Policy & Compliance

  • June 29, 2026

    8th Circ. Backs Tossing Ark. Worker's Pharmacy Network Suit

    The Eighth Circuit on Monday turned down an employee health plan participant's bid to revive a proposed class action alleging CVS Caremark unjustly enriched itself by failing to comply with Arkansas laws on pharmacy network adequacy, holding a lower court didn't err in tossing the dispute.

  • June 29, 2026

    Supreme Court To Review Wash. Youth Gender Care Law

    The U.S. Supreme Court will hear a challenge to Washington state's law permitting shelters not to notify the parents of runaway teens who seek gender-affirming treatment, reviving a lawsuit that a Ninth Circuit panel unanimously shot down after a district judge found the plaintiffs could only show speculative injury.

  • June 29, 2026

    Justices Skip New York Health Workers' Fight Over Vax Rule

    The U.S. Supreme Court refused Monday to take up religious healthcare workers' challenge to a pandemic-era New York state policy requiring healthcare providers to make their employees get vaccinated against COVID-19, drawing a dissent from Justices Neil Gorsuch, Clarence Thomas and Samuel Alito.

  • June 26, 2026

    Conn. Provider Must Share Takeover Data After $49M Verdict

    A Connecticut state court has ordered Westchester Medical Group PC to produce corporate takeover documents and leadership information as the court contemplates the provider's bid to set aside a $49 million jury verdict over claims its staff failed to diagnose a woman with cervical cancer.

  • June 26, 2026

    En Banc 4th Circ. Splits Over Stay Of DOD HIV Enlistment Ban

    The Fourth Circuit voted en banc Thursday to grant the federal government's bid to pause a lower court's permanent injunction blocking its policies excluding HIV-positive individuals from enlisting in the military, with a dissenting appellate judge writing that "the government is playing games!"

  • June 26, 2026

    DC Circ. Backs CMS In Medicare Advantage Rating Fight

    A D.C. Circuit panel on Friday upheld the Centers for Medicare & Medicaid Services' calculation of a Louisiana insurer's Medicare Advantage star rating, rejecting the insurer's claims that the agency unlawfully included data from a contract that had been folded into another one.

  • June 26, 2026

    5 ERISA Cases To Keep An Eye On In The Second Half Of 2026

    A U.S. Supreme Court challenge to Intel Corp.'s 401(k) investment lineup tops the list of cases benefits attorneys will be watching this summer and fall, though appeals involving health plan tobacco fees, plan forfeiture spending and a potential Eleventh Circuit precedent shift are also top of mind. Here, Law360 looks at five ERISA cases that attorneys should have on their radar as 2026 rolls on.

  • June 26, 2026

    High Court To Issue Big Decisions In Term's Final Days

    As the U.S. Supreme Court enters the final days of its term, the justices still have several major decisions to issue, including some concerning birthright citizenship, the president's power to remove independent agency officials, transgender athletes and election rules. 

  • June 25, 2026

    Sandoz Still Can't Escape Generics Claims From GM, Others

    A Pennsylvania federal judge on Thursday declined to rethink her decision forcing Sandoz's Swiss parent company to face generic-drug price-fixing claims from major employers like American Airlines Inc. and General Motors LLC, saying the pharmaceutical company "has no new evidence" backing up its argument that the court lacks personal jurisdiction.

  • June 25, 2026

    Texas Faces Tough Questions In Tylenol Autism Appeal

    A Texas appellate court seemed skeptical Thursday of an argument that the parent entities of the company that sells Tylenol should have to defend claims that the pain reliever causes autism, suggesting that the companies don't have enough ties to Texas.

  • June 25, 2026

    Netflix Urges Justices Not To Disturb 9th Circ. ERISA Docs Ruling

    Netflix urged the U.S. Supreme Court Thursday not to take up a petition from an employee health plan participant who alleged the company failed to provide him access to plan documents in violation of federal benefits law, arguing the Ninth Circuit's ruling in the case should remain in place.

  • June 25, 2026

    Wash. Therapist Seeks Bar On 'Conversion Therapy' Ban

    A Washington therapist has urged a federal court to bar the state from enforcing its ban on what is commonly known as conversion therapy, arguing that a U.S. Supreme Court decision this year has "vindicated" his right to provide counseling targeted by the ban.

  • June 25, 2026

    Novo Nordisk Gets 401(k) Investment Suit Narrowed

    A New Jersey federal judge dismissed allegations accusing Novo Nordisk of unlawfully keeping underperforming investment options in its employee 401(k) plan, handing the pharmaceutical company a partial win by concluding workers hadn't identified comparable funds that performed significantly better.

