Policy & Compliance

  • May 01, 2026

    Diagnostic Imaging Co. Pays $8.3M To End FCA Case

    An Orange County medical scan company will pay $8.3 million to resolve allegations it violated the False Claims Act by paying kickbacks to referring cardiologists to supervise positron emission tomography scans, California federal prosecutors said Friday. 

  • May 01, 2026

    Hospitals Say HHS Is Withholding Safety Net Reimbursements

    For more than 20 years, the U.S. Department of Health and Human Services has failed to pay tens of millions in reimbursements to hospitals serving low-income populations by incorrectly factoring service days for patients enrolled in Medicare Part C, a coalition of 91 medical centers claimed in a D.C. federal lawsuit.

  • May 01, 2026

    5th Circ. Pauses Mail-Order Access To Abortion Pills

    The Fifth Circuit on Friday reinstated an in-person dispensing requirement for the abortion medication mifepristone, blocking mail-order access while a challenge to a Biden administration regulation brought by Louisiana officials moves forward.

  • May 01, 2026

    Calif. Sued Over Ballot Measure For Health Clinic Fund Use

    Federally designated community health clinics that serve vulnerable populations sued the California secretary of state and a union to keep an initiative off the November 2026 ballot that would control their budgets and expenditures, warning it could lead to shutdowns, disrupt patients' access to services and have other devastating consequences.

  • May 01, 2026

    DOJ Asks 4th Circ. To Revive Children's Hospital Subpoena

    The U.S. Department of Justice is asking the Fourth Circuit to reverse a district court order quashing its subpoena of transgender minor records from Children's National Hospital in Maryland, arguing that the patients' families — who sued to block the subpoena — lacked standing to bring a HIPAA challenge.

  • May 01, 2026

    Med Groups Say HHS Stalling Challenge To Vax Changes

    A Massachusetts federal judge on Friday rejected the government's request to pause discovery in a challenge by medical groups to the Trump administration's new childhood vaccination schedule while it appeals his March order blocking the changes.

  • May 01, 2026

    Medical Practice's Assets Targeted After $49M Verdict

    The Westchester Medical Group PC has only disclosed $2 million worth of insurance against a $49 million malpractice verdict that could nearly double during an expected appeal, a Connecticut cancer patient and her husband said in seeking to secure the defendant's property and other assets now.

  • May 01, 2026

    Mylan Inks $11M Deal With NC Over EpiPen Pricing

    North Carolina Attorney General Jeff Jackson announced Thursday that the state has inked an $11 million settlement with EpiPen distributor Mylan Pharmaceuticals, resolving claims of anticompetitive conduct and funneling millions back into public healthcare programs.

  • April 30, 2026

    Gov't Pauses Medicaid Data Use For ICE Amid Injunction Fight

    The Trump administration agreed at a hearing Thursday to temporarily halt the use of 22 states' Medicaid data for immigration enforcement purposes until a San Francisco federal judge clarifies the boundaries of an injunction that the largely Democratic-controlled states had accused the government of flouting.

  • April 30, 2026

    Debt Collectors Owe Charity Care Notice, Wash. Justices Say

    Just as hospitals must inform low-income patients they might qualify for financial assistance, so too must agencies collecting on medical debt, the Washington Supreme Court clarified Thursday.

  • April 30, 2026

    Jury Begins Mulling If Doctors Are Liable For Fatal Overdose

    A Philadelphia jury on Thursday began deliberations in a lawsuit accusing two doctors of enabling a 26-year-old man with chronic back pain to become hooked on opioid painkillers and fatally overdose.

  • April 30, 2026

    Trump Taps 3rd Surgeon General Pick, Drops Casey Means

    President Donald Trump nominated his third pick to be surgeon general on Thursday, withdrawing consideration for Casey Means after her confirmation stalled in the Senate. 

  • April 30, 2026

    Supplement Industry Says FDA Wrongly Muzzled Label Claims

    A coalition of dietary supplement companies and an alternative medicine advocacy group filed suit Wednesday against the U.S. Food and Drug Administration, claiming that the agency violated First Amendment commercial speech protections when it blocked product label claims connecting certain nutrients or ingredients to health outcomes.

