Policy & Compliance

  • May 20, 2026

    Bass Berry Adds Crowell & Moring Healthcare Atty In DC

    Bass Berry & Sims PLC has hired a former Crowell & Moring LLP partner, who in her last role represented a healthcare insurer against whistleblower claims that it participated in a kickback scheme involving Medicare Advantage customers.

  • May 19, 2026

    New Suits Target Fed. Loan Rule, CVS 340B Rates And More

    Law360 Healthcare Authority looks at new lawsuits targeting a U.S. Department of Education rule limiting loans available to students in nursing and other healthcare programs, CVS reimbursement practices for safety net providers under the federal 340B drug discount program and more.

  • May 19, 2026

    Cigna Can't Knock Out 401(k) Forfeiture, Fund Suit

    Cigna can't escape a proposed class action alleging that underperforming investment offerings and misallocated forfeitures in its employee 401(k) plan cost workers millions, after a Pennsylvania federal judge ruled Tuesday that alleged violations of federal benefits law were sufficiently backed up to reach discovery.

  • May 19, 2026

    Justice Alito Calls Out Slow Pace Of FDA Mifepristone Study

    The Trump administration’s slow-paced review of the abortion medication mifepristone has the attention of a U.S. Supreme Court justice, not just anti-abortion activists.

  • May 19, 2026

    9th Circ. Reopens Ex-Transit Manager's Vaccine Bias Suit

    The Ninth Circuit breathed new life into a Washington transit system manager's lawsuit alleging she was fired for requesting a religious exemption from a county's COVID-19 vaccine requirement, ruling Tuesday that she should be given a chance to revise her complaint.

  • May 19, 2026

    3 Things To Know As Distributors Test Conn. Drug Price Law

    The Second Circuit will hear arguments in a suit filed by a wholesale drug distributor group seeking to take down —​​​​​​​ or at least hold up —​​​​​​​ a Connecticut law tying price increases for generics to inflation.

  • May 19, 2026

    States Sue Over Student Loan Limits On Professional Degrees

    A coalition of 24 attorneys general and two governors are challenging a rule recently promulgated by the U.S. Department of Education, alleging in a complaint in Maryland federal court Tuesday that it unlawfully limits access to federal student loans for those pursuing professional degree programs.

  • May 19, 2026

    Mich. Hospitals Say CVS Diverted $66M In 340B Drug Savings

    CVS Health Corp. and several affiliates implemented a pricing scheme to divert to themselves savings from the federal 340B Drug Pricing Program, two University of Michigan hospital operators told a federal court, saying the scheme has resulted in more than $66 million in lost revenue over six years.

  • May 19, 2026

    Anthem Inks $3.6M Settlement In Proton Beam Therapy Suit

    Anthem and its affiliates have agreed to fork over approximately $3.6 million to end a proposed class action from employee health plan participants who challenged coverage denials for proton beam therapy to treat cancer, according to Tuesday filings in Tennessee federal court.

  • May 18, 2026

    PBMs Tell Mich. Court They're Not To Blame For Opioid Abuse

    Pharmacy benefit managers told a Michigan federal court on Monday they are not responsible for opioid abuse because they do not control prescription drugs once they are sold to patients, as Evernorth Health, Express Scripts and other companies seek an exit from the state attorney general's public nuisance suit.

  • May 18, 2026

    Aetna Denied A Freeze On Trans Facial Surgery Order

    A Connecticut federal judge ordered Aetna to comply with a preliminary injunction requiring it to reconsider coverage denials affecting two transgender health plan participants who sought gender-affirming facial surgery, refusing to stay the insurer's compliance obligations during its pending appeal in the proposed class action.  

  • May 18, 2026

    Morgan & Morgan Atty Barred From Harvard Suit Over AI Error

    A Massachusetts judge on Monday said a Morgan & Morgan PA attorney may not appear before him in a suit against Harvard University over the theft of body parts donated to its medical school, saying the lawyer did not learn his lesson after signing off on briefs in another case with fake case law generated by artificial intelligence.

  • May 18, 2026

    Justices Deny Eli Lilly's Qui Tam Constitutional Challenge

    The U.S. Supreme Court on Monday declined to review Eli Lilly's $183 million trial loss to a whistleblower who claimed the drugmaker knowingly defrauded the government by underpaying Medicaid drug rebates.

