Policy & Compliance

  • November 24, 2025

    Hi-Tech Pharma CEO Beats Most Of Feds' Fraud Case

    A Georgia federal jury acquitted Hi-Tech Pharmaceuticals' chief executive on the bulk of the conspiracy, fraud and money laundering charges leveled against him, rejecting allegations that he cheated his customers by drawing up bogus quality certificates.

  • November 24, 2025

    Justices Won't Review Doctor's Conviction For Reusing Devices

    The U.S. Supreme Court on Monday rejected a petition from a North Carolina physician seeking to revisit the Fourth Circuit's decision to back her conviction for healthcare fraud.

  • November 21, 2025

    DC Judge Axes Teva Challenge To Drug Price Program

    A D.C. federal judge tossed a challenge by Teva Pharmaceuticals to the Medicare drug price negotiation program, marking the latest in a series of losses by drugmakers and trade groups seeking to upend the program.

  • November 21, 2025

    Fla. Wound Doctor Agrees To Pay $45M For Overbilling Claims

    A Florida doctor and his companies agreed to pay $45 million to settle a suit alleging he submitted fraudulent claims to Medicare for medically unnecessary wound care procedures, the U.S. government said Friday. 

  • November 21, 2025

    Colo. Healthcare System Stiffing Workers, Court Told

    A pair of former workers for a hospital and healthcare facility operator in Colorado have accused their past employer of routinely shortchanging their pay in violation of state and federal wage and hour laws, according to a proposed class action filed in federal court.

  • November 21, 2025

    PBMs Say Gov't Benefits From Drug Rebates FTC Condemns

    Caremark Rx, Express Scripts and OptumRx have been given permission to seek documents they say will show the government benefits from the same type of prescription drug rebating activity that's being targeted by the Federal Trade Commission's insulin pricing case.

  • November 21, 2025

    'No Evidence' New Info Backs J&J Unit's Libel Suit, Court Told

    A doctor being sued by Johnson & Johnson's bankrupt talc subsidiary pushed back on the unit's bid to revive its trade libel claim over a scientific article she wrote linking asbestos in talc to mesothelioma, arguing it failed to cite any evidence that undermines the court's finding that the article was a nonactionable statement of scientific opinion.

  • November 21, 2025

    Rothman Orthopaedics Hit With Pa. Wiretapping Lawsuit

    Rothman Orthopaedics has been hit with a proposed class action in Pennsylvania alleging the company violated state wiretapping laws by intercepting private healthcare information on its website using a third-party tracking pixel.

  • November 21, 2025

    Hyperbaric Chamber Death Suit Not Covered, Insurers Say

    Two Nationwide insurers said they have no duty to defend or indemnify a hyperbaric oxygen therapy center or its employees in a suit over the death of a 5-year-old boy, telling a Michigan federal court that there was no bodily injury or property damage caused by an occurrence, or accident.

  • November 21, 2025

    1st Circ. Clears IT Co. In Suit Over Zoll Patient Data Breach

    An information technology company cannot be held liable for a data breach exposing the health information of patients of a unit of medical device maker Zoll Medical Corp, the First Circuit ruled, because the two companies did not have a business relationship permitting them to hold one responsible for another's conduct.

  • November 20, 2025

    Pharma Cos. Seek Early Win In States' Price-Fixing Lawsuit

    A collection of states failed to prove an overarching conspiracy among 25 separate pharmaceutical companies to fix the prices of generic drugs, most of them dermatology formulations, the drugmakers argued Wednesday in support of a bid for an early win on one element of dozens of antitrust claims.

  • November 20, 2025

    5th Circ. Seeks Interpretation Of Miss. Health Decisions Law

    A Fifth Circuit panel asked the Mississippi Supreme Court on Thursday to clarify an "ambiguous" state law that sets out which family members can act as surrogates and make healthcare decisions for relatives without the capacity to decide for themselves.

  • November 20, 2025

    Ala. County Must Face Inmate Death Claim, 11th Circ. Rules

    An Eleventh Circuit panel ruled Thursday that no Alabama state law prevents a county from facing liability for an incarcerated person's death after substandard healthcare from a third-party medical provider the county hired. 

