Policy & Compliance
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September 16, 2025
Pharma Tests Drug Price Policies In Court: 3 Cases To Know
Two circuit courts issued notable rulings over the past week upholding laws aimed at lowering prescription drug prices. Elsewhere, insulin makers are seeking a panel rehearing in a proposed class action targeting discount programs. Here, Law360 Healthcare Authority looks at three key drug pricing cases you may have missed.
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September 16, 2025
Wash. Justices Scrutinize Minimum Wage 'Live In' Exclusion
Washington Supreme Court justices on Tuesday pushed counsel for an adult family home on the stance that its "live in" workers are adequately protected by existing laws and regulations, pointing to testimony its employees are always on call and sometimes at risk of physical assault by residents.
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September 16, 2025
Ill. Hospital Nonprofit Must Face Tobacco Fee Suit
An Illinois federal judge refused to toss the bulk of a proposed class action from an Illinois hospital worker who claimed a fee on the employee health plans of tobacco users was discriminatory and breached fiduciary duties under benefits law, finding most allegations sufficiently backed up to survive dismissal.
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September 16, 2025
DC Circ. Asked To Look At ADA Injunction In Segregation Case
Washington, D.C., wants the D.C. Circuit to narrow an injunction commanding the district to help people in Medicaid-funded nursing homes move out of those facilities and into less restrictive forms of care, as the litigation approaches its 15th birthday.
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September 16, 2025
$50B Rural Health Fund: A Primer
The U.S. Centers for Medicare & Medicaid Services will use a newly created $50 billion rural health fund to entice states to take unhealthy foods out of their food-stamp programs, expand telehealth and embrace other Trump administration priorities.
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September 16, 2025
Calif. Healthcare Bills: 4 You Need To Know
Golden State lawmakers passed a flurry of healthcare bills this legislative session, including measures meant to ease prior authorization requirements on providers and increase oversight of PBMs and PE-backed transactions. Healthcare Authority looks at four bills now on the governor's desk.
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September 16, 2025
CVS Caremark Takes $290M Overbilling Judgment To 3rd Circ.
CVS's pharmacy benefits manager will appeal a judgment against the company that was recently increased from $95 million to $290 million in a suit alleging it overbilled Medicare Part D-sponsored drugs, according to a notice of appeal filed in Pennsylvania federal court.
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September 16, 2025
WellSpan Health Elevates Atty To Legal Chief
Regional healthcare provider WellSpan Health has tapped one of the company's in-house attorneys to lead its law department in its south central Pennsylvania headquarters.
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September 16, 2025
For Cahill Atty, Rare Disease Pro Bono Work Is Personal
John MacGregor of Cahill Gordon & Reindel LLP didn't have any experience in healthcare law before taking on a pro bono client that supports people with a rare form of epilepsy. MacGregor's son is one of them.
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September 16, 2025
HHS OIG Senior Counsel Joins Polsinelli As Shareholder
A former senior counsel in the U.S. Department of Health and Human Services' Office of Counsel to the Inspector General, who spent more than a decade in private practice before his most-recent six years in public service, has joined Polsinelli PC.
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September 15, 2025
Mich. Says HHS Can't Justify $195M Medicaid Clawback
The state of Michigan urged a federal judge to find that the U.S. Department of Health and Human Services cannot catch a payday for its yearslong delay in affirming a decision to disallow $195 million in Medicaid payments to two state-operated psychiatric hospitals, arguing that the delay runs afoul of federal law and the department's own policies.
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September 15, 2025
Stewart Says New Policies Seek Fairness For Patent Owners
Acting U.S. Patent and Trademark Office Director Coke Morgan Stewart said Monday the numerous changes to patent reviews she has implemented are intended to provide "more balance and fairness" for patent owners, and bring the reviews "back to how they were originally intended."
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September 15, 2025
Corcept Can't Escape Teva's Mifepristone Antitrust Suit
Corcept Therapeutics must face most of Teva Pharmaceuticals' lawsuit alleging it suppressed generic competition for its brand-name medication used to treat a rare cortisol disorder, a California federal judge ruled, saying the claims are not time-barred and Teva has adequately alleged unlawful monopolization.
