Policy & Compliance
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November 21, 2025
1st Circ. Clears IT Co. In Suit Over Zoll Patient Data Breach
An information technology company cannot be held liable for a data breach exposing the health information of patients of a unit of medical device maker Zoll Medical Corp, the First Circuit ruled, because the two companies did not have a business relationship permitting them to hold one responsible for another's conduct.
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November 20, 2025
Pharma Cos. Seek Early Win In States' Price-Fixing Lawsuit
A collection of states failed to prove an overarching conspiracy among 25 separate pharmaceutical companies to fix the prices of generic drugs, most of them dermatology formulations, the drugmakers argued Wednesday in support of a bid for an early win on one element of dozens of antitrust claims.
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November 20, 2025
5th Circ. Seeks Interpretation Of Miss. Health Decisions Law
A Fifth Circuit panel asked the Mississippi Supreme Court on Thursday to clarify an "ambiguous" state law that sets out which family members can act as surrogates and make healthcare decisions for relatives without the capacity to decide for themselves.
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November 20, 2025
Ala. County Must Face Inmate Death Claim, 11th Circ. Rules
An Eleventh Circuit panel ruled Thursday that no Alabama state law prevents a county from facing liability for an incarcerated person's death after substandard healthcare from a third-party medical provider the county hired.
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November 20, 2025
Blue Shield Of California, Magellan Sued Over 'Ghost Network'
Blue Shield of California and Magellan Health maintain a "ghost network" directory of mental health providers who don't exist or don't accept new patients, leading customers to hit a dead end or desperately resort to expensive out-of-network providers, according to a proposed class action filed Wednesday in California federal court.
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November 20, 2025
10th Circ. Weighs Colo. Law On Healthcare Sharing Plans
A Tenth Circuit panel grappled Thursday with how the court should interpret a Colorado law requiring entities not authorized to offer insurance in the state to report certain information about their healthcare sharing plans, in an appeal by a religious trade group challenging the law's constitutionality.
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November 20, 2025
Claims Firms Barred From Misleading Plaintiffs In Pharma MDL
On the same day that a Philadelphia federal judge approved $58 million in settlements as part of an ongoing generic-drug price-fixing multidistrict litigation, she also ordered several claims recovery firms to correct allegedly false and misleading ads used to attract potential clients seeking to make claims on the settlements.
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November 19, 2025
Senior Living Co. Inks $7.2M Deal To End Wash. AG's Probe
Oregon-based senior living provider Bonaventure will invest $7 million in staffing and upgrades and shell out $200,000 in resident credits to resolve allegations of substandard care at 10 Washington state facilities, under a settlement filed Wednesday.
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November 19, 2025
Is 'Red Book' Best For Drug Pricing? Pa. Justices Ask
The Pennsylvania Supreme Court seemed skeptical Wednesday that the state workers' compensation authorities were using the best guide to calculate pharmacy reimbursements for injured workers' prescription drugs, with the justices questioning the fairness of the industry's long-used "red book" method.
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November 19, 2025
11th Circ. Backs Kaiser In Air Ambulance Arbitration Dispute
The Eleventh Circuit on Wednesday declined an air ambulance company's bid to scrap an arbitrator's ruling that Kaiser only owes $24,000 for an emergency helicopter flight, rejecting the emergency medical provider's arguments that the insurer committed fraud by strategically lowballing the arbitrator.
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November 19, 2025
Aetna Gets OK For $3.4M Deal In Cancer Treatment Denial Suit
A Florida federal judge has signed off on Aetna's $3.4 million settlement agreement resolving a class action that alleged the insurer unlawfully mischaracterized a proton beam cancer radiation treatment as experimental to deny dozens of claims.
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November 19, 2025
Senate GOP Resists Extending Expanded ACA Tax Premiums
Senate Finance Committee Democrats on Wednesday urged their Republican counterparts to extend the enhanced tax credits for the Affordable Care Act, which is set to expire at the end of the year, but Republicans said they were looking for other options to address rising healthcare costs.
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November 19, 2025
Conn. Dentists Pay $714K To Settle Patient Kickback Claims
Two Connecticut dentists will pay more than $714,000 to the state and federal governments to settle joint allegations that their practices submitted false government benefits claims that contained kickbacks for patient recruiters.
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November 19, 2025
Pa. Health Network's $1.15M 401(k) Suit Deal Gets Initial OK
A healthcare system Wednesday secured initial approval from a Pennsylvania federal court for a $1.15 million settlement agreement that would resolve a proposed class action alleging the company misused forfeited retirement plan funds and allowed the plan's administrative costs to soar.
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November 19, 2025
Whoop Blood Pressure Tracker Hit With False Ad Suit
A consumer on Tuesday hit health and wellness wearable tech company Whoop Inc. with a proposed class action in California federal court alleging that its boasting of the blood pressure features of its fitness tracker duped consumers and prompted a warning from health regulators.
