Policy & Compliance
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April 20, 2026
Justices Won't Block Multimillion-Dollar Health Fraud Retrial
A man accused of pocketing $12 million as a part of a larger $140 million scheme to defraud public and private healthcare programs can't get out of a second trial, as the U.S. Supreme Court declined to review his case on Monday.
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April 17, 2026
9th Circ. Revives Doctor's PeaceHealth Whistleblower Suit
A Ninth Circuit panel has reinstated a psychiatrist's claims that PeaceHealth Inc. retaliated against him for expressing concerns about potential Medicaid fraud at a Washington hospital, concluding on Friday that the district court overlooked evidence that the employer punished him by not renewing his employment contract.
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April 17, 2026
Up Next At High Court: SEC And FCC Enforcement Authority
The U.S. Supreme Court's final argument session of this term kicks off Monday, when the justices will consider the U.S. Securities and Exchange Commission's authority to seek disgorgement orders against alleged wrongdoers without proving investors were harmed. Here, Law360 breaks down the week's oral arguments.
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April 17, 2026
Allstate Says Fla. Surgery Centers Padded Bills For Care
Seven ambulatory surgery centers, a pain clinic and an anesthesia practice that are all run by Surgery Partners conducted "extraordinarily aggressive treatment" on patients involved in minor car crashes to inflate the bills submitted to Allstate, the insurer told a Florida federal court Friday, alleging it paid millions for unnecessary treatment.
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April 17, 2026
Bill Floated To Nix Medical Residency Antitrust Exemption
U.S. Sen. Mike Lee, R-Utah, has introduced legislation to repeal an antitrust exemption given to the medical residency matching program by Congress two decades ago, over concerns about wages and a bottleneck of medical school graduates.
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April 17, 2026
Aramark Joins NJ Insulin Pricing Suits Against PBMs
Aramark Services Inc. joined multidistrict litigation accusing CVS and pharmacy benefit managers of colluding to inflate the price of insulin.
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April 17, 2026
Doc Says Texas Man Can't Sue Over Mailed Abortion Pills
A Texas man suing his ex-girlfriend's out-of-state doctor for prescribing mail-order abortion pills can't prove that the doctor caused the wrongful death of their unborn child, the doctor told a federal court, saying the case should be dismissed because he's not responsible for the woman's actions.
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April 16, 2026
Trump Taps Ret. Rear Admiral Schwartz As New CDC Chief
President Donald Trump on Thursday nominated Dr. Erica Schwartz, a retired rear admiral who served in the U.S. Coast Guard and as deputy surgeon general in the first Trump administration, to be the Centers for Disease Control and Prevention's next director.
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April 16, 2026
Feds Can't Stay Trans Healthcare Orders During Appeal
The Trump administration won't be able to enforce two executive orders that ban federal funding for gender-affirming care for patients under the age of 19 while the federal government appeals a nationwide injunction blocking the orders, the Fourth Circuit ruled Thursday.
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April 16, 2026
DOL Benefits Chief Pressed On Labor Secretary's Conduct
The head of the U.S. Department of Labor's employee benefits arm faced tough questions from House Democrats at an oversight hearing Thursday, fielding questions about the labor secretary's on-the-job conduct as well as the DOL's take on mental health parity enforcement.
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April 15, 2026
Aluminum Co. Settles Trans Worker's Suit Over Health Plan
A subsidiary of Kaiser Aluminum has agreed to resolve a lawsuit claiming it discriminated against transgender employees by excluding coverage for medical treatments related to gender-affirming care from its health plan, according to a filing in Washington federal court.
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April 15, 2026
NC Judge Won't Undo $4M Philips Copyright Verdict
A North Carolina federal judge has refused to erase a $4 million jury verdict against independent service organization Transtate Equipment Co. for violations of the Digital Millennium Copyright Act, saying trial evidence provided a "firm basis" to support the jury's statutory damages award.
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April 14, 2026
4th Circ. Revives Pharma Bid To Block Maryland's 340B Law
A split Fourth Circuit panel on Tuesday tossed a Maryland district court's order denying a preliminary injunction to pharmaceutical manufacturers that have challenged a state law addressing drug delivery in the federal 340B discount program, pointing to its recent ruling that West Virginia's similar statute is likely preempted.
