Policy & Compliance

  • July 01, 2026

    Big Pharma Cos. Want 340B Drug Price FCA Suit Tossed

    Four major pharmaceutical companies Wednesday urged a California federal court to toss False Claims Act allegations revived by the Ninth Circuit claiming they filed false ceiling prices for drugs and overcharged entities covered by a federal discount program, saying the suit is precluded by the FCA's public disclosure bar.

  • July 01, 2026

    Gov't Officials Tout Unprecedented Healthcare Fraud Push

    It's been an unprecedented year for healthcare fraud enforcement, senior government officials from the U.S. Justice Department and Department of Health and Human Services told conference attendees gathered in a ballroom Wednesday morning at the Midtown Hilton in Manhattan.

  • July 01, 2026

    Amgen Wins Order Blocking Colorado's Enbrel Price Cap

    Colorado is preliminarily blocked from enforcing its price cap on Amgen's rheumatoid arthritis drug Enbrel, a federal judge ruled Wednesday, saying the biotech company is likely to succeed on its claim that federal patent law preempts the state's effort to limit the price of patented medications.

  • July 01, 2026

    8th Circ. Keeps Missouri's 340B Contract Pharmacy Law Alive

    The Eighth Circuit declined Wednesday to temporarily block a Missouri law that bars drugmakers from imposing restrictions on federally funded providers that contract with pharmacies to distribute discount drugs in the 340B drug discount program.

  • June 30, 2026

    Health Attys Talk Cooperation In Gov't Fraud Investigations

    For attorneys defending healthcare clients hit with grand jury subpoenas and other enforcement actions investigating potential cases of fraud, cooperation with federal prosecutors is key.

  • June 30, 2026

    AIDS Group Says Cigna-Owned Express Scripts Hurts Patients

    AIDS Healthcare Foundation says its nonprofit wellness centers are going to be run out of business if Cigna-owned pharmacy benefit manager Express Scripts isn't stopped from using its muscle in the market to steer pharmacy patients toward specialty pharmacies it's affiliated with.

  • June 30, 2026

    What To Know As Sen. Cassidy Proposes Changes To 340B

    Newly introduced Senate legislation could radically change the scope of the 340B drug discount program, including by altering how providers tap discounts and provider deals with pharmacies.

  • June 30, 2026

    Remedies, Not Suits: How FTC Approaches Health Mergers

    The Federal Trade Commission has not sued over any healthcare provider mergers since President Donald Trump's return to the White House. Attorneys at the American Health Law Association annual meeting say that's not a signal that the agency is backing off.

  • June 30, 2026

    Judge To Mull Surgeon's Dismissal Bid In 'No Surprises' Suit

    A New Jersey court will soon decide whether allegations that a plastic surgeon abused No Surprises Act arbitration can move forward. Law360 looks at a closely watched case testing what role courts play in this and other NSA disputes.

  • June 30, 2026

    Cigna, Others Fight Ohio AG's Drug Price-Fixing Suit

    Ohio pharmacy benefit managers and their corporate parents urged a federal judge to toss the state's drug price-fixing lawsuit, saying in a series of briefs that the state is trying to skirt federal pleading standards, collapse corporate separateness and stretch Ohio's antitrust law beyond its limits.

  • June 30, 2026

    GEO Still Blocking Parts Of NJ Detention Center, State Says

    New Jersey and its Department of Health told a federal judge that despite consent from U.S. Immigration and Customs Enforcement to tour its Newark detention center, facility operator GEO Group Inc. is still barring entrance to certain areas.

  • June 30, 2026

    Patience Thin On Bench For Dragged-Out FCA Probes

    Judicial frustration was on display in recent rulings in which judges took issue with repeated DOJ requests for sealed records. A desire to speed up fraud cases factors into a fish-or-cut-bait policy for federal prosecutors.

  • June 29, 2026

    Feds Sue Mich., Other States For Not Sharing SNAP Records

    The U.S. Department of Justice is asking federal courts to force Kentucky, Michigan, Minnesota and Pennsylvania to turn over their Supplemental Nutrition Assistance Program applicant data that the Trump administration claims it needs to uncover billions of dollars in overpayments and fraud.

  • June 29, 2026

    26 States Sue To Nix Medicaid Work Rule For Medically Frail

    More than two dozen states sued the Trump administration Monday in Massachusetts federal court in a bid to strike down new Medicaid work requirements for certain enrollees, saying the administration did not consider the consequences the requirements would have on vulnerable Medicaid enrollees.

  • June 29, 2026

    AstraZeneca To Pay $34M In Texas Kickbacks Settlement

    AstraZeneca has agreed to pay nearly $34 million to the state of Texas to put to rest allegations the pharmaceutical company gave kickbacks to providers for prescribing its drugs, many of which were covered by the Lone Star State's Medicaid program, according to an announcement made Monday.

  • June 29, 2026

    Hospital That Halted Gender Care Must Show Cause

    A Colorado state court judge issued a citation on Friday to Children's Hospital Colorado ordering it to show cause for why the hospital refuses to provide gender-affirming care to patients in violation of a preliminary injunction order issued by the Colorado Supreme Court. 

  • June 29, 2026

    Insurers Seek NJ Mass Tort For No Surprises Act Suits

    Five of the largest health insurers in the Garden State have asked the New Jersey Supreme Court to designate 160 pending cases seeking the enforcement of alleged independent dispute resolution payment determinations issued under the federal No Surprises Act as multicounty litigation, according to a notice to the Bar Association.

  • 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. 

Expert Analysis

  • Preparing For Congressional Investigations In A Midterm Year

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    2026 will be a consequential year for congressional oversight as the upcoming midterm elections may yield bolder investigations and more aggressive state attorneys general coalitions, so companies should consider adopting risk management measures to get ahead of potential changes, say attorneys at Morgan Lewis.

  • A Meaningful Shift In FDA's Biosimilarity Analysis

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    The U.S. Food and Drug Administration's potential pivot away from routinely requiring comparative efficacy studies for interchangeable biosimilar applications would not lower regulatory standards, but instead allow applicants to allocate resources toward establishing more probative evidence, says Theodore Thompson at Stinson.

  • Top 5 Antitrust Issues For In-House Counsel To Watch In 2026

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    With Trump administration enforcement policy having largely taken shape last year, antitrust issues that in-house counsel should have on the radar range from scrutiny of technology-assisted pricing to the return of merger remedies, say attorneys at Squire Patton.

  • 2025 Legal Milestones That Will Shape Psychedelics Sector

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    As 2025 draws to a close, psychedelic drug development stands at an inflection point, experiencing unprecedented momentum through recent sweeping regulatory changes and landmark clinical milestones, amid rapidly evolving regulatory expectations, say Odette Hauke at Odette Alina LLC and Kimberly Chew at Husch Blackwell.

  • 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.