Policy & Compliance

  • July 15, 2026

    NC Panel Nixes Nurse Noncompetes For Being 'Too Broad'

    A medical clinic provider couldn't convince a North Carolina state appeals court to overturn a ruling that noncompete agreements for two former nurses were unenforceable, after a split panel ruled Wednesday that the terms were overly broad and voidable under public policy.

  • July 15, 2026

    United Owes $630K In Fight Over Teen's Mental Health Care

    United Healthcare must pay $630,000 to a mother who challenged the insurance company's decision to deny coverage for her son's residential mental health treatment, a Utah federal judge ordered, after rejecting the company's bid to slim her requests for interest and attorney fees.

  • July 15, 2026

    Mass. Says UnitedHealth FCA Case Belongs In State Court

    Massachusetts asked a federal judge to send its $100 million state False Claims Act lawsuit alleging overbilling by UnitedHealthcare back to state court, accusing the insurer of forum shopping with a theoretical defense touching on federal law.

  • July 15, 2026

    DC Circ. Affirms Ratings For Alignment Medicare Plans

    The D.C. Circuit sided with the Centers for Medicare & Medicaid Services regarding its decision not to discard certain unfavorable surveys for Alignment Healthcare's Medicare Advantage plans, saying there is no indication of an administrative error.

  • July 14, 2026

    Albertsons Probed On Pharmacy Compliance Staffing At Trial

    Two former Albertsons pharmacy compliance executives testified in video depositions played Tuesday before a Washington judge considering whether Albertsons failed to prevent the diversion of opioids in the state, acknowledging the nationwide compliance team consisted of just six staffers between 2015 and 2020 despite heightened scrutiny amid the opioid epidemic.

  • July 14, 2026

    3rd Circ. Revives Providers' Underpayment Suit Against Cigna

    The Third Circuit partially revived several New Jersey-based healthcare practices' Employee Retirement Income Security Act suit alleging Cigna improperly underreimbursed them for covered healthcare services provided to Cigna's subscribers, ruling Monday the plaintiffs sufficiently alleged they were underpaid for some out-of-network services when compared to their normal charges for similar services.

  • July 14, 2026

    Patent Eligibility Bill Divides Senators Over Health Costs

    Several U.S. senators expressed strong support at a hearing Tuesday for a bill aimed at expanding which inventions are eligible for patents, while others appeared to have reservations about the potential effect of the proposed changes on healthcare costs.

  • July 14, 2026

    Medical Device Co. Settles FCA Claims

    A company that sells compression devices to reduce swelling in patients with certain medical conditions will pay $551,000 to settle allegations that it obtained Medicare reimbursement with falsified medical records, the U.S. attorney's office in Massachusetts announced Tuesday.

  • July 14, 2026

    FDA Resumes Drug Denial Letters Amid Secrecy Clash

    Drugmakers are examining a new batch of drug application rejection letters released by the U.S. Food and Drug Administration this month — the first disclosure since regulators paused the releases amid industry outcry.

  • July 14, 2026

    CVS Caremark Settles Out Of FTC Suit Over Insulin Pricing

    The Federal Trade Commission reached a settlement on Tuesday with CVS Caremark that includes a number of changes to its business practices, the second deal in a case accusing the country's largest pharmacy benefit managers of inflating insulin prices through unfair rebate schemes.

  • July 14, 2026

    The Latest Medicare Star Lawsuits: What You Need To Know

    Following a win in a Georgia federal court for a health plan challenging a Medicare Advantage Star Ratings calculation, Law360 Healthcare Authority looks at a recent batch of insurer lawsuits seeking to capitalize on the ruling.

  • July 14, 2026

    1st Circ. Backs CDC Ban On Importing Dogs Under 6 Months

    The First Circuit has upheld a rule requiring all dogs imported into the U.S. to be at least six months of age, saying the federal Centers for Disease Control and Prevention had shown it was a reasonable measure to fight rabies.

  • July 14, 2026

    DOJ Asks 9th Circ. Undo Trans Health Ruling Against Premera

    The federal government has backed Premera Blue Cross in its bid at the Ninth Circuit to overturn a Washington federal court's judgment that held the insurance company's coverage policy for gender dysphoria surgery is discriminatory, arguing the decision is out of line with U.S. Supreme Court precedent.