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April 14, 2026
Justices Told That Eli Lilly's FCA Qui Tam Challenge Too Late
A whistleblower who secured a $183 million trial win against Eli Lilly urged the U.S. Supreme Court on Tuesday to reject its constitutional challenge over his ability to sue for the federal government, arguing the drugmaker's arguments came too late.
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April 14, 2026
Colo. Justices Weigh Bid To Restore Trans Youth Care
Colorado's justices pushed Children's Hospital Colorado on Tuesday to explain how its decision to halt gender-affirming care for transgender youth patients is not discriminatory, even amid the federal government's threats to cut funding for providers that offer the care to children and adolescents.
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April 14, 2026
Trade Group Latest To Sue Wash. Over 340B Drug Pricing Law
Pharmaceutical Research and Manufacturers of America claims a new Washington state law attempts to illegally reshape the federal 340B Drug Pricing Program and singles out participating drugmakers with burdensome regulations, according to a fresh federal lawsuit that follows similar constitutional challenges mounted by Novartis and AbbVie.
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April 14, 2026
Ga. Providers Say Rutledge Bars United's Preemption Win
Medical providers are urging a Georgia federal court to deny United's bid for an early win in its case seeking a declaration that the providers' purported attempt to claw back reimbursements for out-of-network services are preempted, arguing that state-law claims involving employee benefits aren't preempted by federal benefits law.
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April 14, 2026
FDA Offers Guidance On Safety Testing For Gene-Editing Tech
The U.S. Food and Drug Administration on Tuesday issued draft guidance recommending steps drug companies should take to evaluate the safety of gene-editing technology as they seek federal approval for cutting-edge treatments aimed at genetic diseases.
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April 14, 2026
Doctors Hope Justices Maintain Shield Against Med Mal Suits
A case headed to the U.S. Supreme Court next week could roll back a legal doctrine that physicians say is key to protecting them from frivolous medical malpractice suits filed by patients who've already lost in state court.
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April 14, 2026
7th Circ. Suggests High Court Ruling Supports Ark. PBM Rule
The Seventh Circuit appeared reluctant Tuesday to revive a union fund's challenge to an Arkansas rule making health plans disclose pharmacy compensation and pay fees, with judges pointing to a 2020 U.S. Supreme Court ruling that permitted state cost regulations on pharmacy benefit managers.
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April 14, 2026
Mich. AG Says PBMs Can't Duck Drug-Pricing Suit
Two pharmacy benefit managers can't dodge an antitrust lawsuit accusing them of price-fixing reimbursement rates because Michigan has properly claimed an antitrust violation, state Attorney General Dana Nessel told a federal court, asking it to toss aside the PBMs' dismissal bid.
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April 14, 2026
Vehicle Co. Inks $150K Deal To End Tobacco Fee Suit
International Motors LLC, formerly Navistar, has agreed to pay $150,000 to resolve a suit claiming the company illegally charged workers an extra $600 a year if they used tobacco without giving them a proper avenue to dodge the fee, according to an Illinois federal court filing.
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April 14, 2026
Screening Time Deal Doesn't Bar Break Suit, Wash. Panel Says
An eldercare company's class settlement over COVID-19 screening time doesn't bar a separate suit claiming the company failed to pay workers for missed meal breaks, a Washington state appeals court ruled, reviving the break claims.
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April 13, 2026
Ill. Judge Wants More Proof To Recalculate Kickback Damages
An Illinois federal judge tasked with recalculating damages from a home health company's referral kickback scheme said Monday that she needs more complete and reliable evidence to help determine the appropriate amount, but allowed the government to continue offsetting Medicare payments as part of its judgment collection bid.
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April 13, 2026
Mylan Can't Revive Copaxone Antitrust Claims Against Teva
A New Jersey federal judge sided Monday with a special master's recommendations to nix some of the parallel claims from Mylan and retailers like Walgreens accusing Teva of using regulatory deception, false advertising, improper rebates and more to delay generic competition to its Copaxone multiple sclerosis treatment.
Expert Analysis
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FDA's Crackdown On Drug Ads Conflicts With Precedent
Recent U.S. Food and Drug Administration warning letters to drug manufacturers targeting direct-to-consumer advertising raise significant constitutional concerns, and directly clash with prior FDA stances, say attorneys at Sidley.
