Policy & Compliance

  • March 10, 2026

    Lab's Aetna Payment Suit Survives, But With Deep Cuts

    A Connecticut federal judge ruled Aetna and its parent company, CVS Health Corp., must face a pared down lawsuit from a medical laboratory alleging it is owed $20.6 million in unpaid invoices.

  • March 10, 2026

    Wash. To Set Its Own Vaccine Schedule Under New State Law

    Washington Gov. Bob Ferguson has signed legislation that requires health plans to cover vaccines and other preventive care recommended by the state rather than the federal government, joining a movement toward states setting their own recommendations.

  • March 10, 2026

    4th Circ. Backs W.Va.'s Trans Care Coverage Exclusion

    The Fourth Circuit said Tuesday that West Virginia's Medicaid coverage exclusion for gender-affirming care passes constitutional muster and does not discriminate based on sex, basing its conclusion on a U.S. Supreme Court ruling that upheld Tennessee's ban on gender-affirming care for minors.

  • March 10, 2026

    CVS Can't 'Relitigate' Price-Gouging Class Cert.

    A Rhode Island federal judge refused to narrow the certified classes of health plans alleging CVS schemed with pharmacy benefit managers to overcharge insured health plans for generic drugs, finding that PBM Express Scripts' refusal to produce its contracts changes nothing about how the classes will be assessed.

  • March 10, 2026

    2nd Circ. Revives Geico's Suit Over Acupuncture Referrals

    A lower court erred in granting summary judgment to Geico after the insurer sued over reimbursements to an acupuncturist involved in what Geico said was a kickback scheme, the Second Circuit ruled Tuesday, finding the district court misinterpreted a state law detailing requirements for referrals and no-fault payments. 

  • March 10, 2026

    Minn. Medicaid Funds Case A Test For CMS Tactic

    Minnesota’s fight over $243 million in Medicaid funding frozen by the Trump administration sets up an unusual, politically tinged legal clash that may shape the government’s anti-fraud tactics in other states.

  • March 10, 2026

    Wyoming Abortion Ruling Sets Off Lawmaker Backlash

    Lawmakers in Wyoming won't let judges have the final word on abortion and have considered slashing judicial security funding and shrinking the top court. This week, the governor signed a new "heartbeat" abortion ban likely to see new legal challenges.

  • March 10, 2026

    Former Conn. Prosecutor Can Stay On Generic-Drug Case

    Connecticut's former assistant attorney general can continue to represent insurers Humana and Molina Healthcare Inc. in multidistrict litigation over alleged price-fixing of generic drugs, after the Pennsylvania federal judge overseeing the case agreed Monday with a report that the attorney has no information that had not already been shared.

  • March 10, 2026

    AFSCME Sues Trump Admin Over $600M Health Funding Cuts

    The American Federation of State, County and Municipal Employees is seeking to block a federal government directive to cancel more than $600 million in public health grants administered by the Centers for Disease Control and Prevention, alleging that the directive was issued to target Democratic-led states.

  • March 10, 2026

    Abortion Ban, Drug Pricing: Health Litigation Week In Review

    Indiana's abortion ban and religious freedom, a proposed class action over Express Scripts pricing, and a deal over abortion pill ads. Law360 looks at big legal developments from the past week.

  • March 09, 2026

    Texas AG Gets Temporary Ban On Chest Binder Sales

    A Texas state judge has issued a temporary restraining order against a New York-based online retailer of undergarments and chest binders for young women and teens from selling its clothing in the Lone Star State.

  • March 09, 2026

    Vehicle Manufacturer Strikes Deal In Tobacco Surcharge Suit

    Commercial vehicle manufacturer International Motors LLC has agreed to end a proposed class action claiming it unlawfully charges employees who use tobacco products an additional $600 per year for health insurance without providing an alternative to the fee, according to a filing in Illinois federal court.

  • March 09, 2026

    NC Providers Sue UnitedHealth Over 'Devastating' Cyberattack

    UnitedHealth Group Inc. and several of its subsidiaries are facing a proposed class action in North Carolina state court over a 2024 data breach that took its claims processing platform offline and allegedly delayed billions of dollars in reimbursements to providers.