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November 19, 2025
Hospice Co. Should Face Tobacco Fee Suit, Judge Says
A hospice and home healthcare provider shouldn't escape a proposed class action challenging a tobacco surcharge in its employee health plan, a Pennsylvania federal judge recommended, finding that allegations sufficiently backed up that a wellness program implementing the fee didn't meet all regulatory requirements.
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November 19, 2025
Doctor, Husband Admit $16M Healthcare Fraud, Tax Evasion
A physician and her husband admitted to committing more than $16 million in healthcare fraud and tax evasion as part of a scheme that injected sick patients with the wrong medications or dosages, according to their plea agreements in Alaska federal court.
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November 19, 2025
COVID-19 Testing Co. Settles Wage Suit With Testers, Drivers
A COVID-19 mobile testing company told a New York federal court that it has reached a settlement with a group of testers and drivers who claimed they were not paid full wages and overtime.
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November 19, 2025
Doc Takes Plea, Avoids Prison In Novel Opioid Death Case
A retired Massachusetts doctor pled guilty and was sentenced to five years of probation in a first-of-its-kind involuntary manslaughter case over a patient's 2016 opioid overdose death, the state attorney general's office announced.
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November 18, 2025
Health Co. Execs Convicted In $100M Adderall Sales Scheme
A San Francisco federal jury weighing a first-of-its-kind case on Tuesday convicted two digital healthcare company executives of scheming to sell Adderall through deceptive advertising, allegedly bringing in $100 million in illicit profits.
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November 18, 2025
'Surrender' Note Warrants Med Mal Retrial, Ill. Justices Hear
A below-the-knee amputee who lost his medical malpractice trial urged the Illinois Supreme Court to order a retrial in his case Tuesday, arguing a note stating a juror sided with the defense simply to end deliberations proves the verdict was not unanimous.
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November 18, 2025
Severe SC Abortion Bill Falters in Committee
A South Carolina bill that would have further criminalized abortion and subjected patients and doctors to up to 30 years in prison failed to advance out of a Senate committee on Tuesday, with antiabortion committee members raising concerns that the bill went too far.
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November 18, 2025
Feds Say Hi-Tech 'Trampled' Trust At Close Of Fraud Trial
Federal prosecutors closed out a nearly monthlong fraud trial against Hi-Tech Pharmaceuticals and its longtime CEO by telling a Georgia jury Tuesday that they "proudly" stood by what defense attorneys for the supplement manufacturer and distributor previously derided as a "paper case."
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November 18, 2025
Bristol-Myers Squibb Can Appeal Pension Suit To 2nd Circ.
Drugmaker Bristol-Myers Squibb and its investment manager can ask the Second Circuit to review a decision from September denying their motion to dismiss a pension dispute for lack of standing, a New York federal judge ruled.
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November 18, 2025
1st Circ. May Nix Trump Funding Freeze In 'Weird' Case
The First Circuit on Tuesday hinted that a federal judge may have been in bounds when blocking the Trump administration from withholding certain funds for states, expressing skepticism that the judge's order was improper or overly broad.
Expert Analysis
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Reproductive Health Under Trump So Far, And What's Next
Based on priorities stated so far, the Trump administration will likely continue to weaken Biden-era policies that protect reproductive health, with abortion, in vitro fertilization and contraception all being issues to watch closely amid a post-Dobbs shift, say attorneys at McDermott.
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What's Next For Lab Test Regulation Without FDA Authority
A recent Texas federal court decision vacating the U.S. Food and Drug Administration's final rule that would apply FDA regulations to laboratory-developed tests signals potential positive impacts in the diagnostic space, and could inspire more healthcare entities to litigate against the government, say attorneys at Hooper Lundy.
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6 Criteria Can Help Assess Executive Branch Actions
With new executive policy changes announced seemingly every day, several questions can help courts, policymakers and businesses determine whether such actions are proper, effective and in keeping with our democratic norms, say Marc Levin and Khalil Cumberbatch at the Council on Criminal Justice.
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Learning From COVID-19 Enforcement Against Nursing Homes
Five years after the COVID-19 outbreak caused a high number of deaths in nursing homes, an examination of enforcement actions against nursing homes in New York and elsewhere in the country highlights obstacles that may arise when bringing cases of this type, and ways to overcome them, says Kenneth Levine at Stone & Magnanini.
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How Plan Sponsors Can Mitigate Risk In PBM Contracts
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.
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4th Circ. Health Data Ruling Opens Door To State Law Claims
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.
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Unpacking Trump Admin Plans For Value-Based Care
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.
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What To Expect For Stem Cell Regulation Under Trump Admin
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.
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How Importers Can Minimize FCA Risks Of Tariff Mitigation
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.
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10 Practical Takeaways From FDA's Biopharma AI Guidance
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.
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Lawmakers Shouldn't Overlook Rare Disease Therapies' Value
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.
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What Trump's Order Means For The Legal Status Of IVF
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.
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Mitigating Tariff Risks For Healthcare In US And Canada
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.