Policy & Compliance

  • August 18, 2026

    Iowa Board Opens Door For Doctor Self-Defense Arguments

    An Iowa medical board's decision to dismiss disciplinary charges against a doctor who claimed the state's "stand your ground" law enabled him to defend himself against a violent patient could open the door to other providers protecting themselves from lawsuits on similar grounds, experts say.

  • August 18, 2026

    DOJ Targets Small Pharmacies With Novel FCA Claims

    The Justice Department in recent weeks has indicated that it's willing to use the False Claims Act to bring stronger charges and levy stiffer fines against smaller pharmacies accused of violating controlled substances laws by contributing to the opioid crisis, legal experts say.

  • August 18, 2026

    Aetna Says It Doesn't Use Repricing Tools In Antitrust Case

    Aetna Inc. urged a Massachusetts federal court to toss it from an antitrust case accusing insurance companies of using repricing tools to reduce reimbursements paid to healthcare providers, arguing that a subsidiary, not Aetna, used the tools at issue.

  • August 18, 2026

    NC Doc Gets Prison For Opioid Recovery Prescription Scheme

    A federal judge has sentenced a North Carolina doctor to half a year in prison for letting administrative staff at a nonprofit where he worked as medical director use his credentials to prescribe the opioid use disorder medication buprenorphine to thousands of patients.

  • August 18, 2026

    CMS Aims To Sidestep Past Setbacks In New Trans Care Rule

    A new Medicaid rule that bars federal funding for minors’ gender-affirming care is likely to ignite a swift legal fight over discrimination law, procedural requirements and the reach of last year’s landmark Supreme Court decision in U.S. v. Skrmetti, experts say.

  • August 18, 2026

    Marriott Gets Trim Of Worker's Tobacco Health Fee Suit

    A Maryland federal judge on Tuesday refused to completely toss a Marriott worker's proposed class action alleging the hotel giant's $15 weekly health fee on employees who use tobacco violated federal benefits law, but trimmed the dispute of some claims as insufficiently backed up. 

  • August 18, 2026

    What To Know: AMA Faces Medical Coding Copyright Suit

    A healthcare transparency group is asking a judge for permission to publish the medical codes that help determine the billing for medical procedures, setting up a confrontation with the American Medical Association, which developed the coding system. Here, Law360 takes a closer look at the case and the broader transparency debate.

  • August 17, 2026

    Albertsons Judge Hears $44B Opioid Abatement Plan In Wash.

    Addressing harm caused by prescription opioid abuse in Washington would cost nearly $44.4 billion, an expert testified Monday during a bench trial in the state's case accusing Albertsons and its Safeway subsidiary of exacerbating Washington's overdose crisis by failing to curb the flow of controlled substances.

  • August 17, 2026

    Blue States Say FTC Can't Regulate Trans Youth Health

    A group of left-leaning states, including Massachusetts and California, asked a Texas federal court to toss a Federal Trade Commission suit against the World Professional Association for Transgender Health, saying Monday that the FTC's suit constitutes a "federal attack on state-regulated transgender healthcare."

  • August 17, 2026

    AIG Exclusion Doesn't Bar Multiplied Damages, Judge Says

    A California federal judge in a narrow ruling declared that a portion of Kaiser Foundation Health Plan's insurance policy does not automatically bar coverage for a portion of a $581 million False Claims Act settlement attributable to multiplied damages, but will decide later whether the agreement actually included such damages. 

  • August 17, 2026

    Hospital Employees Seek Class Cert. In Retirement Funds Suit

    Employees of a faith-based nonprofit Colorado hospital urged a federal judge to grant class certification in their lawsuit alleging the hospital mismanaged employees' retirement funds and ultimately cost participants tens of millions of dollars.

  • August 17, 2026

    Mass. Judge Vacates ACA Gender-Affirming Care Restriction

    A Massachusetts federal judge handed a coalition of 21 states a win on their claim that the U.S. Department of Health and Human Services unlawfully issued Affordable Care Act reforms barring marketplace plans from requiring coverage for medical procedures used in gender-affirming care.

  • August 17, 2026

    7th Circ. Reverses Alcoa Union Retirees' Lifetime Benefits Win

    The Seventh Circuit reversed an Indiana federal court's decision holding that certain union retirees of aluminum giant Alcoa and their beneficiaries had a vested right to health benefits for life, finding error with the lower court's judicial estoppel analysis that formed the basis for its judgment on liability.

  • August 14, 2026

    AstraZeneca Joins States Aiming To Block Ill. 340B Drug Law

    AstraZeneca on Friday joined some other large pharmaceutical companies in urging an Illinois federal court to block a new state law that prohibits drugmakers from restricting the types or number of pharmacies healthcare providers can contract with to provide medications under a federal discount drug program.

  • August 14, 2026

    United, Ga. Providers Settle Out-Of-Network Benefits Pay Fight

    United Healthcare has settled claims that three Georgia medical providers that are outside the insurer's network requested "exorbitantly high" reimbursements for care provided to United customers, according to documents filed in Georgia federal court.

  • August 14, 2026

    NC County Sues Bankrupt Hospital Operator For $10M

    North Carolina's Martin County has sued CHS/Community Health Systems Inc. for $10 million in North Carolina federal court, alleging the company failed to honor its obligations to run Martin General Hospital after its affiliate filed for Chapter 7 in 2023.

