Policy & Compliance

  • June 12, 2026

    Aetna Can't Nix Unfair Practices Claims In Medical Billing Row

    A Washington acupuncture clinic and doctor accused of submitting fraudulent bills for medical services may proceed with their counterclaims against Aetna for unfair trade practices under the state's Consumer Protection Act, a federal court ruled.

  • June 12, 2026

    $1.9M Deal In Health System Retirement Suit Gets 1st OK

    A Michigan federal judge granted initial approval to a $1.9 million deal between a health system and a proposed class of employee retirement plan participants who alleged underperforming investment options violated federal benefits law, greenlighting a deal that was first submitted to the court for approval in late April.

  • June 11, 2026

    Ed. Dept. Tries New Tack To Scrap K-12 Mental Health Grants

    The U.S. Department of Education pressed ahead with its plan to end up to a billion dollars in school mental health grants, arguing Wednesday that a Seattle federal judge's December 2025 injunction barring the discontinuation of the grants shouldn't block the government from canceling the contracts outright.

  • June 11, 2026

    AbbVie Loses Colorado 340B Drug Pricing Law Challenge

    A Colorado federal judge on Wednesday dismissed all of AbbVie Inc.'s claims against the state over its federal 340B drug pricing law, finding that the Colorado law isn't federally preempted and courts across the country have settled the issue.

  • June 11, 2026

    Stop & Shop Parent Pays $40M On Inflated Drug Price Claims

    Stop & Shop's parent company will pay $40 million to resolve allegations it violated the False Claims Act by failing to report discounted prescription drug prices as "usual and customary" in claims submitted to federal Medicare, Medicaid and TRICARE programs, which resulted in overcharges, the U.S. Department of Justice announced Wednesday.

  • June 11, 2026

    HHS OIG Reports 'Concerning' Medicare Advantage Denials

    A pair of reports released by the inspector general for the U.S. Department of Health and Human Services on Thursday found that UnitedHealth Group, Humana and CVS Health logged some of the highest prior authorization denial rates among their Medicare Advantage peers for post-acute care.

  • June 11, 2026

    Braidwood Files New Challenge To ACA Birth Control Mandate

    For-profit healthcare company Braidwood Management and several individuals sued the government in Texas federal court to challenge no-cost contraception coverage requirements under the Affordable Care Act, arguing that the court should enjoin enforcement of the policy because it burdened their faith in violation of federal religious freedom law.

  • June 10, 2026

    Morgan & Morgan Atty Again Blocked From Harvard Suit

    A Massachusetts judge rebuffed a Morgan & Morgan PA attorney's second attempt to appear in a lawsuit over the theft of body parts from a Harvard Medical School morgue, saying he would not reconsider his earlier decision to bar the attorney over an incident in a separate court involving fake AI-generated case citations.

  • June 10, 2026

    Judge Won't Certify Class Of Health Workers In No-Poach Suit

    An Illinois federal judge on Wednesday refused to certify a class of former healthcare employees claiming that their wages were suppressed by alleged no-poach agreements among DaVita, UnitedHealth Group's Surgical Care Affiliates and Tenet Healthcare Corp. unit United Surgical Partners International, ruling that the proposed class is too diverse.

  • June 10, 2026

    Abbott Offered Faulty Health Plan Option, Ex-Worker Says

    Abbott Laboratories violated federal benefits law by offering a health plan option with higher premiums and lower deductibles without disclosing that participants would always pay less if they chose a high-deductible plan, according to a proposed class action filed Wednesday in Illinois federal court.

  • June 10, 2026

    NJ High Court Says Nonprofit Hospital Gets Limited Immunity

    The New Jersey Supreme Court unanimously concluded Wednesday that a nonprofit federally qualified health center isn't immune from a patient's negligence suit under a statute shielding nonprofits organized "exclusively" for charitable or educational purposes, reversing a lower court's finding to the contrary.

  • June 10, 2026

    Insurance Cos. Score Dismissal Of Zepbound Coverage Case

    A D.C. federal judge Wednesday agreed to toss a proposed class action against CVS Caremark and CareFirst BlueCross BlueShield from a worker who challenged coverage denials for Zepbound to treat sleep apnea, holding an exclusion in his employee health plan that the companies administered complied with federal benefits law.

  • June 10, 2026

    Lab To Pay $4.9M To Settle AGs' COVID Test Pricing Suit

    Eighteen states' attorneys general have entered into a $4.87 million settlement with GS Labs to resolve claims that the defunct testing company overcharged consumers for COVID-19 tests, according to statements issued Wednesday.

  • June 10, 2026

    Houston Hospital System Settles Retirement Fee, Fund Fight

    A Texas hospital system agreed to settle a proposed class action from ex-workers alleging the healthcare nonprofit failed to curb excessive recordkeeping fees and remove underperforming funds from its $2.8 billion employee retirement plan, after a magistrate judge recommended denying its motion to dismiss an amended complaint in May.