  • May 18, 2026

    Colo. Justices Tell Hospital To Resume Gender-Affirming Care

    The Colorado Supreme Court ordered Children's Hospital Colorado on Monday to resume its provision of gender-affirming care for transgender youth patients, finding the patients demonstrated actual harm from the denial of care.

  • May 18, 2026

    High Court Spurns Pharma Challenges To IRA Drug Price Talks

    The U.S. Supreme Court rejected six petitions Monday from pharmaceutical giants seeking to bring down the Medicare drug price negotiations established as part of the Inflation Reduction Act three years ago.

  • May 15, 2026

    Texas Hospital Creates 'De-Transition Clinic' After Settlement

    The Texas attorney general announced a settlement with Texas Children's Hospital that will see the creation of a detransition clinic, saying Friday that the hospital will pay $10 million for billing Texas Medicaid for "illegal 'gender-transition' interventions."

  • May 15, 2026

    Minn. Twins Doctor Can't Claim Immunity In Player Death Suit

    A doctor employed by the Minnesota Twins can't claim immunity in a lawsuit alleging he failed to diagnose a heart condition in a ballplayer that led to his death, a Florida appeals panel ruled on Friday.

  • May 15, 2026

    4th Circ. Hands Express Scripts Jury Trial In W.Va. Opioid Suit

    The Fourth Circuit on Friday issued a writ of mandamus backing Express Scripts Inc.'s right to a jury trial in litigation over the pharmacy benefit manager's alleged role in contributing to the opioid crisis in West Virginia.

  • May 15, 2026

    Texas Justices Revive Anti-SLAPP Bid In Abortion Fund Suit

    The Texas Supreme Court on Friday revived a woman's anti-SLAPP bid in an abortion fund's suit against her, holding that the suit was filed in response to the woman's earlier attempt to investigate the fund's deputy director for potential violations of state abortion law.

  • May 15, 2026

    NC Social Worker Wants Resentencing In Medicaid Fraud Suit

    A clinical social worker in North Carolina serving more than 11 years in prison on healthcare fraud charges is challenging her sentence in the Fourth Circuit, saying Thursday that a lower court used overly generalized findings to apply a vulnerable victim sentence enhancement.

  • May 14, 2026

    NJ Doctor Prescribed Medical Marijuana To Kids, AG Says

    A New Jersey doctor had his medical license temporarily suspended by a state board, which found there is good reason to believe he is "a grave danger" to his patients after prosecutors accused him of repeatedly prescribing marijuana to adults and children without complying with state law.

  • May 14, 2026

    NC Republicans Want Fetal Personhood Question On '26 Ballot

    Two Republicans in the North Carolina House who have a history of advancing so-called fetal personhood bills have made another attempt to put a constitutional amendment to voters in November to decide if life begins at fertilization.

  • May 14, 2026

    Pa. Psych Hospital Faces Multiple Abuse Lawsuits

    A Pittsburgh-area psychiatric hospital has been hit with five state court lawsuits alleging it allowed patients as young as 10 years old to be physically and sexually abused by staff members and other patients, despite multiple investigations and warnings.

  • May 14, 2026

    Moda Health Settles Wilderness Therapy Coverage Suit

    Health insurance provider Moda Health has agreed to settle a lawsuit alleging it unlawfully denied a family's claims for their daughter's stays at two wilderness therapy programs and left them with thousands of dollars in medical bills, according to a filing in Oregon federal court.

  • May 14, 2026

    Albertsons Not Covered In Opioid Litigation, Del. Judge Says

    Albertsons isn't entitled to defense or indemnity for more than 100 suits accusing the pharmacy and grocery chain of fueling the opioid epidemic, a Delaware state court ruled, tracking the state high court's rulings in nearly identical disputes involving Rite Aid and CVS.

Expert Analysis

  • Organ Transplant System Reforms Mark Regulatory Overhaul

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    Recent oversight, enforcement and operational developments in the U.S. organ procurement and transplantation system, alongside challenges like the federal shutdown, highlight heightened regulatory scrutiny and the need for compliance to maintain public trust, say attorneys at Hall Render.

