Policy & Compliance

  • July 21, 2026

    Hospitals Say Saul Ewing Atty's Board Role Taints FCA Suit

    A Saul Ewing LLP attorney should be disqualified from leading a whistleblower suit over a nurse's alleged diversion of prescription narcotics, as the former Heritage Valley Health System in western Pennsylvania said he was previously a member of its board of directors.

  • July 21, 2026

    CMS Withholds $1B In Medicaid From Calif., Minn., Citing Fraud

    The Centers for Medicare & Medicaid Services is withholding more than $1 billion in Medicaid dollars from California and Minnesota because the agency suspects healthcare fraud in those states, officials announced Tuesday.

  • July 21, 2026

    Research Or Crime? Feds Eye Scientists Crossing Borders

    At U.S. airports and border crossings, scientists returning from trips abroad are getting a closer look from law enforcement agents. More smuggling and paperwork violations that might once have been overlooked are turning into criminal cases.

  • July 21, 2026

    2nd Circ. Tylenol Expert Call Sows Admissibility Confusion

    A circuit court decision on expert admissibility in a dispute over an alleged link between Tylenol and autism is raising legal experts' concerns that the panel will sow confusion among judges trying to weed out unreliable medical opinions.

  • July 20, 2026

    Albertsons Data Suggests Opioids Were Diverted, Expert Says

    Albertsons pharmacies in Washington state received considerably more opioid medications from distributors between 2009 and 2015 than the company reported dispensing — a sign of potential diversion, according to an expert witness who testified Monday at a bench trial in Washington's lawsuit accusing the chain of exacerbating the state's opioid crisis.

  • July 20, 2026

    SD Judge Blocks Abortion Ad Ban Against Atty, Nonprofit

    A South Dakota federal judge barred the state from enforcing an abortion advertising ban against a reproductive health education nonprofit and an attorney, ruling that doing so would likely violate the First Amendment.

  • July 20, 2026

    Vanda's NDA Rejection Challenge Can't Be Heard At DC Court

    A D.C. federal judge has said he no longer has jurisdiction to hear Vanda Pharmaceuticals Inc.'s challenge alleging the FDA violated the Appointments Clause by allowing a non-officer to exercise "signatory authority" and reject its new drug application for tradipitant, since Vanda went to the D.C. Circuit raising the same argument already.

  • July 20, 2026

    Top Gov't Contracting Cases To Watch In The 2nd Half Of 2026

    Federal courts in the latter half of 2026 are expected to decide if the Trump administration overstepped by designating Anthropic a supply chain risk to national security and whether the False Claims Act's qui tam provisions pass constitutional muster, potentially affecting the government's ability to tackle fraud.

  • July 17, 2026

    Md. Judge Stays Reforms Set To Shrink ACA Coverage Pool

    A Maryland federal judge stayed a set of Affordable Care Act marketplace reforms that were set to take effect Monday, finding several cities and groups representing doctors and small businesses were likely to succeed in their Administrative Procedure Act challenge against them.

  • July 17, 2026

    Medical Groups Urge 1st Circ. To Back Vaccine Panel Freeze

    The American Academy of Pediatrics and other public health organizations on Friday defended before the First Circuit a Massachusetts judge's decision to block Health Secretary Robert F. Kennedy Jr.'s vaccine policy committee appointments, countering claims that the judge overreached.

  • July 16, 2026

    FDA, Drugmakers Urge 5th Circ. To Allow Abortion Pill By Mail

    The U.S. Food and Drug Administration and the makers of the abortion medication mifepristone have urged the Fifth Circuit not to reinstate an in-person dispensing requirement, arguing that doing so would disrupt the government's ongoing review of the drug, "threaten chaos" and defy the U.S. Supreme Court.

  • July 16, 2026

    3rd Circ. Partly Revives Hospitals' ERISA Suit Against Cigna

    The Third Circuit on Thursday revived some ERISA contract claims in a New Jersey hospital network's suit alleging Cigna underpaid out-of-network reimbursements by $114 million, but backed the dismissal of the network's fiduciary duty claims.

  • July 16, 2026

    Walgreens Sues Mass. Medicaid Program Over Drug Rates

    Walgreens says administrators of the Massachusetts Medicaid program cannot rely on drug prices negotiated with pharmacy benefit managers to determine reimbursement rates, in a challenge to the state's effort to claw back $242,000 in alleged overpayments.

