Policy & Compliance

  • 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.

  • August 10, 2026

    Spa Fights 9th Circ.'s 'Swinging Dicks' Order At High Court

    The Ninth Circuit's rejection of a spa's religious objections to serving transgender customers is incompatible with several major precedents, according to a U.S. Supreme Court petition filed Monday in litigation that soared in prominence when dozens of circuit judges decried a salacious dissent.

  • August 10, 2026

    Pharma Co. To Pay $46M Over Transplant Drug Kickbacks

    Veloxis Pharmaceuticals Inc. will enter a deferred prosecution agreement and pay more than $46 million to resolve criminal and civil allegations that the North Carolina-based drug manufacturer paid kickbacks to spur prescriptions and purchases of its kidney transplant immunosuppression drug Envarsus XR, the U.S. Department of Justice announced Monday.

  • August 10, 2026

    Drugmakers Lose 2nd Bid To Appeal Ex-Prosecutor DQ Rebuff

    A former Connecticut prosecutor and his current firm Lowey Dannenberg PC can keep representing insurers Humana Inc. and Molina Healthcare Inc. in an antitrust lawsuit against generic-drug makers, after the judge overseeing the multidistrict litigation rejected a second attempt to appeal her denial of disqualification.

  • August 10, 2026

    Trump Revives Push To Reduce Kids' Vaccine Schedule

    Responding to a legal setback, President Donald Trump signed an executive order Monday recommending fewer vaccines for most children and calling on parents and doctors to space out the vaccines they do give.

  • August 10, 2026

    Clinics' Suit Over Fund Use Ballot Measure Gets Tossed

    A California federal judge tossed a suit that federally designated community health clinics filed to block the placement of an expenditure transparency reporting initiative on the November ballot, saying the clinics' claims aren't ripe for court review.

  • August 10, 2026

    Arkansas Medical System Escapes Target-Date 401(k) Suit

    An Arkansas federal judge on Monday dismissed a proposed class action alleging Arkansas medical system Washington Regional mismanaged the system's employee 401(k) plan, holding that allegations of underperforming investment funds weren't backed up with enough comparisons to better-performing ones to state a claim for violating federal benefits law.

  • August 07, 2026

    ERISA Recap: 6 Important Rulings From July

    The Ninth Circuit rejected a fund manager's bid to force a 401(k) suit into arbitration, a district court tossed a pension de-risking suit, and the D.C. Circuit unraveled a union pension fund's $13 million withdrawal liability win.

  • August 06, 2026

    SEC Nets Win In Suit Over Ex-CEO's Alleged Revenue Scheme

    A Washington, D.C., federal judge on Thursday largely sided with the U.S. Securities and Exchange Commission in its civil enforcement case against the former CEO of RTI Surgical Holdings, finding he misled investors by failing to disclose that the surgical implant company regularly shipped orders early to artificially inflate its quarterly revenues.

  • August 06, 2026

    SpineFrontier CFO Sentenced To 4 Months In Kickback Case

    The former chief financial officer of spinal implant startup SpineFrontier was sentenced Thursday to four months in prison for his involvement in an alleged conspiracy to pay surgeons kickbacks disguised as consulting fees.

  • August 06, 2026

    7th Circ. Backs Outcome Health Execs' $1B Fraud Convictions

    The Seventh Circuit on Thursday upheld the convictions of two Outcome Health executives for lying about the company's capabilities and value in a $1 billion fraud, rejecting their argument that an overzealous pretrial freeze on millions in assets violated their constitutional right to hire the defense attorneys of their choice.

  • August 06, 2026

    GOP Sens. Vote To Hold Fauci In Contempt, AGs Open Probe

    A U.S. Senate committee voted along party lines Thursday to hold Dr. Anthony Fauci in contempt of Congress after he declined to answer questions about the government's handling of the pandemic, while the Florida, West Virginia and Louisiana attorneys general are investigating potential "self-dealing" by Fauci during the crisis.

  • August 06, 2026

    Cigna Wins Dismissal Of Pa. In-Network Pharmacy Suit

    A Pennsylvania federal judge on Thursday dismissed a suit against Cigna, Evernorth and Express Scripts from Pennsylvania pharmacy customers who alleged injury because the companies designated their community pharmacy as out-of-network, holding state-law claims were preempted by federal benefits law but allowing another chance at re-pleading.

  • August 06, 2026

    Data Breach Case Against Allegheny Health Mostly Advances

    A Pennsylvania federal judge cleared most of a data breach class action against Allegheny Health System to move forward, leaving the healthcare company and its information technology vendor to face allegations that they are liable for allowing patients' sensitive information stored on internal networks to be compromised by a hacker.

  • August 06, 2026

    Eli Lilly, Novo Nordisk Antitrust Suit Tossed By Texas Judge

    A Texas federal court has dismissed compounding pharmacy Strive Specialties Inc.'s antitrust lawsuit against Eli Lilly and Novo Nordisk, finding it failed to allege the companies blocked competition for GLP-1 medications.

  • August 05, 2026

    Drug Cos. Can't Trim Humana's Price-Fix Claims In Bellwether

    A Pennsylvania federal judge on Tuesday denied a bid by a number of generic drug manufacturers to dismiss two antitrust claims brought by health insurer Humana Inc. from an upcoming bellwether trial in long-running antitrust multidistrict litigation, finding they were brought within the statute of limitations.

