Policy & Compliance

  • April 07, 2026

    Pa. Hospitals Accuse Aetna Of Underpaying Medicare Claims

    Two Pennsylvania hospital operators have sued Aetna Health Inc. in federal court, alleging the insurer has been improperly denying Medicare Advantage claims for inpatient services, or underpaying, under a new policy.

  • April 07, 2026

    Insurer Premera Accuses Clinic Of Misusing No Surprises Act

    Premera Blue Cross sued a weight loss clinic on Monday in Washington federal court saying it abused a federal law aimed at safeguarding patients from unexpected medical bills in order to shake down the insurer for exorbitant amounts of money — as much as 10 times what Premera pays in-network providers.

  • April 07, 2026

    Acadia Still On Hook For $9M Rehab Death Negligence Verdict

    A California state appeals court on Tuesday affirmed a more than $9 million jury verdict against Acadia Healthcare Co. Inc. in a suit stemming from the death of a patient at one of its addiction treatment centers, saying there was substantial evidence that the Marin County facility was negligently understaffed.

  • April 07, 2026

    HHS Must Face States' Suit Over RFK's 'Dramatic Overhaul'

    A Rhode Island federal judge rejected Tuesday the government's bid to toss a group of states' lawsuit challenging Robert F. Kennedy Jr.'s "dramatic overhaul" of the U.S. Department of Health and Human Services, criticizing the government for rehashing jurisdictional arguments the court already rejected and finding the states' claims are plausible.

  • April 07, 2026

    Minn. Can't Unfreeze $243M In Medicaid Funds, Judge Says

    A Minnesota federal judge on Monday denied the state's preliminary injunction request to release $243 million in Medicaid funds deferred by the federal government during a fraud investigation, holding that the "unprecedented" size and scope of the deferral action doesn't mean the Centers for Medicare & Medicaid Services isn't legally cleared to pursue the action.

  • April 07, 2026

    3 Healthcare Decisions You May Have Missed This Week

    A proposed class of HIV and AIDS patients is dropping their disability bias lawsuit, the Third Circuit on a COVID-era fraudster sentence, and Aetna escapes a testing payment lawsuit. Law360 Healthcare Authority looks at three decisions you may have missed.

  • April 07, 2026

    Judge Questions FTC's Motive In Gender-Care Probe

    A federal judge in Washington said Tuesday he would have to balance any legitimate concerns about parents and children being misled on the issue of gender-affirming care with what appeared to be retaliatory motives behind Federal Trade Commission investigative demands to a pair of nonprofits.

  • April 07, 2026

    HHS Staff Changes Likely To Lead To Uncertain 2026

    Healthcare experts are keeping a close eye on personnel changes at the U.S. Department of Health and Human Services. Law360 Healthcare Authority looks at how they could affect key agency policies.

  • April 07, 2026

    Mich. AG Says PBMs Can't Stall Discovery In Drug-Pricing Suit

    Michigan's attorney general is urging a federal court to reject a renewed bid by pharmacy benefit managers to pause discovery in an antitrust case accusing them of price-fixing reimbursement rates, claiming the companies are relying on exaggerated burden claims and an ordinary motion to dismiss that is unlikely to succeed.

  • April 07, 2026

    DC Circ. Skeptical Ex-Steward CEO Could Skip Senate Hearing

    A D.C. Circuit judge told the attorney for the embattled former CEO of Steward Health Care on Tuesday that she couldn't comprehend how his client could invoke his Fifth Amendment rights without showing up to his scheduled appearance before a Senate committee.

  • April 07, 2026

    High Court Ruling Won't End 'Conversion Therapy' Battles

    The U.S. Supreme Court's rejection of Colorado's ban on what is commonly known as gay conversion therapy may have rendered dozens of similar laws toothless, but don't expect it to be the end of legal challenges in this arena.

  • April 07, 2026

    Jury Awards $39.5M Over Discharged Psych Patient's Victims

    A Philadelphia jury on Tuesday hit a healthcare management company and a Pennsylvania hospital with a $39.5 million verdict, finding them liable for the deaths of four people who were murdered by a family member who was discharged from a psychiatric unit that failed to submit paperwork that would have prevented him from purchasing the gun he used to kill them.

  • April 06, 2026

    RFK Jr. Tweaks HHS Vaccine Policy Panel Membership Criteria

    U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. is making changes to a key federal vaccine advisory panel's charter, according to a renewal notice the agency published Monday, after a Massachusetts federal judge last month declared Kennedy's committee picks "appear distinctly unqualified."

  • April 06, 2026

    Anthem Owes $2.1M For No Surprises Act Awards, Court Told

    Two medical providers said Anthem Blue Cross and Blue Shield owes them a combined $2.1 million for medically necessary services rendered to its insured members, telling a Colorado state court that the carrier is wrongfully withholding payment despite losing multiple federal arbitration proceedings.