  • November 20, 2025

    Blue Shield Of California, Magellan Sued Over 'Ghost Network'

    Blue Shield of California and Magellan Health maintain a "ghost network" directory of mental health providers who don't exist or don't accept new patients, leading customers to hit a dead end or desperately resort to expensive out-of-network providers, according to a proposed class action filed Wednesday in California federal court. 

  • November 20, 2025

    10th Circ. Weighs Colo. Law On Healthcare Sharing Plans

    A Tenth Circuit panel grappled Thursday with how the court should interpret a Colorado law requiring entities not authorized to offer insurance in the state to report certain information about their healthcare sharing plans, in an appeal by a religious trade group challenging the law's constitutionality.

  • November 20, 2025

    Claims Firms Barred From Misleading Plaintiffs In Pharma MDL

    On the same day that a Philadelphia federal judge approved $58 million in settlements as part of an ongoing generic-drug price-fixing multidistrict litigation, she also ordered several claims recovery firms to correct allegedly false and misleading ads used to attract potential clients seeking to make claims on the settlements.

  • November 19, 2025

    Senior Living Co. Inks $7.2M Deal To End Wash. AG's Probe

    Oregon-based senior living provider Bonaventure will invest $7 million in staffing and upgrades and shell out $200,000 in resident credits to resolve allegations of substandard care at 10 Washington state facilities, under a settlement filed Wednesday.

  • November 19, 2025

    Is 'Red Book' Best For Drug Pricing? Pa. Justices Ask

    The Pennsylvania Supreme Court seemed skeptical Wednesday that the state workers' compensation authorities were using the best guide to calculate pharmacy reimbursements for injured workers' prescription drugs, with the justices questioning the fairness of the industry's long-used "red book" method.

  • November 19, 2025

    11th Circ. Backs Kaiser In Air Ambulance Arbitration Dispute

    The Eleventh Circuit on Wednesday declined an air ambulance company's bid to scrap an arbitrator's ruling that Kaiser only owes $24,000 for an emergency helicopter flight, rejecting the emergency medical provider's arguments that the insurer committed fraud by strategically lowballing the arbitrator.

  • November 19, 2025

    Aetna Gets OK For $3.4M Deal In Cancer Treatment Denial Suit

    A Florida federal judge has signed off on Aetna's $3.4 million settlement agreement resolving a class action that alleged the insurer unlawfully mischaracterized a proton beam cancer radiation treatment as experimental to deny dozens of claims.

  • November 19, 2025

    Senate GOP Resists Extending Expanded ACA Tax Premiums

    Senate Finance Committee Democrats on Wednesday urged their Republican counterparts to extend the enhanced tax credits for the Affordable Care Act, which is set to expire at the end of the year, but Republicans said they were looking for other options to address rising healthcare costs.

  • November 19, 2025

    Conn. Dentists Pay $714K To Settle Patient Kickback Claims

    Two Connecticut dentists will pay more than $714,000 to the state and federal governments to settle joint allegations that their practices submitted false government benefits claims that contained kickbacks for patient recruiters.

  • November 19, 2025

    Pa. Health Network's $1.15M 401(k) Suit Deal Gets Initial OK

    A healthcare system Wednesday secured initial approval from a Pennsylvania federal court for a $1.15 million settlement agreement that would resolve a proposed class action alleging the company misused forfeited retirement plan funds and allowed the plan's administrative costs to soar.

  • November 19, 2025

    Whoop Blood Pressure Tracker Hit With False Ad Suit

    A consumer on Tuesday hit health and wellness wearable tech company Whoop Inc. with a proposed class action in California federal court alleging that its boasting of the blood pressure features of its fitness tracker duped consumers and prompted a warning from health regulators.

  • November 19, 2025

    Hospice Co. Should Face Tobacco Fee Suit, Judge Says

    A hospice and home healthcare provider shouldn't escape a proposed class action challenging a tobacco surcharge in its employee health plan, a Pennsylvania federal judge recommended, finding that allegations sufficiently backed up that a wellness program implementing the fee didn't meet all regulatory requirements.