  • August 05, 2026

    Kansas Judge Permanently Blocks Abortion Care Restrictions

    A Kansas state court has permanently enjoined a slew of restrictions on abortion care, including requirements that providers disclose patients' reasons for seeking an abortion to the state and inform patients about abortion pill "reversal" treatments the court said were "unlikely to be biologically plausible."

  • August 05, 2026

    No Coverage For Assisted Living Death, Fla. Panel Says

    A Florida appellate court on Wednesday reversed a judgment that required National Assisted Living Risk Retention Group to provide coverage for a wrongful death suit from a resident's 2012 death, finding no claim was made during the relevant policy period.

  • August 05, 2026

    NY Health Center Can't Pare Back Wage Suit, Judge Says

    A New York federal judge refused Wednesday to narrow proposed groups of workers suing a healthcare facility over overtime and sick pay or dismiss the sick-leave and wage-statement claims, finding a former worker plausibly alleged broad pay practices and harm from misleading records.

  • August 04, 2026

    Colo. Panel Mulls Med Mal Retrial Bid Over Pretrial Meeting

    A Colorado man urged a state appellate court Tuesday to order a new trial in his medical malpractice lawsuit in which jurors sided with his physicians, arguing to a skeptical panel that the defense's ex parte pretrial meeting with his own treating surgeon caused him prejudicial harm.

Expert Analysis

  • 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.

  • Regulatory Uncertainty Ahead For Organ Transplant System

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    Pending court cases against a Centers for Medicare and Medicaid Services final rule that introduced a competition-centric model for assessing organ procurement organizations' performance will significantly influence the path forward for such organizations and transplant hospitals, say attorneys at Crowell & Moring.

  • Key False Claims Act Trends From The Last Year

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    The False Claims Act remains a powerful enforcement tool after some record verdicts and settlements in 2025, and while traditional fraud areas remain a priority, new initiatives are raising questions about its expanding application, says Veronica Nannis at Joseph Greenwald.

  • It's Too Soon To Remove Suicide Warnings From GLP-1 Drugs

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    The U.S. Food and Drug Administration's decision this month to order removal of warnings about the risk of suicidal thoughts from GLP-1 weight-loss drugs is premature — and from a safety and legal standpoint, the downside of acting too soon could be profound, says Sean Domnick at Rafferty Domnick.

  • What To Know About DOL's New FLSA, FMLA Opinion Letters

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    The U.S. Department of Labor kicked off 2026 by releasing several opinion letters addressing employee classification, incentive bonuses and intermittent leave, reminding employers that common practices can create significant risk if they are handled inconsistently or without careful documentation, say attorneys at Woods Rogers.

  • What Changed For Healthcare Transaction Law In 2025

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    Though much of the legislation introduced last year to expand state scrutiny of healthcare transactions did not pass, investors should pay close attention to the overarching trends, which are likely to continue in this year's legislative sessions, say attorneys at Ropes & Gray.

  • Expect State Noncompete Reforms, FTC Scrutiny In 2026

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    Employer noncompete practices are facing intensified federal scrutiny and state reforms heading into 2026, with the Federal Trade Commission pivoting to case-by-case enforcement and states continuing to tighten the rules, especially in the healthcare sector, say attorneys at DLA Piper.

  • CMS 2027 Proposal Is Mixed Bag For Medicare Advantage

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    The Centers for Medicare and Medicaid Services' recent proposed rule for the Medicare Advantage and Part D programs gives small organizations reason for optimism, although certain elements may be inconsistent with the Centers' desire to enhance competition, says Christine Clements at Sheppard Mullin.

  • 3 Key Takeaways From Planned Rescheduling Of Cannabis

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    An executive order reviving cannabis rescheduling represents a monumental change for the industry and, while the substance will remain illegal at the federal level, introduces several benefits, including improving state-legal cannabis operators' tax treatment, lowering the industry's legal risk profile, and leaving state-regulated markets largely intact, say attorneys at Dentons.

  • 6 Issues That May Follow The 340B Rebate Pilot Challenge

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    Though the Health Resources and Services Administration withdrew a pending case to reconsider the controversial 340B rebate pilot program, a number of crucial considerations remain, including the likelihood of a rework and questions about what that rework might look like, say attorneys at Spencer Fane.

  • 2026 State AI Bills That Could Expand Liability, Insurance Risk

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    State bills legislating artificial intelligence that are expected to pass in 2026 will reshape the liability landscape for all companies incorporating AI solutions into their business operations, as any novel private rights of action authorized under AI-related statutes signal expanding exposures, say attorneys at Wiley.

  • How 11th Circ.'s Zafirov Decision Could Upend Qui Tam Cases

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    Oral argument before the Eleventh Circuit last month in U.S. ex rel. Zafirov v. Florida Medical Associates suggests that the court may affirm a lower court's opinion that the qui tam provisions of the False Claims Act are unconstitutional — which could wreak havoc on pending and future qui tam cases, say attorneys at Morgan Lewis.

  • Key Trends For Life Sciences Cos. To Watch In 2026

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    Following a year of drastic change at the U.S. Food and Drug Administration, two themes are likely to drive the coming year — a commitment to lowering the cost of drugs and an inherent tension between the priorities of the health agencies and the broader administration, say attorneys at Sheppard Mullin.