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Informal Announcements Are Reshaping FDA Regulations
The U.S. Food and Drug Administration's recent shift toward using press releases, podcasts and other informal channels to announce major policy changes reflects a valid desire to modernize and accelerate regulatory efforts, but it could lead to diminished transparency, increased industry burden and reduced policy durability, says Rachel Turow at Skadden.
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A Shift In Fed. Circ.'s Approach To Patent Summary Judgment
The Federal Circuit's recent decision in Range of Motion v. Armaid may come to be seen as a seminal opinion for potentially exposing and entrenching the Federal Circuit's movement away from its previous framework for identifying obvious noninfringement cases, says Nicholas Nowak at Nowak IP Group.
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DOJ Actions Suggest Expansion Of Healthcare Enforcement
Recent actions by the U.S. Department of Justice and U.S. Food and Drug Administration suggest that federal healthcare enforcement efforts are moving away from traditional program-based fraud and toward cases centered on product integrity, regulatory transparency and telehealth marketing, effectively widening the government's enforcement playbook, say attorneys at MoFo.
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New Orphan Drug Law Provides A Key Fix For Pharma Cos.
The Consolidated Appropriations Act enacted last month restores the U.S. Food and Drug Administration's long-standing interpretation of "same disease or condition," related to orphan drug exclusivity, resolving years of regulatory uncertainty and litigation that have discouraged rare disease research, say attorneys at Spencer Fane.
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FDA User Fee Talks Offer Clues On Upcoming Reforms
As the U.S. Food and Drug Administration undergoes the User Fee Act reauthorization process and renegotiates its user fee agreements over the next several months, the agency's consultation meetings with relevant industries can shed light on the FDA's priorities, and provides stakeholders an opportunity to participate in the reform process, say attorneys at Holland & Knight.
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Changes Coming To The SBIR And STTR Programs
Legislation recently approved by Congress to reauthorize the Small Business Innovation Research and Small Business Technology Transfer Programs includes changes focused on national security that would improve transparency but also increase applicants' administrative burdens, slow the awards process and likely increase litigation, say attorneys at Fluet & Associates.
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FDA Framework For Personalized Therapies Raises Questions
The U.S. Food and Drug Administration's new plausible mechanism framework for developing individualized therapies reflects the agency's focus on rare-disease drugs, but numerous significant, unresolved issues cast uncertainty on how effective the framework will be in practice, say attorneys at Ropes & Gray.
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Scrutiny Of Nursing Home Practices Marks Inflection Point
Recent congressional inquiries into UnitedHealth Group's Medicare Advantage-linked nursing home practices raise questions about whether financial metrics are allowed to influence decisions governed by the standard of care, and could implicate duties imposed by federal regulations, state negligence laws and elder abuse statutes, says Lindsey Gale at Rafferty Domnick.
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7 Steps For Gov't Contractors In Post-IEEPA Tariff Landscape
In response to U.S. Supreme Court's recent decision to strike down tariffs issued by the Trump administration under the International Emergency Economic Powers Act, there are several actions federal contractors should take to preserve their place in any refund waterfall, and to manage audit, overpayment and False Claims Act risk, say attorneys at Holland & Knight.
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CMS Healthcare Enforcement Initiatives May Cause Disruption
The Centers for Medicare & Medicaid Services' recently announced enforcement actions against healthcare fraud mark a significant escalation, and CMS' prior approach in the hospice sector suggests that even compliant providers and suppliers should brace for impact, say attorneys at Morgan Lewis.
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What We Know About DOJ's New FCA Enforcement Priorities
Recent remarks from the leader of the Justice Department’s commercial litigation branch provide key insights on how False Claims Act cases — especially healthcare fraud, trade fraud, antidiscrimination and cybersecurity claims — will be evaluated, prioritized and pursued as heightened enforcement becomes the new normal, say attorneys at Latham.
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How PBMs Can Adapt To Plan Sponsors' Disclosure Demands
As federal reforms, growing state regulation and litigation threats push plan sponsors to expect visibility into revenue streams, pharmacy benefit managers should leverage transparency strategically, including by simplifying how they get paid, offering clients audit-ready data and co-designing contracts that are easy for fiduciaries to explain and defend, says Kristie Blase at Frazer + Blase.