  • Federal Grantees May Soon Face More Limitations On Speech

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    If courts accept the administration’s new interpretation of preexisting case law, which attempts to graft onto grant recipients the existing limitations on government contractors' free speech, a more deferential standard may soon apply in determining whether an agency’s refusal or termination of a grant was in violation of the First Amendment, say attorneys at Venable.

  • HHS Wound Care Report Highlights Need For Payment Reform

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    The U.S. Department of Health and Human Services' recent report on potential abuse in Medicare Part B payments for skin substitutes highlights specific fraud schemes, but more importantly emphasizes that broader changes are needed for the wound care sector's fundamentally flawed payment system, say attorneys at Paul Hastings.

  • Assessing The Future Of The HIPAA Reproductive Health Rule

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    In light of a Texas federal court's recent decision to strike down a U.S. Department of Health and Human Services rule aimed to protect the privacy of patients seeking abortions and gender-affirming care, entities are at least temporarily relieved from compliance obligations, but tensions are likely to continue for the foreseeable future, says Liz Heddleston at Woods Rogers.

  • DOJ's Tracing Rule For Pandemic Loan Fraud Is Untenable

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    In conducting investigations related to COVID-19 relief fraud, the government's assertion that loan proceeds are nonfungible and had to have been segregated from other funds is unsupported by underlying legislation, precedent or the language establishing similar federal relief programs, say Sharon McCarthy, Jay Nanavati and Lasya Ravulapati at Kostelanetz.

  • New Health AI Guidance Features A Provider-Centric Approach

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    New guidance from the Joint Commission and Coalition for Health AI regarding the responsible use of artificial intelligence in healthcare deviates from preexisting guidance by recommending a comprehensive framework for using AI tools, focusing on healthcare provider organizations rather than on AI developers, say attorneys at Ropes & Gray.

  • Mass. Ruling May Pave New Avenue To Target Subpoenas

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    A Massachusetts federal court’s recent decision to quash a subpoena seeking information on gender-affirming care at Boston Children’s Hospital is a significant departure from courts' deferential approach to subpoena enforcement, and may open a new pathway for practitioners challenging investigative tools in the future, say attorneys at Gibson Dunn.

  • What To Expect After FDA Warnings To GLP-1 Compounders

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    The U.S. Food and Drug Administration's recent warning letters to companies advertising compounded versions of GLP-1 medications raise questions not just about the enforcement outlook for marketing such products, but also about the future of drug compounding as a whole, say attorneys at Spencer Fane.

  • How Financial Cos. Can Prep As NYDFS Cyber Changes Loom

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    Financial institutions supervised by the New York State Department of Financial Services can prepare for two critical cybersecurity requirements relating to multifactor authentication and asset inventories, effective Nov. 1, by conducting gap analyses and allocating resources to high-risk assets, among other steps, say attorneys at Pillsbury.

  • How Courts May Interpret Data-Driven Healthcare Fraud Suits

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    As the U.S. Department of Justice and other agencies increasingly turn to data mining as an enforcement tool, courts will have to determine how far data alone can take a fraud case, and sound theory, clinical expertise and institutional context will play an important role, say Jaime Jones at Sidley and Andrée-Anne Fournier and Atang Gilika at Analysis Group.

  • How Gov't Shutdown Will Affect Federal Health Agencies

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    Federal health agencies' contingency plans indicate that many major programs will remain insulated from disruption during the ongoing government shutdown, but significant policy proposals will likely be delayed and the Trump administration's emphasis on reduction-in-force plans distinguishes this shutdown from past lapses, says Miranda Franco at Holland & Knight.

  • Assessing Legal, Regulatory Hurdles Of Healthcare Offshoring

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    The offshoring of administrative, nonclinical functions has emerged as an increasingly attractive option for healthcare companies seeking to reduce costs, but this presents challenges in navigating the web of state restrictions on the access or storage of patient data outside the U.S., say attorneys at McDermott.

  • 5 Years In, COVID-19 Fraud Enforcement Landscape Is Shifting

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    As the government moves pandemic fraud enforcement from small-dollar individual prosecutions to high-value corporate cases, and billions of dollars remain unaccounted for, companies and defense attorneys must take steps now to prepare for the next five years of scrutiny, says attorney David Tarras.