  • June 09, 2026

    Novartis, AbbVie Lose Bid To Halt Wash. 340B Pharmacy Law

    A Washington federal judge declined Tuesday to block a state law passed to protect prescription drug access for low-income and uninsured patients, rejecting arguments from AbbVie and Novartis that the new measure illegally adds to pharmaceutical manufacturers' obligations under the federal 340B Drug Pricing Program.

  • June 09, 2026

    Trans Care In Court: 7th Circ. Appeal, Atty Discipline And More

    Law360 Healthcare Authority looks at an emergency request related to the American Academy of Pediatrics, a Rhode Island judge's referral of Justice Department attorneys to a disciplinary committee, and other top news of the past week.

  • June 09, 2026

    Calif. Judge Blocks DOJ's Bid For Trans Patients' Medical Info

    A California federal judge ordered Stanford Medicine hospital not to disclose medical information belonging to trans adolescents who received gender-related care in response to a Texas grand jury subpoena, and blocked the U.S. Department of Justice from taking further steps to obtain their patient records.

  • June 09, 2026

    Eli Lilly Wins Order Halting Alleged Trulicity Fraud

    A Florida federal judge signed off Tuesday on a preliminary injunction pausing a prescription cost share program purportedly for Church of God in Christ members that pharmaceutical giant Eli Lilly and Co. says is actually a fraud scheme to resell GLP-1 drug Trulicity on the secondary market.

  • June 09, 2026

    Loper Battle Looms For Medicaid Frailty Work Exemption

    New federal work requirements for people on Medicaid take a strict view of who's too sick to work. They're almost certain to face legal challenges contending that the Trump administration went too far.

  • June 09, 2026

    4th Circ. Lets Hartford Unit Off The Hook For Drug Test Fight

    A Hartford unit doesn't owe coverage to a drug testing company accused of reporting false positive drug tests due to substandard quality control, the Fourth Circuit ruled Tuesday, saying the suit is related to an earlier claim that was covered by another insurer.

  • June 09, 2026

    The Law360 400: A Look At The Top 100 Firms

    The race to build the legal industry's largest law firm accelerated in 2025, with major firms leaning on mergers, lateral hiring and strategic expansion to climb the ranks of the Law360 400.

  • June 09, 2026

    Georgia County, Trans Deputy OK End To Surgery Bias Fight

    A Georgia county and a transgender sheriff's deputy who sued over her employee health plan's coverage exclusions for gender-affirming surgery have struck a deal to resolve her case, nine months after the en banc Eleventh Circuit issued a ruling that sided with the county. 

  • June 08, 2026

    Kaiser Member Seeks Class Cert. In Microsoft Site Tracker Suit

    A Kaiser Permanente member has called on a federal judge in Seattle to greenlight a series of national classes and California subclasses in her privacy lawsuit accusing Microsoft and Qualtrics of secretly intercepting millions of patients' private health information through tracking technologies embedded in the healthcare system's website.

  • June 08, 2026

    NC Doctor Avoids Prison For Role In $11M Medicaid Fraud

    A North Carolina doctor received five years of probation with eight months of house arrest for making false statements in an $11 million Medicaid fraud scheme, after a federal judge said he was struggling to balance the need to deter others with unwarranted sentencing disparities.

  • June 08, 2026

    Cleveland Clinic Deal With DOJ Bars Trans Care For Minors

    The Cleveland Clinic Foundation will pay over $2.3 million under agreements with the U.S. Department of Justice and the Ohio attorney general to prohibit the provision of puberty blockers and other forms of medical care for minors going through gender transition.

Expert Analysis

  • 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.

  • How Healthcare Practices Can Prepare For ICE Visits

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    Healthcare providers that may face encounters with immigration enforcement should familiarize themselves with compliance obligations beyond ensuring employment authorization, and mitigate risk by establishing clear policies and specific procedures that safeguard patient rights and manage staff interactions with agents, say attorneys at Roetzel & Andress.

  • Adapting To Calif.'s Enhanced Regulation Of PE In Healthcare

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    New California legislation enhances oversight on the role of private equity groups and hedge funds in healthcare transactions, featuring both a highly targeted nature and vague language that will require organizations to carefully evaluate existing practices, says Andrew Demetriou at Husch Blackwell.

  • Lessons From 7th Circ. Decision Affirming $183M FCA Verdict

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    The Seventh Circuit's decision to uphold a $183 million False Claims Act award against Eli Lilly engages substantively with recurring materiality and scienter questions and provides insights into appellate review of complex trial court judgments, say Ellen London at London & Naor, Li Yu at Bernstein Litowitz and Kimberly Friday at Osborn Maledon.

  • Calif. Justices Continued Anti-Arbitration Trend This Term

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    In the 2024-2025 term, the California Supreme Court justices continued to narrow arbitration's reach under state law, despite state courts' extreme caseload backlog and even as they embraced contractual autonomy in other contexts, says Josephine Petrick at The Norton Law Firm.

  • Steps For Healthcare Providers After Cigna ERISA Settlement

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    Following the Cigna class action's settlement, where Employee Retirement Income Security Act violations arose from Cigna's online provider directory advertising providers as in-network who were actually out-of-network, providers should routinely audit their contract status and directory listings, and proactively coordinate with plans and payor partners, say attorneys at ArentFox Schiff.