  • June 24, 2026

    NY Judge Halts DOJ Bid For Trans Youth Medical Records

    A New York federal judge Wednesday barred the U.S. Department of Justice from seeking medical records of transgender patients who received gender-affirming care as minors in the wake of a grand jury subpoena to NYU Langone Health System, saying the government's investigation doesn't outweigh the patients' privacy interests.

  • June 24, 2026

    Delta Dental Says Wash. Antitrust Suit Echoes Faulty Claims

    Delta Dental of Washington said Tuesday an Evergreen State dentist targeting the dental insurer in a proposed antitrust class action has excluded its national affiliates from the case to "escape from a federal court's rejection of identical arguments" that the companies conspired to stifle insurer competition and suppress reimbursement rates.

  • June 24, 2026

    Wholesalers Say Novo Can't Duck GLP-1 Antitrust Suits

    Drug buyers want a New York federal judge to preserve proposed class claims accusing Novo Nordisk of paying Teva to delay generic competition with its Victoza GLP-1 drug, arguing that whatever the underlying deal was, no generic version materialized when it could have.  

  • June 24, 2026

    Doc's Defamation Claim Against Cigna Barred By ERISA

    In a precedential opinion dealing with an issue of first impression, the Third Circuit on Wednesday held that the Employee Retirement Income Security Act preempts a doctor's defamation claim against Cigna because the statements stemmed from the administration of his patients' health plans.

  • June 24, 2026

    11th Circ. Urged To Toss Convictions In $1.4B Hospital Fraud

    Two brothers convicted in a $1.4 billion scheme to bill insurers inflated rates for drug tests told the Eleventh Circuit on Wednesday that there was insufficient evidence to support their convictions and that they should have been allowed an evidentiary hearing after potential juror misconduct emerged following the trial.

  • June 24, 2026

    3rd Circ. Extends Lenient Retaliation Test To ADA, FMLA Suits

    The Third Circuit declared Wednesday that the long-standing, worker-friendly standard used to evaluate Title VII retaliation claims also applies to analogue allegations under the Americans with Disabilities Act and the Family and Medical Leave Act, kickstarting a former Marine's suit over a leaner-than-expected bonus and pay raise.

  • June 24, 2026

    UnitedHealthcare Turns Blame On MassHealth In Fraud Case

    UnitedHealthcare said it plans to defend itself against accusations that it overcharged Massachusetts for senior care, claiming the state's Medicaid program was not properly administered as it moved the case to federal court. 

  • June 23, 2026

    Kaiser Owes LA County Hospital $82M In Out-Of-Network Suit

    Kaiser Permanente's health coverage arm must pay more than $82 million to Pomona Valley Hospital Medical Center to cover unreimbursed emergency medical services, a California state judge ordered Tuesday, after a state appeals court backed a jury's verdict concerning payment for roughly 4,000 disputed medical service claims.

  • June 23, 2026

    Texas Woman Says ERs Violated EMTALA Amid Miscarriage

    A Texas woman urged the U.S. Centers for Medicare & Medicaid Services to investigate two providers over their alleged violations of the Emergency Medical Treatment and Labor Act, or EMTALA, when she sought treatment for a miscarriage, arguing her case "is not an isolated incident."

  • June 23, 2026

    What To Know About State-Level PBM Reform

    Healthcare attorneys are keeping a close eye on new laws focused on the vertical integration of pharmacy benefit managers.

  • June 23, 2026

    FTC Tells 4th Circ. Court Got It Wrong In J&J Stelara Case

    The Federal Trade Commission has told the Fourth Circuit that a Virginia federal court messed up when it ruled in an antitrust suit against Johnson & Johnson that the company bringing the suit needed to show specific intent in order to prop up a monopolization claim over the immunosuppressive drug Stelara.

  • June 23, 2026

    What To Know About The Missouri Abortion Law Ruling

    Nearly two years after Missouri residents enshrined reproductive rights into the state constitution, a judge ruled that more than three dozen state laws conflicted with the 2024 ballot amendment. Law360 Healthcare Authority looks at the case and what it means for abortion law in the Show-Me State.

Expert Analysis

  • 2025 State AI Laws Expand Liability, Raise Insurance Risks

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    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

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    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

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    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

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    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

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    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

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    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

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    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

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    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

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    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

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    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

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    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

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    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

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    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.