Expert Analysis

  • A Look At Healthcare Transaction Oversight In Oregon

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    Understanding Oregon's enforcement authority and its impact on proposed transactions last year provides a road map to the state's plans to strengthen its processes this year, though enforcement could be challenged by ongoing litigation, say attorneys at Ropes & Gray.

  • Rethinking 'No Comment' For Clients Facing Public Crises

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    “No comment” is no longer a cost-free or even a viable public communications strategy for companies in crisis, and counsel must tailor their guidance based on a variety of competing factors to help clients emerge successfully, says Robert Bowers at Moore & Van Allen.

  • High Court Must Acknowledge US History Of Anti-Trans Laws

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    Despite Justice Amy Coney Barrett's claim to the contrary during oral arguments in U.S. v. Skrmetti, U.S. governments at every level have systematically discriminated against transgender people, and the U.S. Supreme Court must consider this historical context in upcoming cases about transgender issues, says Paisley Currah at the City University of New York.

  • The Fate Of Biden-Era Clinical Study Guidance Under Trump

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    Draft guidance about the study of sex and gender differences in medical product development issued by the outgoing Biden administration currently faces significant uncertainty and litigation potential due to the Trump administration's executive orders and other actions, say attorneys at Arnold & Porter.

  • 10 Issues To Watch In Aerospace And Defense Contracting

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    This year, in addition to evergreen developments driven by national security priorities, disruptive new technologies and competition with rival powers, federal contractors will see significant disruptions driven by the new administration’s efforts to reduce government spending, regulation and the size of the federal workforce, say attorneys at Thompson Hine.

  • Dispelling 10 Myths About Health Provider-Based Compliance

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    Congress appears intent on requiring hospitals to submit provider-based attestations for all off-campus outpatient hospital locations, so now is the time for hospitals to prepare for this change by understanding common misconceptions about provider-based status and proactively correct noncompliance, say attorneys at McDermott.

  • A Look At HHS' New Opinion On Patient Assistance Programs

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    A recent advisory opinion from the U.S. Department of Health and Human Services' Office of Inspector General follows a recent trend of blessing patient assistance program arrangements that implicate the Anti-Kickback Statute, as long as they are structured with appropriate safeguards to minimize the risk of fraud and abuse, say attorneys at Sheppard Mullin.

  • 2 Anti-Kickback Developments Hold Lessons For Biopharma

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    The U.S. Department of Justice's Anti-Kickback Statute settlement with QOL Medical and a favorable advisory opinion from the U.S. Department of Health and Human Services provide a study in contrasts, but there are tips for biopharma manufacturers trying to navigate the vast compliance space between them, says Mary Kohler at Kohler Health Law.

  • Tips For Pharma-Biotech Overlap Reporting In New HSR Form

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    While there’s no secret recipe for reporting overlaps to the Federal Trade Commission in the new Hart-Scott-Rodino Act form, there are several layers of considerations for all pharma-biotech companies and counsel to reflect on internally before reporting on any deal, say attorneys at A&O Shearman.

  • A Look At Drug Price Negotiation Program's Ongoing Impact

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    More than two years after the passage of the Inflation Reduction Act and the rapid implementation of the drug price negotiation program, attorneys at Ropes & Gray discuss how the IRA has influenced licensing strategies, and how maximum fair prices under the law have economically affected certain drugs.

  • Preparing For A Possible End To The Subminimum Wage

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    The U.S. Department of Labor's proposed rule to end the subminimum wage for employees with disabilities may significantly affect the community-based rehabilitation and training programs that employ these workers, so certified programs should be especially vigilant about compliance during this period of evaluation and scrutiny, say attorneys at Jackson Lewis.

  • Drug Pricing Policy Trends To Expect In 2025 And Beyond

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    Though 2025 may bring more of the same in the realm of drug pricing policy, business as usual entails a sustained, high level of legal and policy developments across at least six major areas, say attorneys at Ropes & Gray.

  • Top 10 Healthcare And Life Sciences Issues To Watch In 2025

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    Under the new Trump administration, this coming year may benefit some healthcare and life sciences stakeholders, while creating new challenges for others amid an increasingly complex regulatory environment, say attorneys at Debevoise.