Policy & Compliance
-
August 08, 2025
DC Medicaid Recipients Win Class Cert. For Notice Row
A D.C. federal judge granted a class certification motion lodged by a group of Medicaid beneficiaries who allege the district has violated their due process rights by failing to provide individualized written notices explaining prescription coverage denials and appeal rights.
-
August 08, 2025
Administration Says States Can't Second-Guess ACA Changes
The Trump administration urged a Massachusetts federal court to reject a request by a group of states seeking to stay implementation of new rules that will reduce Affordable Care Act healthcare marketplace subsidies and enforce certain enrollment restrictions.
-
August 08, 2025
Iowa PBM Law Challengers Seek Wider Block At 8th Circ.
Employers and benefit plans challenging an Iowa law aiming to limit pharmacy benefit managers' power to set drug prices will seek Eighth Circuit review of a district court judge's decision from July that temporarily blocked parts of the new policy as preempted by federal benefits law.
-
August 08, 2025
Attys Seek Final OK Of $100M Walgreens Rx Cost Settlement
An Illinois federal judge should greenlight a $100 million settlement to claims that Walgreens overcharged insured customers for generic prescription drugs, the plaintiffs' attorneys said, asking the judge to wrap up the 8-year-old consumer protection litigation.
-
August 07, 2025
Health Insurance Telemarketers Cough Up $145M In FTC Suits
Two telemarketing companies will pay $145 million to settle Federal Trade Commission claims that they misled millions of consumers into buying phony health insurance plans, the FTC said in a Thursday announcement accusing the telemarketers of making false promises that didn't provide what they offered.
-
August 07, 2025
HHS Wins Another Round In Medicare Drug Negotiation Battle
A Texas federal court dealt another blow to the pharmaceutical industry Thursday when it ruled in favor of Medicare's Drug Price Negotiation Program, turning away arguments that the program is unconstitutional — the third such decision in two days.
-
August 07, 2025
BioPharma Co.'s $15M Deal Over Ruined J&J Vaccines OK'd
A Maryland federal judge on Thursday granted final approval to a $15 million settlement to close out a stockholder derivative suit claiming Emergent BioSolutions Inc. and its top brass made a mint selling stock before their allegedly lax oversight led to the contamination of over 15 million Johnson & Johnson COVID-19 vaccine doses.
-
August 07, 2025
Michigan AG Fights Bid To Pause PBM Price-Fixing Suit
Michigan's attorney general has said there is no reason to pause her price-fixing suit against pharmacy benefit managers Express Scripts and Prime Therapeutics for a pending dismissal motion, urging a federal judge not to put discovery on ice.
-
August 07, 2025
10th Circ. Upholds Okla. Law Banning Trans Care For Minors
The Tenth Circuit declined to block an Oklahoma law banning gender-affirming care for transgender minors, ruling that a recent U.S. Supreme Court opinion backing a similar law from Tennessee undermines state residents' claims that the statute is discriminatory.
-
August 07, 2025
2nd Circ. Axes Challenge To Medicare Drug Price Negotiations
In a published opinion Thursday, the Second Circuit turned away Boehringer Ingelheim's constitutional and administrative challenge to the Medicare Drug Price Negotiation Program, finding that the program is voluntary and it was lawfully implemented under the Inflation Reduction Act.
-
August 07, 2025
Mich. Agency Can't Shake Suit Over Fights At Psych Hospital
The Michigan claims court has ruled that the state's health department must face a lawsuit over the beating of a child at a state-run psychiatric facility because the complaint adequately alleged hospital staff took intentional steps that "directly and predictably" led to the fight.
-
August 06, 2025
6th Circ. Rips 'Stalking Horse' Ploy In Drug Negotiation Suit
The pharmaceutical industry will feel the sting of a Wednesday loss in a wide-ranging war over Medicare's power to negotiate drug prices, as the Sixth Circuit tossed a suit and accused one major company of utilizing a "stalking horse" to sue in a more favorable forum.
-
August 06, 2025
States Urge Justices To Back Med Mal Laws In Federal Court
Tennessee and 26 other states on Wednesday urged the U.S. Supreme Court to hold that state statutes requiring an expert affidavit in all medical malpractice suits may be applied in federal court, arguing that overriding these laws under federal procedure rules would undermine state authority.
-
August 06, 2025
Compelling ERISA Arbitration No Sure Thing, 9th Circ. Shows
The Ninth Circuit aligned with several other federal appeals courts when it recently struck down a clause in a food service company's employee health plan that barred class or representative actions, marking the latest in a series of setbacks for employers looking to push federal benefits suits into solo arbitration.
-
August 06, 2025
Texas Hospital Should Face Retirement Plan Suit, Judge Says
A Houston hospital shouldn't dodge a proposed class action claiming it failed to remove a J.P. Morgan fund from its $2.8 billion employee retirement plan despite the investment option's consistent underperformance, a Texas federal magistrate judge recommended Wednesday, saying the allegations are solid enough to stay in court.
-
August 06, 2025
Spinal Implant Co. CEO Avoids Prison After Plea Deal
The founder and CEO of Massachusetts medical device maker SpineFrontier was sentenced Wednesday to a year of supervised release, the first six months on home confinement, for directing employees to mislead the government about the nature of payments to a surgeon who was using the company's products.
-
August 06, 2025
State AGs Want Final OK For $39M Apotex Price-Fixing Deal
Nearly every state attorney general in the country has asked a Connecticut federal judge to give final approval to a $39.1 million deal to settle claims that drugmaker Apotex Corp. schemed with others to fix prices and allocate markets for generic drugs, noting that the Florida-based company has already made the payment.