  • July 16, 2026

    Arnall Golden Brings On Arnold & Porter Litigator In DC

    Arnall Golden Gregory LLP has added an Arnold & Porter Kaye Scholer LLP partner in the firm's Washington, D.C., office and named him chair of the firm's Foreign Agents Registration Act compliance practice.

  • July 16, 2026

    Aramark Asks Full 5th Circ. To Nix Aetna ERISA Arbitration Bid

    Food services company Aramark urged the full Fifth Circuit to deny Aetna's request to arbitrate allegations that it cost Aramark millions by bungling health benefits claims, arguing that the insurer is attempting to twist U.S. Supreme Court precedent to kick the case out of court.

  • July 16, 2026

    Diagnostics Co. Labcorp Settles FCA Claims For $14.5M

    Diagnostics testing company Labcorp will pay $14.5 million to settle False Claims Act allegations that it submitted unnecessary Medicare claims for urine drug tests, the Massachusetts U.S. attorney's office announced.

  • July 15, 2026

    Albertsons Slow To Review Wash. Opioid Sales, Judge Told

    Albertsons conducted few reviews of opioid dispensing by its Washington pharmacies for years after establishing a controlled substances compliance team, according to testimony played on Day 3 of a bench trial in the state's lawsuit accusing the company and its Safeway subsidiary of exacerbating Washington's opioid epidemic.

  • July 15, 2026

    Acorda Can't Add $66M To Award In Ampyra Royalty Fight

    The Second Circuit on Wednesday refused to alter an arbitral award issued to Acorda Therapeutics to include nearly $66 million beyond the $16.6 million it won in a multiple sclerosis drug dispute, saying the company "slept on its rights" and couldn't change the result now.

  • July 15, 2026

    2nd Circ. Revives NY Provider's BCBS Underpayment Suit

    The Second Circuit on Wednesday revived a New York healthcare provider's suit accusing out-of-state Blue Cross Blue Shield licensees of underpaying insurance claims, saying the carriers' long-standing business relationship with a New York licensee to obtain preferential prices in the state supports jurisdiction there.

  • July 15, 2026

    Local Gov'ts Seek To Bar HHS Teen Health Program Changes

    A group of local governments and health nonprofits urged a D.C. federal court Wednesday to block recent federal mandates requiring Teen Pregnancy Prevention Program grant recipients to incorporate abstinence education and other changes to their reproductive health programming, arguing the changes are arbitrary and capricious.

  • July 15, 2026

    NC Panel Nixes Nurse Noncompetes For Being 'Too Broad'

    A medical clinic provider couldn't convince a North Carolina state appeals court to overturn a ruling that noncompete agreements for two former nurses were unenforceable, after a split panel ruled Wednesday that the terms were overly broad and voidable under public policy.

  • July 15, 2026

    United Owes $630K In Fight Over Teen's Mental Health Care

    United Healthcare must pay $630,000 to a mother who challenged the insurance company's decision to deny coverage for her son's residential mental health treatment, a Utah federal judge ordered, after rejecting the company's bid to slim her requests for interest and attorney fees.

  • July 15, 2026

    Mass. Says UnitedHealth FCA Case Belongs In State Court

    Massachusetts asked a federal judge to send its $100 million state False Claims Act lawsuit alleging overbilling by UnitedHealthcare back to state court, accusing the insurer of forum shopping with a theoretical defense touching on federal law.

  • July 15, 2026

    DC Circ. Affirms Ratings For Alignment Medicare Plans

    The D.C. Circuit sided with the Centers for Medicare & Medicaid Services regarding its decision not to discard certain unfavorable surveys for Alignment Healthcare's Medicare Advantage plans, saying there is no indication of an administrative error.

  • July 14, 2026

    Albertsons Probed On Pharmacy Compliance Staffing At Trial

    Two former Albertsons pharmacy compliance executives testified in video depositions played Tuesday before a Washington judge considering whether Albertsons failed to prevent the diversion of opioids in the state, acknowledging the nationwide compliance team consisted of just six staffers between 2015 and 2020 despite heightened scrutiny amid the opioid epidemic.

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.