Policy & Compliance

  • August 14, 2026

    AstraZeneca Joins States Aiming To Block Ill. 340B Drug Law

    AstraZeneca on Friday joined some other large pharmaceutical companies in urging an Illinois federal court to block a new state law that prohibits drugmakers from restricting the types or number of pharmacies healthcare providers can contract with to provide medications under a federal discount drug program.

  • August 14, 2026

    United, Ga. Providers Settle Out-Of-Network Benefits Pay Fight

    United Healthcare has settled claims that three Georgia medical providers that are outside the insurer's network requested "exorbitantly high" reimbursements for care provided to United customers, according to documents filed in Georgia federal court.

  • August 14, 2026

    NC County Sues Bankrupt Hospital Operator For $10M

    North Carolina's Martin County has sued CHS/Community Health Systems Inc. for $10 million in North Carolina federal court, alleging the company failed to honor its obligations to run Martin General Hospital after its affiliate filed for Chapter 7 in 2023.

  • August 14, 2026

    Idaho Abortion Ban Needs Health Exceptions, Judge Finds

    An Idaho federal judge barred the state from criminalizing abortions in cases where continuing a pregnancy puts a patient at risk of lasting harm or death via self-harm, finding that the 14th Amendment establishes a fundamental right to health- and life-preserving abortion care.

  • August 13, 2026

    Albertsons Didn't Flag Suspicious Opioid Orders, Judge Hears

    Albertsons failed to report its pharmacies' unusual opioid orders to the U.S. Drug Enforcement Administration despite explicit instructions from the agency to do so, the retailer's vice president of pharmacy compliance testified Thursday during a bench trial in Washington's lawsuit accusing the chain of exacerbating the state's opioid epidemic.

  • August 13, 2026

    Blue Cross Affiliates Get Trim Of Aramark Health Benefits Row

    A Pennsylvania federal judge on Thursday trimmed but refused to toss a federal benefits lawsuit from food service giant Aramark against a Blue Cross affiliate that administered the company's employee health benefit plans, opening discovery on allegations that improper claims management cost tens of millions and breached fiduciary duties.

  • August 13, 2026

    J&J Says No To Reviving Stelara Case

    Johnson & Johnson has asked the Fourth Circuit not to revive CareFirst's antitrust suit alleging the company tried to monopolize the market for the immunosuppressive drug Stelara.

  • August 13, 2026

    Wash. Halts Conversion Therapy Ban For Therapist Amid Suit

    Washington state has agreed not to enforce its ban on a practice commonly known as conversion therapy against a therapist while his First Amendment challenge to the prohibition plays out in federal court, according to a stipulation entered Thursday.

  • August 13, 2026

    Vaccine Challengers Slam Connecticut's 'One-Party Rule'

    Challengers to Connecticut's mandatory school vaccination laws have accused political leaders of exercising "one-party rule" over state government, claiming the House speaker, governor and attorney general, who are all Democrats, tweaked or defended state laws specifically to stymie their religious freedom claims.

  • August 13, 2026

    Employers Expecting Bump In Health Plan Costs, Survey Says

    GLP-1 medications and catastrophic coverage claims are two leading factors employers anticipate will push health plan costs up 10% in 2027, according to new data released Thursday by the International Foundation of Employee Benefit Plans.

  • August 13, 2026

    Glenmark Will Pay $15.3M To End Humana's Price-Fixing Claims

    The U.S. arm of Glenmark Pharmaceuticals Ltd. has agreed to settle generic-drug price-fixing claims brought by Humana Inc. in three lawsuits centralized in Pennsylvania-based multidistrict litigation, according to a filing with Indian stock exchanges.

  • August 13, 2026

    NC Biz Court Bulletin: Judges Retire, HCA Suit Heads To Trial

    The North Carolina Business Court dropped a host of heavy-hitting opinions in July ahead of two judicial retirements and a new chief judge rising in the ranks.

  • August 12, 2026

    Full 5th Circ. Rejects Planned Parenthood's Immunity Appeal

    The full Fifth Circuit Wednesday tossed an appeal over whether Planned Parenthood is entitled to attorney immunity in a whistleblower suit accusing the organization of improper Medicaid billing, reversing a panel's decision that went in favor of Planned Parenthood.

  • August 12, 2026

    Albertsons Judge Hears Testimony On Rx Opioid, Abuse Link

    An "undeniable" causal link exists between excess prescription opioids and problem use of drugs such as heroin and fentanyl, an expert witness testified during a bench trial Wednesday in Washington's lawsuit accusing Albertsons of fueling the state's overdose crisis by irresponsibly dispensing opioids.

  • August 12, 2026

    Feds Enter FCA Suit, Say 3 Health Cos. Overbilled Medicare

    The federal government has intervened in a False Claims Act suit accusing a trio of Colorado healthcare companies of conspiring to file inflated claims for services they never rendered in order to get more money from Medicare and Tricare.

  • August 12, 2026

    Full 5th Circ. Invalidates Part Of No Surprises Act Rules

    The full Fifth Circuit partially unraveled federal regulations that implemented an arbitration system between insurers and out-of-network providers that Congress established in a 2020 law called the No Surprises Act, holding aspects of how the rules calculated payment amounts for disputed claims were unlawful.

  • August 12, 2026

    DC Physician Group Settles ERISA Plan Mismanagement Suit

    A George Washington University-affiliated physician group has agreed to settle a suit claiming it allowed its $345 million retirement plan to be bogged down by underperforming and pricey investment funds, according to a filing Tuesday in D.C. federal court.