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September 15, 2025
Mich. Ordered To Clarify Stance On Clinic's Trans Care Policy
A federal magistrate judge on Monday ordered Michigan civil rights enforcers to clarify in discovery responses whether a Christian medical clinic's opposition to gender-affirming care violates the state's antidiscrimination law.
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September 12, 2025
AbbVie Can't Halt Miss. Discount Drug Law, 5th Circ. Says
AbbVie and other pharmaceutical manufacturers that participate in Medicaid cannot preliminarily block a Mississippi law barring their interference with the distribution of discounted prescriptions to pharmacies serving low-income patients, the Fifth Circuit ruled Friday, saying the drugmakers haven't shown that the statute likely effectuates a taking of their property.
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September 12, 2025
Ex-Conn. Assistant AG Faces DQ Bid In Price-Fixing Case
Drug companies accused of fixing prices for generics are seeking to disqualify former Connecticut Assistant Attorney General Joseph Nielsen and his law firm from representing insurers in a multidistrict litigation, arguing Nielsen had access to confidential information as a government attorney that he could unfairly use against them now.
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September 11, 2025
States Push Conn. Court To Ban Generic Drug Price-Fixing
A court order is necessary to prevent pharmaceutical companies and their executives from illegally fixing the prices of generic drugs, a coalition of state enforcers have told a Connecticut federal judge, arguing there is a "reasonable expectation" that the allegedly anticompetitive behavior at the center of multidistrict litigation will happen again.
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September 11, 2025
Medicare Drug Pricing Plan Survives Novartis' 3rd Circ. Appeal
The Third Circuit ruled Thursday that the Centers for Medicare & Medicaid Services' ability to negotiate "maximum fair prices" with drugmakers doesn't violate their constitutional rights, rejecting an argument by Novartis Pharmaceuticals Corp. that the practice amounted to a raw deal for the pharmaceutical industry.
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September 11, 2025
Expert's AI Hallucinations Blamed On Attys' 'Willful Blindness'
Utah anesthesiologists facing a False Claims Act fraudulent billing suit doubled down Wednesday on their bid to sanction and disqualify the whistleblower's counsel for not catching an expert witness report with numerous AI-generated fabrications, arguing the errors were so obvious that the failure to catch them constitutes "willful blindness."
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September 11, 2025
1st Circ. OKs Freeze Of Planned Parenthood Medicaid Funding
The First Circuit on Thursday allowed the Trump administration to halt Medicaid reimbursements to Planned Parenthood and its affiliates, pausing a pair of lower court rulings that had blocked the funding cut.
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September 11, 2025
7th Circ. Backs $183M FCA Award Over Eli Lilly Drug Rebates
The Seventh Circuit refused on Thursday to unwind a whistleblower's $183 million trial win against Eli Lilly in a false claims case targeting more than a decade of drug rebate miscalculations, saying a jury reasonably found that the company knowingly "hid the truth" about how much it charged for Medicaid-covered drugs.
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September 11, 2025
LifePoint Must Face Workers' 401(k) Mismanagement Suit
A Tennessee federal judge refused to toss a proposed class action against LifePoint Health Inc. from participants in the healthcare company's employee 401(k) plan who alleged their retirement savings were dragged down by excessive recordkeeping and administrative fees, concluding allegations were sufficiently backed up to proceed to discovery.
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September 10, 2025
Feds Barred From Axing 30-Year Noncitizen Services, For Now
A Rhode Island federal judge Wednesday blocked the Trump administration from enacting a policy change requiring immigration status checks for a number of federally funded community services, saying a coalition of Democratic-led states is likely to succeed in its assertion that the move is unconstitutional, as well as arbitrary and capricious.
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September 10, 2025
FTC Urged To Probe Microsoft Over Ascension Data Breach
U.S. Sen. Ron Wyden, D-Ore., is calling on the Federal Trade Commission to open an investigation into Microsoft's "gross cybersecurity negligence" that has allegedly contributed to cyberattacks against critical infrastructure providers, including a 2024 ransomware hack that targeted hospital system Ascension.
