Policy & Compliance

  • June 05, 2026

    Health Funds Ink $5.5M Generic Drug Deal With Breckenridge

    A proposed class of end-payers who allegedly overpaid for generic drugs have asked a federal court for preliminary approval of a $5.5 million settlement with Breckenridge Pharmaceutical Inc., though notifying class members and seeking final approval would wait until the process could be combined with another settlement, the plaintiffs said Thursday.

  • June 05, 2026

    4 Argument Sessions For Benefits Attys To Watch In June

    The Ninth Circuit will hear from a benefits administrator that claims federal law preempts state-law data breach claims, and Amazon will defend its win in a military leave bias suit at the Second Circuit. Here, Law360 looks at cases being argued in June that benefits attorneys should have on their radar.

  • June 04, 2026

    Policyholder Attys Praise Kaiser's Damages Bid In FCA Row 

    Kaiser Foundation Health Plan's call for coverage of any multiplied damages in a $581 million False Claims Act settlement with the U.S. Department of Justice grabbed the attention of policyholder attorneys, who see a smart strategy to simplify litigation and are curious about how an AIG unit may respond. 

  • June 04, 2026

    Feds Tout Medicaid Fraud Crackdown In Ohio, Slam Hawaii

    The Trump administration on Thursday praised Ohio's fight against Medicaid fraud and said Hawaii was doing too little, as federal officials pushed states to ramp up anti-fraud prosecutions or risk the loss of federal funding.

  • June 04, 2026

    Cities, Doctors' Group Seek Bar On ACA Marketplace Reforms

    Several cities and groups representing doctors and small businesses urged a Maryland federal court to strike down recently finalized Affordable Care Act marketplace reforms, arguing they will strain community resources by increasing the population of underinsured and uninsured Americans.

  • June 04, 2026

    NC Doctor Seeks Probation In $11M Medicare Fraud Case

    A North Carolina doctor convicted of making false statements as part of an $11 million Medicaid fraud scheme has asked a federal judge in the state to not send her to federal prison and instead give her probation after a jury found her guilty.

  • June 03, 2026

    AbbVie Loses Miss. Discount Drug Law Challenge For Good

    A Mississippi federal judge on Wednesday threw out a suit brought by AbbVie and other pharmaceutical manufacturers that participate in Medicaid challenging a law barring their interference with the distribution of discounted prescriptions to pharmacies serving low-income patients.

  • June 03, 2026

    Judge Questions Terms Of Student Loan Forgiveness Change

    A Massachusetts federal judge considering whether to block a new Trump administration rule that could kick millions of public sector and nonprofit employees out of a student loan forgiveness program repeatedly pressed a government lawyer Wednesday on the precise criteria the U.S. Department of Education would use to decide who is no longer eligible.

  • June 03, 2026

    Treatment Providers Can't DQ Participants' Atty In Wage Suit

    Several Texas-based addiction recovery program operators cannot remove a worker's attorney from a proposed wage class action over his prior involvement with the programs, a federal judge found, saying the operators failed to show the attorney had a conflict of interest or was a necessary witness.

  • June 03, 2026

    Medical Equipment Co. Inks $14.3M Deal In Overbilling Suit

    Pennsylvania-based AdaptHealth Corp. will pay $14.3 million to settle claims that it violated the North Carolina Debt Collection Act by overcharging and trying to collect debts from patients who had returned medical equipment to the company, according to details of a deal released this week.

  • June 03, 2026

    Bankrupt Hospital Can't Exit $3B BCBS Antitrust Deal

    A bankrupt Alabama hospital with "settler's remorse" can't bail on a multibillion-dollar antitrust settlement with Blue Cross Blue Shield, a federal judge ruled Tuesday.

  • June 03, 2026

    Ill. Court Blocks Fla. Suit Targeting Gender Care Policies

    An Illinois federal judge blocked the Florida attorney general's lawsuit targeting medical groups' policies on youth gender-affirming care, saying there's sufficient jurisdiction over Sunshine State officials because of a potential nationwide chilling effect the enforcement action caused.