  • August 12, 2026

    9th Circ. Says Aetna Must Face Benefit Misrepresentation Suit

    The Ninth Circuit revived allegations that Aetna misrepresented how much it would pay toward a patient's $150,000 surgery, finding that federal benefits law didn't preempt a claim brought under state law because the dispute centered on the payment commitments rather than the health plan itself.

  • August 12, 2026

    CMS Ends Medicaid Funds For Youth Transgender Care

    Medicaid will no longer cover the cost of some gender-affirming care for minors, including gender reassignment surgery and hormone treatments, the Centers for Medicare and Medicaid Services announced after issuing a final rule set to take effect this year. 

  • August 11, 2026

    CMS Fraud Concerns Drive Call For Autism Therapy Audits

    Healthcare providers who work with autistic people are facing greater scrutiny from the federal government over fraud concerns. Experts say the drivers of ballooning costs are complex.

  • August 11, 2026

    Fed. Circ. Revives Man's Vax Injury Case, Citing Mail Delay

    The Federal Circuit reversed a U.S. Court of Federal Claims decision that rejected a man's case seeking vaccine injury compensation, concluding that the court wrongly faulted him for the late arrival of his petition.

  • August 11, 2026

    Judge Probes 7th Circ. Fallout Of Ending Gender Care Fight

    An Illinois federal judge questioned Tuesday what would become of a pending appeal before the full Seventh Circuit if he allows the American Academy of Pediatrics to voluntarily dismiss, without prejudice, its challenge to a Florida racketeering probe over the medical group's gender-affirming care guidelines, an issue one attorney predicted would be "hotly contested."

  • August 11, 2026

    What To Know About Hartford HealthCare Privilege Row

    Hartford HealthCare, a Teamsters health insurance plan and a transit district are heading to court to argue over whether Hartford must produce documents in an antitrust lawsuit accusing the hospital group of exercising monopoly power.

  • August 11, 2026

    DOJ Drops 3rd Circ. Bid For Pa. Hospital Trans Patient Info

    The U.S. Department of Justice has dropped its request for the Third Circuit to review a district court's order quashing its demand for records on patients who received gender-affirming care at a University of Pittsburgh Medical Center children's hospital, effectively ending its subpoena fight in the district.

  • August 11, 2026

    Ga. Justices Call For Balancing Privacy Rights In Herpes Suit

    Georgia's top court ruled Tuesday that the privacy rights of a man accused of giving his ex-girlfriend genital herpes must be balanced against her interest in obtaining medical records to support her claims, resolving what the justices called a novel question.

Expert Analysis

  • What Rescheduling Means For Cannabis Labels, Marketing

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    The proposed reclassification of cannabis is expected to bring heightened scrutiny of labeling, advertising and marketing from the U.S. Food and Drug Administration and the Federal Trade Commission, but the brands that tighten evidence, standardize operations and professionalize marketing controls now will see fewer surprises and better outcomes, say attorneys at Wilson Elser.

  • What's At Stake In Possible Circuit Split On Medicaid Rule

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    A recent Eleventh Circuit decision, reviving Florida's lawsuit against a federal rule that reduces Medicaid funding based on agreements between hospitals, sets up a potential circuit split with the Fifth Circuit, with important ramifications for states looking to private administrators to run provider tax programs, say Liz Goodman, Karuna Seshasai and Rebecca Pitt at FTI Consulting.

  • Courts' Rare Quash Of DOJ Subpoenas Has Lessons For Cos.

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    In a rare move, three federal courts recently quashed or partially quashed expansive U.S. Department of Justice administrative subpoenas issued to providers of gender-affirming care, demonstrating that courts will scrutinize purpose, cabin statutory authority and acknowledge the profound privacy burdens of overbroad government demands for sensitive records, say attorneys at ArentFox Schiff.

  • Remote Patient Monitoring Is At Regulatory Inflection Point

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    With remote patient monitoring at the center of new federal pilot programs and a recent report from the U.S. Department of Health and Human Services' Office of Inspector General examining Medicare billing for those services, it is clear that balancing innovation and risk will be a central challenge ahead for digital health stakeholders, say attorneys at Morgan Lewis.

  • Utah's AI Prescription Renewal Pilot Could Inform Policy

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    Utah recently became the first state to approve an artificial intelligence system for autonomously renewing certain prescription medicines, providing a test case for how regulators may be able to draw boundaries between administrative automation and medical judgment, say Jashaswi Ghosh at Holon Law Partners and Bryant Godfrey at Foley Hoag.

  • Ramped Up Psychedelic Production Carries Opportunity, Risk

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    Kimberly Chew at Husch Blackwell discusses the key legal implications of the U.S. Drug Enforcement Administration's recent dramatic increases in the production quotas for a range of psychedelic substances, offering guidance on compliance, risk management and strategic opportunities for practitioners navigating this rapidly evolving landscape.

  • New Biotech Nat'l Security Controls May Have Blunted Impact

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    While the newly enacted federal prohibition against contracting with certain biotechnology providers associated with countries of concern may have consequences on U.S. companies' ability to develop drugs, the restrictions may prove to be less problematic for the industry than the significant publicity around their passage would suggest, say attorneys at Wilson Sonsini.

  • Takeaways From The DOJ Fraud Section's 2025 Year In Review

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    Former acting Principal Deputy Chief Sean Tonolli of the U.S. Department of Justice's Fraud Section, now at Cahill Gordon, analyzes key findings from the section’s annual report — including the changes implemented to adapt to the new administration’s priorities — and lays out what to watch for this year.

  • 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.