  • April 06, 2026

    Biz Groups Urge 4th Circ. To End Allergan Overcharge Suit

    Major pharmaceutical and business associations urged the Fourth Circuit to reconsider a panel decision that revived a whistleblower lawsuit accusing an Allergan Sales LLC predecessor of overcharging Medicaid, warning it threatens to become a road map for False Claims Act abuses.

  • April 06, 2026

    Splenda Loses Bid To End Scientist's Libel Counterclaim

    The maker of Splenda lost its bid for a pretrial win on a scientist's counterclaims for libel after a North Carolina federal judge on Monday ruled they weren't filed too late because the counterclaims are directly linked to the company's defamation suit challenging her statements linking Splenda to cancer-causing chemicals.

  • April 06, 2026

    1st Circ. Suggests It May Resurrect AdTech Wiretap Case

    A panel of the First Circuit appeared receptive Monday to reinstating federal wiretap claims leveled against a Massachusetts healthcare system over its use of online tracking tools, despite arguments that such a ruling could cripple the industry amid an influx of similar cases nationwide.

  • April 06, 2026

    Cleary FCA Task Force Head On Enforcement Trends To Watch

    Former U.S. Attorney for the Eastern District of New York Breon Peace, who now leads a False Claims Act task force at Cleary Gottlieb Steen & Hamilton LLP, is predicting a continued surge in enforcement as the Trump administration wields the law in new ways.

  • April 06, 2026

    Mass. Justices Hint Insurer Owes Defense In Doc's Discipline

    An allegation that a Massachusetts doctor prescribed addictive medications to manipulate a patient into a sexual relationship could be enough to trigger a malpractice insurer's duty to defend him in a disciplinary proceeding launched years later over other alleged misconduct, justices on the state's highest court hinted Monday.

  • April 06, 2026

    WilmerHale Adds Regulatory Atty From Mayer Brown In DC

    WilmerHale announced Monday it has hired a veteran U.S. Food and Drug Administration and life sciences regulatory attorney from Mayer Brown LLP.

  • April 03, 2026

    Case-By-Case Guide As Justices Eye Landmark Pharma Law

    Drugmakers and prominent allies are inundating the U.S. Supreme Court with calls to scrutinize Medicare's new power to slash payments by tens of billions of dollars, and the justices look poised to take up or turn down a fistful of legal challenges in one fell swoop.

  • April 03, 2026

    Wash. DOC Inks Deal Over Trans Treatment In Facilities

    The Washington State Department of Corrections will start improving conditions for transgender, intersex and nonbinary people in its facilities and submit to yearly monitoring, according to a settlement agreement between the agency and a nonprofit in the state.

  • April 03, 2026

    SEC Moves To Set Up $40M Investor Fund In Cassava Case

    The U.S. Securities and Exchange Commission asked a Texas federal court on Friday to establish a $40 million fund to potentially compensate investors harmed by a Texas biopharmaceutical company and two former executives' alleged misstatements about an Alzheimer's drug, following the company's 2024 settlement with the regulator.

  • April 03, 2026

    Northwestern Can't Escape ERISA Fight Over Health Offerings

    An Illinois federal court refused to toss a proposed class action against Northwestern University alleging excessive employee healthcare costs violated federal benefits law, concluding ex-workers had sufficiently backed up their allegations that an expensive plan option breached fiduciary duties.

  • April 03, 2026

    Law360 Announces The Members Of Its 2026 Editorial Boards

    Law360 is pleased to announce the formation of its 2026 Editorial Advisory Boards.

Expert Analysis

  • 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.

  • FDA's Hasty Policymaking Approach Faces APA Challenges

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    Though the U.S. Food and Drug Administration has abandoned its usual notice-and-comment process for implementing new regulatory initiatives, two recent district court decisions make clear that these programs are still susceptible to Administrative Procedure Act challenges, says Rachel Turow at Skadden.

  • The Metamorphosis Of The Major Questions Doctrine

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    The so-called major questions doctrine arose as a counterweight to Chevron deference over the past few decades, but invocations of the doctrine have persisted in the year since Chevron was overturned, suggesting it still has a role to play in reining in agency overreach, say attorneys at Crowell & Moring.

  • A Rapidly Evolving Landscape For Noncompetes In Healthcare

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    A wave of new state laws regulating noncompete agreements in the healthcare sector, varying in scope, approach and enforceability, are shaped by several factors unique to the industry and are likely to distort the market, say attorneys at Seyfarth.

  • Arguing The 8th Amendment For Reduction In FCA Penalties

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    While False Claims Act decisions lack consistency in how high the judgment-to-damages ratio in such cases can be before it becomes unconstitutional, defense counsel should cite the Eighth Amendment's excessive fines clause in pre-trial settlement negotiations, and seek penalty decreases in post-judgment motions and on appeal, says Scott Grubman at Chilivis Grubman.