  • June 03, 2026

    Trans Youth Sue NYU Langone, DOJ To Bar Records Release

    A group of transgender minors and young adults who received gender dysphoria care at NYU Langone urged a New York federal court to bar the U.S. Department of Justice from accessing their sensitive health records through a criminal subpoena.

  • June 03, 2026

    HHS Says Bronx Facility $31M Payback Suit Filed Prematurely

    The U.S. Department of Health and Human Services says a nursing center in New York City should have pursued administrative remedies before fighting the collection of $31 million in Medicare overpayments with a lawsuit.

  • June 03, 2026

    EEOC Sues Health System Over Female Van Driver's Firing

    A Maryland healthcare system discriminated against a female driver by firing her after a wheelchair-bound nursing home resident fell from her transport van, whereas a male van driver was not disciplined after a similar episode, the U.S. Equal Employment Opportunity Commission said in a new suit.

  • June 02, 2026

    NJ Sues GEO Group Over Denial Of Detention Center Access

    New Jersey sued the owner and operator of immigration detention center Delaney Hall in state court on Tuesday, accusing the contractor of violating state law by blocking health officials from inspecting the center.

  • June 02, 2026

    NC Doctor Says 'Acquitted' Conduct Skews Sentencing

    A doctor convicted of making false statements in connection with an $11 million Medicare fraud scheme is urging a North Carolina federal court to exclude conduct she says she was acquitted of from her sentencing calculation, while the government argues she's mischaracterizing the outcome of the case. 

  • June 02, 2026

    No Surprises Act's New Rule Hands Win To Providers

    A long-awaited update to the No Surprises Act includes technical changes to dispute resolutions that attorneys say add up to a win for providers seeking to navigate a complex process.

  • June 02, 2026

    John Oliver Dodges Defamation Suit Over Medicaid Segment

    A physician highlighted in a "Last Week Tonight" segment on Medicaid who sued host John Oliver for defamation lost his case Tuesday, after a New York federal judge found the challenged statements were protected speech.

  • June 02, 2026

    3 State Drug Pricing Bills Attys Should Know

    State lawmakers continue to debate bills aimed at controlling the prices of prescription drugs. In recent weeks, high-profile bills in Illinois, Virginia and Minnesota all saw movement. Here, Law360 breaks down what attorneys need to know about these three bills. 

  • June 02, 2026

    4 Things To Know Before Feds Fight Rhode Island's 340B Law

    With the federal government's support, drug companies will try to persuade the First Circuit on Wednesday to strike down a Rhode Island law blocking them from constraining federally funded hospitals and contract pharmacies that use the 340B program. Here what you need to know about the legal battles surrounding the program ahead of the hearing.

  • June 02, 2026

    Generics Makers Tell 3rd Circ. Buyers Too Few For Class

    Two pharmaceutical companies embroiled in decadelong litigation over the alleged price-fixing of generic drugs told a Third Circuit panel on Tuesday that groups of drug buyers either didn't have the numbers necessary to support class certification or were not clearly identifiable.

  • June 02, 2026

    Nonnetwork Insurance Plans Could Spur Legal Challenges

    A new Centers for Medicare & Medicaid Services rule will bring more high-deductible, low-premium plans to the Affordable Care Act marketplace. Some legal experts believe the inclusion of insurers without provider networks may run afoul of the law. .

  • June 01, 2026

    Albertsons Had Duty To Curb Opioid Diversion, Judge Rules

    As providers of controlled substances, pharmacy giants Albertsons and Safeway had legal duties to prevent the diversion of opioid drugs, a Washington state judge ruled on Monday, though whether the companies failed to fulfill those duties will be determined at trial.

  • June 01, 2026

    DC Circ. Says Military Trans Ban Flouts Constitutional Rights

    A divided D.C. Circuit panel Monday said the Trump administration illegally banned transgender individuals from military service, then narrowed a preliminary injunction to prevent the government's exclusion of transgender people presently serving in the military but not those desiring to enlist.

Expert Analysis

  • 2025 State AI Laws Expand Liability, Raise Insurance Risks

    Author Photo

    As 2025 nears its end, claims professionals should be aware of trends in state legislation addressing artificial intelligence use, as insurance claims based on some of these liability-expanding statutes are a certainty, say attorneys at Wiley.