  • March 09, 2026

    JPMorgan Trims But Can't Escape ERISA Drug Costs Suit

    A New York federal judge pared claims Monday against JPMorgan Chase & Co. in a suit from workers who alleged they paid too much for prescription drugs, but opened discovery on allegations that the bank's contract with its pharmacy benefit manager caused transactions prohibited by federal benefits law.

  • March 06, 2026

    ExThera Exec Hid Patient Deaths To Keep $10M Deal, DOJ Says

    Medical device company ExThera concealed the deaths of two U.S. patients treated with its unapproved blood filtration device at a clinic in Antigua, according to federal prosecutors, with the company agreeing to forfeit nearly $5.7 million and one executive facing up to three years in prison.

  • March 06, 2026

    Health Groups Back Bid To Bar Noncitizen Benefit Restrictions

    A group of public health organizations and scholars Friday urged a Rhode Island federal court to make permanent its order blocking the Trump administration from enacting a policy change basing access to a host of federally funded services on immigration status.

  • March 06, 2026

    FDA Vaccine Chief Prasad To Exit Agency For 2nd Time

    Dr. Vinay Prasad, the U.S. Food and Drug Administration's top vaccine regulator, will leave the agency in the coming weeks, FDA Commissioner Marty Makary said Friday.

  • March 06, 2026

    9th Circ. Mulls Whether Politics Tainted DOJ Trans Care Probe

    A Ninth Circuit panel on Friday grappled with where to draw the line between a legitimate law enforcement investigation and a politically motivated crusade, as the U.S. Department of Justice sought to revive a subpoena against a telehealth provider of gender-affirming medical care.

  • March 06, 2026

    Mass. Judge Told Vax Committee Must Be Fairly Balanced

    A key federal vaccine committee remains subject to statutory requirements that its membership be fairly balanced, a Massachusetts federal judge heard from both U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. and medical organizations challenging his overhaul of the group.

  • March 06, 2026

    Dentist Says She Was Fired For Exposing Medicaid Fraud

    A dentist filed suit against several West Michigan dental practices and a dental management company, claiming she was fired after reporting that the clinics billed Medicaid for dental procedures that were never performed.

  • March 05, 2026

    Telehealth Co. Swaps In Gordon Rees In Novo's GLP-1 Fight

    A telehealth platform facing allegations from Novo Nordisk that it falsely advertised Ozempic alternatives has picked new counsel in the dispute, withdrawing attorneys from Foley & Lardner LLP and Miller Nash LLP and substituting in two lawyers from Gordon Rees Scully Mansukhani LLP.

  • March 05, 2026

    Pharma Co. Investors Secure Class Cert. Over FDA Obstacles

    A Pennsylvania federal judge has granted certification to a group of Verrica Pharmaceuticals Inc. investors who claim the company defrauded them by hiding obstacles it faced in obtaining approval from the U.S. Food and Drug Administration for its lead product, though she made a slight change to the class definition to avoid what she called a "heads I win, tails you lose strategy."

  • March 05, 2026

    9th Circ. Denies Bail Pending Nurse Wage-Fixing Appeal

    A Ninth Circuit panel summarily refused to allow a Las Vegas home nursing executive to avoid prison while appealing the U.S. Department of Justice's first-ever criminal wage-fixing conviction.

  • March 05, 2026

    9th Circ. Judge 'Frustrated' At DOJ Position On Anti-Trans EOs

    A Ninth Circuit judge said Thursday he's "very frustrated" with the Trump administration's argument that a district court judge acted prematurely by partly blocking executive orders to end funding for gender-affirming care, saying it's "pretty clear" the government was poised to do exactly that.

  • March 05, 2026

    BCBS Can't Nix NC Plan Member From Cancer Treatment Row

    A North Carolina federal judge ruled a Blue Cross Blue Shield unit must face proposed class action claims over its administration of a state employee health plan from a participant alleging it arbitrarily characterized a proton beam cancer radiation treatment as experimental to deny coverage.

