Policy & Compliance

  • March 23, 2026

    Progressive Escapes Workers' Tobacco, Vaccine Fee Suit

    Allegations that Progressive Corp. wrongly charged higher health premiums from workers who used tobacco or refused the COVID-19 vaccination failed to state a claim for violating federal benefits law, an Ohio federal judge ruled as he tossed a proposed class action against the insurance giant.

  • March 23, 2026

    Feds Approve Minnesota's Plan To Combat Medicaid Fraud

    Minnesota may soon receive the release of $243 million in deferred Medicaid funds after the Centers for Medicare & Medicaid Services approved the state's updated plan to combat Medicaid fraud, Minnesota state health officials told a federal court last week.

  • March 23, 2026

    Health Insurers Can't Force Conn. ERISA Row Into Arbitration

    Elevance Inc. can't compel arbitration of a union health plan's allegations the insurer caused it to pay excessive administrative fees and medical costs, a Connecticut federal judge ruled, finding the insurer and its subsidiaries waived that right by seeking to dismiss the proposed class action.

  • March 23, 2026

    High Court Won't Hear Mich. Newborn Blood Testing Case

    The U.S. Supreme Court on Monday declined to hear a petition from parents seeking to revive claims that the way newborn blood samples are collected and stored in a Michigan health screening program violates their rights to make medical decisions for their children.

  • March 23, 2026

    Justices Won't Review Lab Owner's Kickback Conviction

    The U.S. Supreme Court on Monday declined to review the conviction of a former California biotech president sentenced to eight years in prison for lying about the efficacy of his company's COVID-19 and allergy testing and conducting a $70 million Medicare fraud scheme. 

  • March 23, 2026

    High Court Won't Hear Calif. Border Hospital Medicaid Fight

    The U.S. Supreme Court said Monday it would not consider a case challenging California's exclusions of hospitals in neighboring states from supplemental federal payments going to providers that serve Medi-Cal beneficiaries.

  • March 20, 2026

    Feds Rip Ex-NFL Player's New Trial Bid Over Medicare Scheme

    The federal government opposed a new trial bid by Keith Gray, a former NFL player and Texas laboratory owner convicted in a $328 million scheme involving billing for unnecessary cardiovascular genetic testing for Medicare beneficiaries, arguing Thursday he lacks any valid basis to "disturb the jury's sound verdict."

  • March 20, 2026

    EPA's Ethylene Oxide Plan May Hinder Other Air Toxics Regs

    A new proposal from the U.S. Environmental Protection Agency to weaken emission standards for a medical sterilizer could have broader implications for the agency's power to tighten air pollution limits when new science becomes available.

  • March 20, 2026

    Pa. Hospital Must Pay $109M For Brain Injury During Birth

    Jefferson Health and its subsidiary Einstein Healthcare Network have been hit with a nearly $109 million verdict by a Philadelphia jury in a lawsuit accusing them of negligence leading to debilitating brain injuries sustained by a child delivered at one of their hospitals.

  • March 20, 2026

    Mich. BCBS Unit Gets Health Plans' Claims Fight Transferred

    A federal judge granted Blue Cross Blue Shield of Michigan's request to transfer a proposed class action alleging the insurance company violated federal benefits law by mismanaging claims in self-funded employee healthcare plans it administered, given that a similar, earlier-filed action was proceeding in an adjacent district.

  • March 20, 2026

    Eye On ERISA: A Chat With King & Spalding's Darren Shuler

    Increased scrutiny of health plans and the high costs of care are fueling a litigation uptick that's coming not just from plan participants but also from employers frustrated with their third-party administrators, said Darren Shuler, a partner at King & Spalding LLP. Here, Shuler speaks with Law360 about litigation trends involving the Employee Retirement Income Security Act.

  • March 19, 2026

    HHS Can't Block Trans Care Under Kennedy Edict, Court Says

    A coalition of 21 states and the District of Columbia prevailed on Thursday in their challenge to a Trump administration move to cut access to gender-affirming care for minors when an Oregon federal judge agreed to void a policy statement from Health and Human Services Secretary Robert F. Kennedy Jr.

  • March 19, 2026

    Pharma Group Can't Halt Colo. Law Over Drug Discount Rules

    A Colorado federal judge denied a bid by the Pharmaceutical Research and Manufacturers of America seeking to halt enforcement of a state law guarding providers' ability to contract with pharmacies to distribute discounted drugs under the federal 340B program.

  • March 19, 2026

    Legislative Update: Cannabis And Psychedelics Bill Roundup

    Virginia lawmakers last week gave final approval to legislation that would tax and regulate the sale of adult-use cannabis, Georgia legislators passed a dramatic expansion of the state's medical cannabis program, and Iowa lawmakers approved a bill to designate kratom as a Schedule I substance. Here are the major moves in cannabis and psychedelics legislation from the past week.

  • March 19, 2026

    11th Circ. Partially Reopens Aetna Twin Birth Coverage Fight

    The Eleventh Circuit on Thursday undid Aetna's escape from a worker's coverage dispute over an extended hospital stay for her newborn twins, agreeing with the lower court that allegations failed to state a claim for violating federal benefits law but holding that an amended complaint should have been allowed.