  • Learning From 2025 FCA Trends Targeting PE In Healthcare

    Author Photo

    False Claims Act enforcement trends and legislative developments from this year signal intensifying state and federal scrutiny of private equity's growing footprint in healthcare, and the urgency of compliance, says Lisa Re at Arnold & Porter.

  • How 11th Circ.'s Qui Tam Review Could Affect FCA Litigation

    Author Photo

    On Dec. 12, the Eleventh Circuit will hear arguments in U.S. ex rel. Zafirov v. Florida Medical Associates, setting the stage for a decision that could drastically reduce enforcement under the False Claims Act, and presenting an opportunity to seek U.S. Supreme Court review of the act's whistleblower provisions, say attorneys at Epstein Becker.

  • How MAHA Is Taking Shape At The State Level

    Author Photo

    The national spotlight on the federal government's Make America Healthy Again movement is bolstering state-level actions regarding potential health impacts of certain food ingredients, increasing the difficulty and importance of maintaining effective compliance programs, say attorneys at Cooley.

  • A Look At Middlemen Fees In 340B Drug Discount Program

    Author Photo

    A U.S. Senate committee's recent hearing on the Section 340B drug discount program, along with statistical analysis of payment amounts, contribute to a growing consensus that middlemen fees are too high, say William Sarraille at the University of Maryland, and Shanyue Zeng and Rory Martin at IQVIA.

  • Nursing Home Abuse Cases Face 3 Barriers That Need Reform

    Author Photo

    Recent headlines reveal persistent gaps in oversight and protection for vulnerable residents in long-term care, but prosecution of these cases is often stymied by numerous challenges that will require a comprehensive overhaul of regulatory, legal and financial structures to address, says Veronica Finkelstein at Wilmington University.

  • Mulling Differing Circuit Rulings On Gender-Affirming Care

    Author Photo

    Despite the Eleventh Circuit's recent holding in Lange v. Houston County that a health plan's exclusion for gender-affirming surgery did not violate Title VII, employers should be mindful of other court decisions suggesting that different legal challenges may still apply to blanket exclusions for such care, say attorneys at Smith Gambrell.

  • State AGs May Extend Their Reach To Nat'l Security Concerns

    Author Photo

    Companies with foreign supply-chain risk exposure need a comprehensive risk-management strategy to address a growing trend in which state attorneys general use broadly written state laws to target conduct that may not violate federal regulations, but arguably constitutes a national security threat, say attorneys at Wiley.

  • Unique Aspects Of Texas' Approach To AI Regulation

    Author Photo

    The Texas Responsible AI Governance Act — which will soon be the sole comprehensive artificial intelligence law in the U.S. — pulls threads from EU and Colorado laws but introduces more targeted rules with fewer obligations on commercial entities, say attorneys at MVA Law.

  • Surveying The Healthcare Policy Landscape Post-Shutdown

    Author Photo

    With last week's agreement to reopen the federal government, at least through the end of January, key healthcare legislation that has been in limbo since a December 2024 spending bill fell apart may recapture the attention of Congress, say attorneys at Faegre Drinker.

  • FDA Biosimilar Guidance Should Ease Biologics Development

    Author Photo

    New draft guidance from the U.S. Food and Drug Administration, indicating that the agency may no longer routinely require comparative efficacy studies when other evidence provides sufficient assurance of biosimilarity, underscores the FDA's trust in analytical technology as a driver of biologics access, say attorneys at Hogan Lovells.

  • Prison Body Cams Raise Health Privacy Compliance Issues

    Author Photo

    The increasing use of prison staff body cameras to enhance transparency and safety presents correctional healthcare partners with new risk management questions where they must carefully reconcile the benefits of surveillance with the imperative to protect patient privacy, say attorneys at Gordon Rees.

  • Employer Considerations After 11th Circ. Gender Care Ruling

    Author Photo

    The Eleventh Circuit's en banc decision in Lange v. Houston County, Georgia, finding that a health plan did not violate Title VII by excluding coverage for gender-affirming care, shows that plans must be increasingly cognizant of federal and state liability as states pass varying mandates, say attorneys at Miller & Chevalier.