  • July 14, 2026

    Clinics Want Medicaid Abortion Stay Lifted After Pa. Court Win

    Allegheny Reproductive Health Center and other healthcare providers on Tuesday asked a Commonwealth Court judge to unfreeze money for Medicaid-funded abortions in Pennsylvania following the court's landmark ruling that the state's coverage exclusions for such abortions were unconstitutional.

  • July 14, 2026

    Kroger Says Flimsy Claims Doom Tobacco Fee Suit

    Grocery giant Kroger urged an Ohio federal judge to toss a suit challenging the legality of an extra health plan fee it charged tobacco users, stating it complied with federal benefits law by giving workers a 90-day window each year to dodge the fee by enrolling in a wellness program.

  • July 14, 2026

    HHS Wields Checkbook To Pressure State Fraud Units

    Cutting off federal funding to Medicaid fraud units in New York and Hawaii could reshape the enforcement priorities of similar units across the country. The HHS watchdog has made clear the agency wants states to lean in on criminal Medicaid fraud cases.

  • July 14, 2026

    Amgen Colo. Win May Chill States' Push To Cap Drug Prices

    A Colorado injunction blocking a prescription drug pricing statute may have thrown a wrench into efforts in other states to limit drug costs for consumers through a new crop of state oversight boards.

  • July 13, 2026

    Albertsons, Safeway Face Trial Over Wash.'s Opioid Epidemic

    Albertsons and Safeway ignored signs of problematic opioid prescriptions in Washington for years, an attorney for the state told a Seattle judge Monday during opening statements in a bench trial over allegations that the pharmacy chains failed to prevent the diversion of opioids that fueled the state's long-running overdose crisis.

  • July 13, 2026

    2nd Circ. Says Tylenol Maker Must Face Autism, ADHD Suits

    The Second Circuit said Monday that a lower court had wrongly excluded plaintiffs experts from testifying about an alleged relationship between using Tylenol during pregnancy and autism spectrum disorder and attention-deficit/hyperactivity disorder, although the panel cautioned that the decision was not political or scientific.

  • July 13, 2026

    J&J Asks 3rd Circ. To Block Return Of Ex-Worker's Fee Claims

    Johnson & Johnson has asked the Third Circuit to keep dismissed excessive fee claims out of a proposed class action alleging the company charged employees too much for a prescription drug benefits program, arguing that the lower court correctly tossed that portion of the suit for lack of standing.

  • July 13, 2026

    Northwell Escapes Suit Over Pension Plan Conversion

    Northwell Health defeated a proposed class action alleging it hid cuts to workers' pension plans when converting to a cash-balance plan in the late 1990s, with a New York federal judge finding the hospital system adequately disclosed how the change could impact participants' benefits.

  • July 13, 2026

    Health Org. Can't Halt FTC Texas Suit Over Trans Youth Care

    A D.C. federal court declined to bar the Federal Trade Commission from pursuing a consumer protection suit in Texas against the World Professional Association for Transgender Health, finding WPATH failed to show those proceedings threatened the court's injunction of a related investigation by the FTC.

  • July 13, 2026

    Utah Health System Beats 401(k) Suit Over Stable Value Fund

    A Utah federal judge tossed a suit by workers who claimed a western U.S. health system kept an underperforming stable value fund in a retirement plan and greenlighted excessive management fees, ruling their case lacks evidence that the plan could have secured better funds and fees.

  • July 10, 2026

    JPMorgan Workers Defend ERISA Suit Over High Drug Costs

    JPMorgan employees urged a New York federal judge on Friday not to end their Employee Retirement Income Security Act suit alleging they paid too much for prescription drugs, arguing JPMorgan still has not shown that its contract with its pharmacy benefit manager was reasonable.

  • July 10, 2026

    States' Stopgap Suit Aims To Shield K-12 Mental Health Grants

    Washington and 14 other states launched a preemptive lawsuit Friday to stop the Trump administration from ending federal grants for mental health programming in public schools, seeking to preserve the funding if the U.S. Department of Education succeeds in asserting new grounds for canceling the grants in a related case.

