant final guidance documents released by the U.S. Food and Drug Administration last month reflect a targeted effort to ease innovation friction around specific areas, including singular clinical decision support recommendations and sensor-based wearables, while maintaining established regulatory boundaries, say attorneys at Covington.
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How State FCA Activity May Affect Civil Fraud Enforcement
A growing trend of state attorneys general enforcing their False Claims Act analogues independently of the U.S. Department of Justice carries potential repercussions for civil fraud enforcement and qui tam litigation considerations, say Li Yu at Bernstein Litowitz, Ellen London at London & Naor and Gwen Stamper at Vogel Slade.