  • April 30, 2026

    Mental Health Co. Can't Undo Jury Verdict In NC Wage Suit

    A mental healthcare company's bid to throw out a jury verdict finding it willfully violated federal and state wage laws fell short because its post-trial arguments lacked supporting evidence, a North Carolina federal judge ruled Thursday.

  • April 30, 2026

    NC Biz Court Bulletin: Corporate Raid, MV Realty Settlement

    A major case settled in the North Carolina Business Court in April as new lawsuits emerged, including a complaint by health information technology company IQVIA Holdings Inc. accusing its former top brass of orchestrating a corporate raid and defecting to a competitor. In case you missed this story and others, here are the highlights.

  • April 30, 2026

    Express Scripts, Cigna Seek End To Ohio PBM Price Suit

    After the Sixth Circuit ruled that a legal dispute between Ohio and a group of pharmacy benefit managers belongs in federal court, Express Scripts and Cigna now want dismissed the lawsuit accusing them of participating in an antitrust conspiracy that is driving up prescription drug prices. 

  • April 30, 2026

    Kroger's Health Plan Tobacco Fee Shirks ERISA, Suit Says

    Supermarket giant Kroger violated federal benefits law by requiring workers to pay an extra fee through their health plan if they used tobacco while failing to give them a fair opportunity to avoid the charge, according to a proposed class action filed in Ohio federal court.

  • April 30, 2026

    Feds Appeal Order Freezing CDC Childhood Vaccine Changes

    The Trump administration said late Wednesday that it's appealing a court order that stopped its pared-down childhood vaccine schedule from going into effect.

  • April 29, 2026

    CEO Stole From His Company To Buy Mansion, SEC Says

    The former CEO of a California-based pharmaceutical company agreed Wednesday to pay the U.S. Securities and Exchange Commission $30,000 to end a lawsuit accusing him of misappropriating $3.2 million in company funds partly to buy a Beverly Hills mansion.

  • April 29, 2026

    Novo Nordisk Rejects Claim It Influences GLP-1 Market

    Pharmaceutical giant Novo Nordisk told a Texas federal judge that it does not control the GLP-1 market and has not attempted to crush its competition in a bid to dismiss an antitrust suit it is facing.

  • April 29, 2026

    PBMs Say Michigan AG Price-Fixing Suit Is Unsound

    Pharmacy benefit managers Express Scripts, Evernorth Health and Prime Therapeutics have bolstered their effort to escape a federal price-fixing suit brought against them by Michigan's attorney general by arguing the statutes cited in the complaint do not apply to them.

  • April 29, 2026

    Mass. AG, Insurer Settle Deceptive Marketing Claims For $5M

    A Texas-headquartered health insurance agency will pay $5 million to settle allegations that it engaged in deceptive and unfair marketing to sell plans and other types of health programs to thousands of Massachusetts consumers, the state's attorney general announced on Wednesday.

  • April 29, 2026

    5th Circ. Will Rehear Aetna Arbitration Bid In Aramark Suit

    The full Fifth Circuit will reconsider insurance company Aetna's bid to force uniform and food services company Aramark to arbitrate its dispute over employee health benefit claims, staying a panel's ruling from December that had kept proceedings in court.

  • April 29, 2026

    AbbVie Seeks Early Win Over HHS In Botox Drug Price Suit

    When the federal government included Botox in Medicare's drug price negotiation program, which allows Medicare officials to negotiate for lower drug prices, it overstepped its authority, drugmaker AbbVie Inc. told a D.C. federal court, arguing the cosmetic drug and migraine treatment is a "plasma-derived" product ineligible for price controls.

  • April 29, 2026

    Medical Equipment Co. Settles Patient Overbilling Claims

    Patients who claim Pennsylvania-based AdaptHealth Corp. overcharged them for returned medical equipment have reached the final version of a class settlement and will soon submit it to a North Carolina federal court for approval, they told the court this week.

Expert Analysis

  • Organ Transplant System Reforms Mark Regulatory Overhaul

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    Recent oversight, enforcement and operational developments in the U.S. organ procurement and transplantation system, alongside challenges like the federal shutdown, highlight heightened regulatory scrutiny and the need for compliance to maintain public trust, say attorneys at Hall Render.