Expert Analysis

  • A Shifting Trend In FDA Form 483 Disclosure Obligations

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    A New York federal court's Checkpoint Therapeutics decision extends a recent streak of dismissals of securities class actions alleging that pharmaceutical companies failed to disclose U.S. Food and Drug Administration Form 483 inspection reports, providing critical guidance for companies during the FDA approval process, say attorneys at Alston & Bird.

  • The Future Of Lab-Test Regs After FDA Rescinds Rule

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    The U.S. Food and Drug Administration recently rescinded its laboratory-developed tests rule in response to a Texas federal court decision this spring, reinforcing a separation of authority between the FDA and the Centers for Medicare & Medicaid Services, and calling into question the FDA's role in overseeing such tests without congressional action, say attorneys at Venable.

  • Unpacking Ore. Law's Limits On PE Healthcare Investment

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    A recent Oregon law imposes significant restrictions on nonphysicians owning or controlling medical practices, but newly enacted amendments provide some additional flexibility in certain ownership arrangements without scuttling the law's intent of addressing concerns about the rise of private equity investment in healthcare, say attorneys at Debevoise.

  • Criminal Healthcare Fraud Takeaways From 4th Circ. Reversal

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    After the Fourth Circuit reversed a doctor’s postconviction acquittal in U.S. v. Elfenbein last month, defense attorneys should consider three strategies when handling complex criminal healthcare matters, says Jonathan Porter at Husch Blackwell.

  • AG Watch: Texas Embraces The MAHA Movement

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    Attorneys at Kelley Drye examine Texas Attorney General Ken Paxton's actions related to the federal Make America Healthy Again movement, and how these actions hinge on representations or omissions by the target companies as opposed to specific analyses of the potential health risks.

  • How States Are Regulating Health Insurers' AI Usage

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    The absence of a federal artificial intelligence framework positions states as key regulators of health insurers’ AI use, making it important for payors and service providers to understand the range of state AI legislation being passed in California and elsewhere, and consider implementing an AI-focused compliance infrastructure, say attorneys at Ropes & Gray.

  • HHS Plan To Cut Immigrant Benefits Spurs Provider Questions

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    A recent notice from the U.S. Department of Health and Human Services identifying new federal public benefit programs for which nonqualified aliens are not eligible may have a major impact on entities that participate in these programs — but many questions remain unanswered, say attorneys at Foley.

  • Noncompete Forecast Shows Tough Weather For Employers

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    Several new state noncompete laws signal rough conditions for employers, particularly in the healthcare sector, so employers must account for employees' geographic circumstances as they cannot rely solely on choice-of-law clauses, say lawyers at McDermott.

  • Previewing State Efforts To Regulate Mental Health Chatbots

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    New York, Nevada and Utah have all recently enacted laws regulating the use of artificial intelligence to deliver mental health services, offering early insights into how other states may regulate this area, say attorneys at Goodwin.

  • How DOJ's New Data Security Rules Leave HIPAA In The Dust

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    The U.S. Department of Justice's recently effective data security requirements carry profound implications for how healthcare providers collect, store, share and use data — and approach vendor oversight — that go far beyond the Health Insurance Portability and Accountability Act, say attorneys at Nelson Mullins.

  • Texas Med Spas Must Prepare For 2 New State Laws

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    Two new laws in Texas — regulating elective intravenous therapy and reforming healthcare noncompetes — mark a pivotal shift in the regulatory framework for medical spas in the state, which must proactively adapt their operations and contractual practices, says Brad Cook at Munsch Hardt.

  • DOJ-HHS Collab Crystallizes Focus On Health Enforcement

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    The recently announced partnership between the U.S. Department of Justice and U.S. Department of Health and Human Services to combat False Claims Act violations, following a multiyear trend of high-dollar DOJ recoveries, signals a long-term enforcement horizon with major implications for healthcare entities and whistleblowers, say attorneys at RJO.

  • How The Healthline Privacy Settlement Redefines Ad Tech Use

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    The Healthline settlement is the first time California has drawn a clear line in the sand around how website tracking must function in practice, so if your site uses tracking technologies, especially around sensitive content like health or finance, regulators are inspecting your website's back end, not just its banner, say attorneys at Baker Donelson.