  • August 14, 2026

    Idaho Abortion Ban Needs Health Exceptions, Judge Finds

    An Idaho federal judge barred the state from criminalizing abortions in cases where continuing a pregnancy puts a patient at risk of lasting harm or death via self-harm, finding that the 14th Amendment establishes a fundamental right to health- and life-preserving abortion care.

  • August 13, 2026

    Albertsons Didn't Flag Suspicious Opioid Orders, Judge Hears

    Albertsons failed to report its pharmacies' unusual opioid orders to the U.S. Drug Enforcement Administration despite explicit instructions from the agency to do so, the retailer's vice president of pharmacy compliance testified Thursday during a bench trial in Washington's lawsuit accusing the chain of exacerbating the state's opioid epidemic.

  • August 13, 2026

    Blue Cross Affiliates Get Trim Of Aramark Health Benefits Row

    A Pennsylvania federal judge on Thursday trimmed but refused to toss a federal benefits lawsuit from food service giant Aramark against a Blue Cross affiliate that administered the company's employee health benefit plans, opening discovery on allegations that improper claims management cost tens of millions and breached fiduciary duties.

  • August 13, 2026

    J&J Says No To Reviving Stelara Case

    Johnson & Johnson has asked the Fourth Circuit not to revive CareFirst's antitrust suit alleging the company tried to monopolize the market for the immunosuppressive drug Stelara.

  • August 13, 2026

    Wash. Halts Conversion Therapy Ban For Therapist Amid Suit

    Washington state has agreed not to enforce its ban on a practice commonly known as conversion therapy against a therapist while his First Amendment challenge to the prohibition plays out in federal court, according to a stipulation entered Thursday.

  • August 13, 2026

    Vaccine Challengers Slam Connecticut's 'One-Party Rule'

    Challengers to Connecticut's mandatory school vaccination laws have accused political leaders of exercising "one-party rule" over state government, claiming the House speaker, governor and attorney general, who are all Democrats, tweaked or defended state laws specifically to stymie their religious freedom claims.

  • August 13, 2026

    Employers Expecting Bump In Health Plan Costs, Survey Says

    GLP-1 medications and catastrophic coverage claims are two leading factors employers anticipate will push health plan costs up 10% in 2027, according to new data released Thursday by the International Foundation of Employee Benefit Plans.

  • August 13, 2026

    Glenmark Will Pay $15.3M To End Humana's Price-Fixing Claims

    The U.S. arm of Glenmark Pharmaceuticals Ltd. has agreed to settle generic-drug price-fixing claims brought by Humana Inc. in three lawsuits centralized in Pennsylvania-based multidistrict litigation, according to a filing with Indian stock exchanges.

  • August 13, 2026

    NC Biz Court Bulletin: Judges Retire, HCA Suit Heads To Trial

    The North Carolina Business Court dropped a host of heavy-hitting opinions in July ahead of two judicial retirements and a new chief judge rising in the ranks.

Expert Analysis

  • Unpacking Key Themes From NY's New Healthcare Strategy

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    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.

  • Trans Care Enforcement Landscape Is Evolving Quickly

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    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.

  • 11th Circ. May Bring Tectonic Shift To FCA Qui Tam Actions

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    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.

  • To Survive FCA Actions, Small Cos. Must Take Offensive Steps

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    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.

  • Record FCA Recoveries Signal Intensified Healthcare Focus

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    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.

  • A Potential Shift In FDA's Approach To Drug Trial Design

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    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.

  • What FDA Guidance Means For Future Of Health Software

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    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.

  • How State FCA Activity May Affect Civil Fraud Enforcement

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    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.

  • Wage-Based H-1B Rule Amplifies Lottery Risks For Law Firms

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    Under the wage-based H-1B lottery rule taking effect Feb. 27, law firms planning to hire noncitizen law graduates awaiting bar admission should consider their options, as the work performed by such candidates may sit at the intersection of multiple occupational classifications with differing chances of success, says Jun Li at Reid & Wise.

  • Assessing Compliance Risks Around TrumpRx Participation

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    As there are novel compliance obligations and potential political opposition related to the new TrumpRx online drug platform, companies intending to participate on the site should consider the pressure points that are likely to draw enforcement scrutiny, say attorneys at Sheppard.

  • Predicting Actual Impact From CDC's New Vaccine Guidance

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    Recent federal changes to the childhood immunization schedule, reducing the number of vaccine recommendations from 18 to 11, do not automatically create enforceable obligations for parents, schools or healthcare providers, but may spur litigation and other downstream effects on school policies and state guidelines, says Mehdi Sinaki at Michelman & Robinson.

  • What Rescheduling Means For Cannabis Labels, Marketing

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    The proposed reclassification of cannabis is expected to bring heightened scrutiny of labeling, advertising and marketing from the U.S. Food and Drug Administration and the Federal Trade Commission, but the brands that tighten evidence, standardize operations and professionalize marketing controls now will see fewer surprises and better outcomes, say attorneys at Wilson Elser.

  • What's At Stake In Possible Circuit Split On Medicaid Rule

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    A recent Eleventh Circuit decision, reviving Florida's lawsuit against a federal rule that reduces Medicaid funding based on agreements between hospitals, sets up a potential circuit split with the Fifth Circuit, with important ramifications for states looking to private administrators to run provider tax programs, say Liz Goodman, Karuna Seshasai and Rebecca Pitt at FTI Consulting.