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September 10, 2025
FTC Warns Healthcare Employers About Noncompetes
The Federal Trade Commission has sent letters warning healthcare employers and staffing companies not to include overly broad noncompete restrictions in their employment contracts and urged them to conduct a review to ensure they comply with the law.
Expert Analysis
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A Look At FDA's Plans To Establish New OTC Drug Category
The U.S. Food and Drug Administration's recently finalized rule, creating a new over-the-counter pathway for drugs when patients satisfy certain conditions, may be useful for off-patent drugs with established safety records, though switching to OTC comes with additional costs and considerations, say attorneys at Skadden.
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2024 Was A Significant Year For HIPAA Compliance
The Office of Civil Rights' high level of Health Insurance Portability and Accountability Act activity in 2024 and press releases about its specific focus on certain cybersecurity issues make it abundantly clear that the OCR is not going to tolerate widespread compliance complacency, says Nathan Kottkamp at Williams Mullen.
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How 2025 NDAA May Affect DOD Procurement Protests
A bid protest pilot program included in the 2025 National Defense Authorization Act shifts litigation costs onto unsuccessful bid protesters and raises claim-filing thresholds, which could increase risks to U.S. Department of Defense contractors who file protests, and reduce oversight of DOD procurement awards, say attorneys at Venable.
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Top 10 Noncompete Developments Of 2024
Following an eventful year in noncompete law at both state and federal levels, employers can no longer rely on a court's willingness to blue-pencil overbroad agreements and are proceeding at their own peril if they do not thoughtfully review and carefully enforce such agreements, say attorneys at Faegre Drinker.
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What 2024 Tells Us About Calif. Health Transaction Reviews
Looking back at the California Office of Health Care Affordability's first year accepting notices for material healthcare transactions reveals critical lessons on what the OHCA's review process may mean for the future of covered transactions in the state, say attorneys at Ropes & Gray.
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Updated HIPAA Rule Is A Necessary Step For Data Protection
The U.S. Department of Health and Human Services' updated rules addressing cybersecurity threats in healthcare will necessitate significant investment in technology, training and compliance infrastructure, but are an essential evolution in safeguarding data in an increasingly digital world, say attorneys at Clark Hill.
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Courts Must Curb The Drug Price Negotiation Program
The Inflation Reduction Act's drug price negotiation program upends incentive structures that drive medical innovation, and courts must act appropriately to avoid devastating consequences for American healthcare and the pharmaceutical industry, says Jeff Stier at the Consumer Choice Center.
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The OIG Report: Preparing For Oversight In 2025
Across sectors, Office of Inspector General work plans and challenge reports for 2025 provide a trove of information on the issues and industries that will likely be the focus of government oversight in the year to come, says Diana Shaw at Wiley.
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5 Drug And Device Developments That Shaped 2024
The last year saw significant legal developments affecting drug and device manufacturers, with landmark decisions and regulatory changes that require vigilance and agility from the industry, say attorneys at Faegre Drinker.
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How New Fraud Enforcement Tool Affects Gov't Contractors
Government contractors will likely face greater scrutiny under the recently enacted Administrative False Claims Act, which broadens federal agencies' authority to pursue low-dollar fraud claims, but contractors may also find the act makes settlement of such claims easier to negotiate, say attorneys at Wiley.
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Consultants Should Be Aware Of DOJ's Potential New Reach
The U.S. Department of Justice's recent first-of-its-kind settlement with McKinsey & Co. indicates not only the DOJ's more aggressive stance toward businesses' potential criminal wrongdoings, but also the benefits of self-disclosure and cooperation when wrongdoing becomes apparent, says Dom Caamano at Kibler Fowler.
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Health Tech Regulatory Trends To Watch In 2025
With an upcoming change in administration and the release of some long-awaited rules, the healthcare industry should prepare for shifting trends, including a growing focus on health data and interest in technology-enabled delivery of healthcare, say attorneys at Orrick.
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10 Noteworthy CFPB Developments From 2024
In a banner year for consumer finance regulation, the Consumer Financial Protection Bureau made significant strides in its efforts to rein in Big Tech and nonbank financial firms, including via rules regarding open banking, credit card late fees, and buy now, pay later products, say attorneys at Wiley.