  • March 19, 2026

    Calif. Families Sue Rady Health Over Move To End Trans Care

    Four families have asked a state judge to prevent California's largest pediatric health system from cutting off gender-affirming care for minors, alleging the move would violate state antidiscrimination laws and leave them scrambling to find new providers, some more than 100 miles away.

  • March 19, 2026

    CVS, Caremark Pocket Money Meant For Rebates, Suit Claims

    CVS charges drug manufacturers "exorbitant" fees in exchange for pushing their products, then pockets the money instead of funneling it toward customer rebates as it promises, a federal lawsuit alleges, accusing the company of collecting billions of dollars at customers' expense and violating the anti-racketeering statute.

  • March 18, 2026

    Key Details As 3rd Circ. Ponders FCA's Fate, $1.6B J&J Fine

    Third Circuit judges Wednesday explored divergent views of the False Claims Act's constitutionality and a record fraud verdict against Johnson & Johnson, expressing little eagerness to gut the FCA's whistleblower mechanism, and voicing uncertainty about evidence and jury instructions underpinning the drug promotion punishment.

  • March 18, 2026

    SelectQuote Looks To Escape Investors' Kickback Probe Suit

    SelectQuote has asked a New York federal judge to dismiss a proposed class action accusing it of harming investors by concealing a kickback scheme, which is currently the subject of a suit by the U.S. Department of Justice, arguing the existence of the government's suit is not enough to show the shareholders were damaged.

  • March 18, 2026

    UnitedHealth Customers Denied Class Cert. In PrEP Suit

    Two UnitedHealthcare customers can't turn their Affordable Care Act lawsuit against a company subsidiary into a class action, a Minnesota federal judge ruled Wednesday, denying the pair's bid to represent thousands of customers in litigation accusing the subsidiary of failing to approve full coverage for PrEP.

  • March 18, 2026

    Ed. Dept. Flouting Mental Health Funding Order, States Claim

    The U.S. Department of Education is flouting orders that it fund K-12 mental health grants given to public schools by only partially funding the grants and threatening to withhold remaining funds, a group of state attorneys general told a Washington federal court.

  • March 18, 2026

    Doctor Gets 6½ Years For Healthcare Fraud, Tax Evasion

    An Anchorage, Alaska, physician was sentenced to six and a half years in prison for committing over $16 million in healthcare fraud and tax evasion as part of a scheme that injected sick patients with the wrong medications or dosages, the federal government said Wednesday. 

  • March 18, 2026

    ADA Challenge to Oregon Psilocybin Law Can Proceed

    An Oregon federal judge Tuesday rejected the state's health regulator's bid for a favorable judgment in a suit brought under federal antidiscrimination law, seeking to broaden access for homebound patients to the state's regulated psilocybin program.

  • March 18, 2026

    Health Litigator Rejoins Holland & Knight From In-House Role

    A former Holland & Knight LLP attorney has returned to the firm in Jacksonville, Florida, after a 10-year stint in-house at Florida Blue, a subsidiary of GuideWell Mutual Holding Corp.

  • March 18, 2026

    FDA Can't 'Refuse To File' Tobacco Applications, Suit Says

    The maker and a seller of Zone nicotine pouches are suing the U.S. Food and Drug Administration in Texas federal court, alleging the agency stalled and eventually refused to file their marketing application, despite federal law requiring the FDA to either approve or deny such applications.

Expert Analysis

  • 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.

  • How Sweeping Budget Bill Shakes Up Health Industry

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    With the recently passed One Big Beautiful Bill Act marking one of the most significant overhauls of federal health policy since the passage of the Affordable Care Act, providers, managed care organizations and life sciences companies must now shift focus from policy review to implementation planning, say advisers at Holland & Knight.

  • New DOJ Penalty Policy Could Spell Trouble For Cos.

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    In light of the U.S. Department of Justice’s recently published guidance making victim relief a core condition of coordinated resolution crediting, companies facing parallel investigations must carefully calibrate their negotiation strategies to minimize the risk of duplicative penalties, say attorneys at Debevoise.

  • A Look At Key 5th Circ. White Collar Rulings So Far This Year

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    In the first half of 2025, the Fifth Circuit has decided numerous cases of particular import to white collar practitioners, which collectively underscore the critical importance of meticulous recordbuilding, procedural compliance and strategic litigation choices at every stage of a case, says Joe Magliolo at Jackson Walker.

  • What US Medicine Onshoring Means For Indian Life Sciences

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    Despite the Trump administration's latest moves to onshore essential medicine manufacturing, India will likely remain an indispensable component of the U.S. drug supply chain, but Indian manufacturers should prepare for stricter compliance checks, says Jashaswi Ghosh at Holon Law Partners.

  • FCA Working Group Reboot Signals EHR Compliance Risk

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    The revival of the False Claims Act working group is an aggressive expansion of enforcement efforts by the Justice Department and the U.S. Department of Health and Human Services targeted toward technology-enabled fraud involving electronic health records and other data, say attorneys at ArentFox Schiff.