  • Federal Grantees May Soon Face More Limitations On Speech

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    If courts accept the administration’s new interpretation of preexisting case law, which attempts to graft onto grant recipients the existing limitations on government contractors' free speech, a more deferential standard may soon apply in determining whether an agency’s refusal or termination of a grant was in violation of the First Amendment, say attorneys at Venable.

  • HHS Wound Care Report Highlights Need For Payment Reform

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    The U.S. Department of Health and Human Services' recent report on potential abuse in Medicare Part B payments for skin substitutes highlights specific fraud schemes, but more importantly emphasizes that broader changes are needed for the wound care sector's fundamentally flawed payment system, say attorneys at Paul Hastings.

  • Assessing The Future Of The HIPAA Reproductive Health Rule

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    In light of a Texas federal court's recent decision to strike down a U.S. Department of Health and Human Services rule aimed to protect the privacy of patients seeking abortions and gender-affirming care, entities are at least temporarily relieved from compliance obligations, but tensions are likely to continue for the foreseeable future, says Liz Heddleston at Woods Rogers.

  • DOJ's Tracing Rule For Pandemic Loan Fraud Is Untenable

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    In conducting investigations related to COVID-19 relief fraud, the government's assertion that loan proceeds are nonfungible and had to have been segregated from other funds is unsupported by underlying legislation, precedent or the language establishing similar federal relief programs, say Sharon McCarthy, Jay Nanavati and Lasya Ravulapati at Kostelanetz.

  • New Health AI Guidance Features A Provider-Centric Approach

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    New guidance from the Joint Commission and Coalition for Health AI regarding the responsible use of artificial intelligence in healthcare deviates from preexisting guidance by recommending a comprehensive framework for using AI tools, focusing on healthcare provider organizations rather than on AI developers, say attorneys at Ropes & Gray.

  • Mass. Ruling May Pave New Avenue To Target Subpoenas

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    A Massachusetts federal court’s recent decision to quash a subpoena seeking information on gender-affirming care at Boston Children’s Hospital is a significant departure from courts' deferential approach to subpoena enforcement, and may open a new pathway for practitioners challenging investigative tools in the future, say attorneys at Gibson Dunn.

  • What To Expect After FDA Warnings To GLP-1 Compounders

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    The U.S. Food and Drug Administration's recent warning letters to companies advertising compounded versions of GLP-1 medications raise questions not just about the enforcement outlook for marketing such products, but also about the future of drug compounding as a whole, say attorneys at Spencer Fane.

  • How Financial Cos. Can Prep As NYDFS Cyber Changes Loom

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    Financial institutions supervised by the New York State Department of Financial Services can prepare for two critical cybersecurity requirements relating to multifactor authentication and asset inventories, effective Nov. 1, by conducting gap analyses and allocating resources to high-risk assets, among other steps, say attorneys at Pillsbury.

  • How Courts May Interpret Data-Driven Healthcare Fraud Suits

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    As the U.S. Department of Justice and other agencies increasingly turn to data mining as an enforcement tool, courts will have to determine how far data alone can take a fraud case, and sound theory, clinical expertise and institutional context will play an important role, say Jaime Jones at Sidley and Andrée-Anne Fournier and Atang Gilika at Analysis Group.

  • How Gov't Shutdown Will Affect Federal Health Agencies

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    Federal health agencies' contingency plans indicate that many major programs will remain insulated from disruption during the ongoing government shutdown, but significant policy proposals will likely be delayed and the Trump administration's emphasis on reduction-in-force plans distinguishes this shutdown from past lapses, says Miranda Franco at Holland & Knight.

  • Assessing Legal, Regulatory Hurdles Of Healthcare Offshoring

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    The offshoring of administrative, nonclinical functions has emerged as an increasingly attractive option for healthcare companies seeking to reduce costs, but this presents challenges in navigating the web of state restrictions on the access or storage of patient data outside the U.S., say attorneys at McDermott.

  • 5 Years In, COVID-19 Fraud Enforcement Landscape Is Shifting

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    As the government moves pandemic fraud enforcement from small-dollar individual prosecutions to high-value corporate cases, and billions of dollars remain unaccounted for, companies and defense attorneys must take steps now to prepare for the next five years of scrutiny, says attorney David Tarras.