Expert Analysis

  • Traditional FCA Enforcement Surges Amid Shifting Priorities

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    The U.S. Department of Justice’s January report on False Claims Act enforcement in fiscal year 2025 reveals that while the administration signaled its intent to expand FCA enforcement into new areas such as tariffs, for now the greatest exposure remains in traditional areas like healthcare — in which the risk is growing, say attorneys at Debevoise.

  • 3 Key Ohio Financial Services Developments From 2025

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    Ohio's banking and financial services sector saw particularly notable developments in 2025, including a significant Ohio Supreme Court decision on creditor disclosure duties to guarantors in Huntington National Bank v. Schneider, and some major proposed changes to the state's Homebuyer Plus program, says Alex Durst at Durst Kerridge.

  • Rescheduling Cannabis Marks New Tax Era For Operators

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    As the attorney general takes steps to move cannabis from Schedule I to Schedule III of the Controlled Substances Act, operators and advisers should prepare by considering the significant changes this will bring from tax, state, industry and market perspectives, says Michael Harlow at CohnReznick.

  • Justices' Med Mal Ruling May Spur Huge Shift For Litigators

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    The U.S. Supreme Court’s recent decision in the medical malpractice suit Berk v. Choy, holding that a Florida procedural requirement does not apply to medical malpractice claims filed in federal court, is likely to encourage eligible parties to file claims in federal court, speed the adjudicatory process and create both opportunities and challenges for litigators, says Thomas Kroeger at Colson Hicks.

  • 5 Drug Pricing Policy Developments To Watch In 2026

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    2026 may prove to be a critical year for drug pricing in the U.S., with potential major shifts including several legislative initiatives moving forward after being in the works for years, and more experimentation on the horizon concerning GLP-1s and Section 340B pricing, say attorneys at Manatt.

  • Regulatory Uncertainty Ahead For Organ Transplant System

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    Pending court cases against a Centers for Medicare and Medicaid Services final rule that introduced a competition-centric model for assessing organ procurement organizations' performance will significantly influence the path forward for such organizations and transplant hospitals, say attorneys at Crowell & Moring.

  • Key False Claims Act Trends From The Last Year

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    The False Claims Act remains a powerful enforcement tool after some record verdicts and settlements in 2025, and while traditional fraud areas remain a priority, new initiatives are raising questions about its expanding application, says Veronica Nannis at Joseph Greenwald.

  • It's Too Soon To Remove Suicide Warnings From GLP-1 Drugs

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    The U.S. Food and Drug Administration's decision this month to order removal of warnings about the risk of suicidal thoughts from GLP-1 weight-loss drugs is premature — and from a safety and legal standpoint, the downside of acting too soon could be profound, says Sean Domnick at Rafferty Domnick.

  • What To Know About DOL's New FLSA, FMLA Opinion Letters

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    The U.S. Department of Labor kicked off 2026 by releasing several opinion letters addressing employee classification, incentive bonuses and intermittent leave, reminding employers that common practices can create significant risk if they are handled inconsistently or without careful documentation, say attorneys at Woods Rogers.

  • What Changed For Healthcare Transaction Law In 2025

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    Though much of the legislation introduced last year to expand state scrutiny of healthcare transactions did not pass, investors should pay close attention to the overarching trends, which are likely to continue in this year's legislative sessions, say attorneys at Ropes & Gray.

  • Expect State Noncompete Reforms, FTC Scrutiny In 2026

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    Employer noncompete practices are facing intensified federal scrutiny and state reforms heading into 2026, with the Federal Trade Commission pivoting to case-by-case enforcement and states continuing to tighten the rules, especially in the healthcare sector, say attorneys at DLA Piper.

  • CMS 2027 Proposal Is Mixed Bag For Medicare Advantage

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    The Centers for Medicare and Medicaid Services' recent proposed rule for the Medicare Advantage and Part D programs gives small organizations reason for optimism, although certain elements may be inconsistent with the Centers' desire to enhance competition, says Christine Clements at Sheppard Mullin.

  • 3 Key Takeaways From Planned Rescheduling Of Cannabis

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    An executive order reviving cannabis rescheduling represents a monumental change for the industry and, while the substance will remain illegal at the federal level, introduces several benefits, including improving state-legal cannabis operators' tax treatment, lowering the industry's legal risk profile, and leaving state-regulated markets largely intact, say attorneys at Dentons.