-
August 05, 2025
Crowell Lands 16 Reed Smith Health Partners Across 4 Cities
Crowell & Moring LLP announced Wednesday that it is expanding its healthcare practice with dozens of attorneys from Reed Smith LLP, including 16 healthcare litigation partners based in Chicago, Los Angeles, San Francisco and Dallas, where the firm is launching a new shop with a former Reed Smith lawyer at the helm.
-
August 05, 2025
Wash. Judge Questions Injunctions' Scope In Head Start Case
A Washington federal judge asked attorneys Tuesday to explain how the U.S. Supreme Court's decision concerning nationwide injunctions might impact efforts by a group of Head Start associations to halt federal directives restricting noncitizen access to the program and use of funds for diversity initiatives.
-
August 05, 2025
OptumRx Urges Panel To DQ Motley Rice In LA Opioid Suit
OptumRx told a California appellate panel Tuesday that Motley Rice should be disqualified from representing Los Angeles County in a lawsuit alleging it colluded with drugmakers to fuel the opioid crisis, saying the firm violated state law by using confidential information obtained in the case in other lawsuits it's handling against Optum.
-
August 05, 2025
Key Opioid Theory Actually Irrelevant, Drug Cos. Tell 4th Circ.
With federal judges in West Virginia suddenly split over the central legal theory in opioid litigation, major drug distributors are insisting the theory actually doesn't matter, telling the Fourth Circuit it can uphold their triumph in a landmark trial without even touching the hot-button issue.
-
August 05, 2025
Law, Medical School Orgs Face Application Fee Antitrust Suits
The Law School Admission Council and the Association of American Medical Colleges have each been hit with a proposed class action in Pennsylvania and D.C. federal courts, respectively, by candidates who said the nonprofits conspired with their member schools to charge excessive application fees that have been fixed at the same price regardless of the school.
-
August 05, 2025
Ex-USPTO Heads, Judges Oppose Anti-Patent Thicket Bill
A pro-innovation group composed of former U.S. Patent and Trademark Office officials and former Federal Circuit judges on Tuesday asked Congress to oppose a bill introduced last month that would limit so-called patent thickets used by pharmaceutical companies to restrict the production of generic counterparts to their drugs.
-
August 05, 2025
UBH Patients Score Partial Win In Mental Health Claims Fight
A California federal judge handed a partial win Tuesday to a class of participants in employee health benefit plans who sought coverage for mental health and substance use disorder treatments from United Behavioral Health, holding the company's overly restrictive guidelines breached fiduciary duties under federal benefits law.
-
August 05, 2025
A Free Exercise 'Blueprint' In Colo. Abortion Reversal Order
A Colorado federal judge's decision to allow medication abortion "reversals" on free exercise grounds could serve as a model for other lawsuits meant to legitimize a practice that is outside the standard practice of medicine.
Expert Analysis
-
A Primer On Navigating The Conrad 30 Immigration Program
As the Conrad 30 program opens its annual window to help place immigrant physicians in medically underserved areas, employers and physicians engaged in the process must carefully understand the program's nuanced requirements, say Andrew Desposito and Greg Berk at Sheppard Mullin.
-
Class Actions At The Circuit Courts: September Lessons
In this month's review of class action appeals, Mitchell Engel at Shook Hardy identifies practice tips from four recent class certification rulings involving denial of Medicare reimbursements, automobile insurance disputes, veterans' rights and automobile defects.
-
Proposed Legislation May Crack Down On Online Drug Ads
A bill recently proposed in Congress could serve as a sea change in how the U.S. Food and Drug Administration regulates drug-related speech, with significant trickle-down effects on various corners of not only the drug industry but also on consumers and providers themselves, say Dominick DiSabatino and Arushi Pandya at Sheppard Mullin.
-
What To Expect From Calif. Bill Regulating PE In Healthcare
A California bill currently awaiting Gov. Gavin Newsom's approval, intended to increase oversight over private equity and hedge fund investments in healthcare, is emblematic of recent increased scrutiny of investments in the space, and may affect transactions and operations in California in a number of ways, say attorneys at Ropes & Gray.
-
Vertex Suit Highlights Issues For Pharma Fertility Support
Vertex Pharmaceuticals' recent lawsuit challenging the U.S. Department of Health and Human Services' interpretation of the Anti-Kickback Statute is influenced by a number of reproductive rights and health equity issues that the Office of Inspector General should address more concretely, including in vitro fertilization and fertility preservation programs, says Mary Kohler at Kohler Health Law.
-
CMS' New 'Breakthrough' Device Policy Shows Little Promise
The Centers for Medicare & Medicaid Services’ recent procedural notice outlining a new Medicare coverage pathway for breakthrough medical devices will, at best, be a failed experiment and, at worst, result in Medicare beneficiaries denied access to innovative treatments, say attorneys at King & Spalding.
-
A Preview Of AI Priorities Under The Next President
For the first time in a presidential election, both of the leading candidates and their parties have been vocal about artificial intelligence policy, offering clues on the future of regulation as AI continues to advance and congressional action continues to stall, say attorneys at Mintz.
-
Managing Community Health Needs Assessments: A Checklist
Excerpt from Practical Guidance
To guide nonprofit hospitals and health systems through their required community health needs assessment every three years, this checklist outlines the steps for 12 phases of the process.
-
Pa. Health Employers Must Prep For Noncompete Restrictions
Newly enacted legislation in Pennsylvania prohibits certain noncompete covenants for healthcare practitioners in the state beginning next year, creating compliance challenges that both employers and employees should be aware of, say attorneys at Buchanan Ingersoll.
-
FTC Focus: What Access To Patent Settlements Would Mean
Settling parties should adopt a series of practice tips, including specifying rationales to support specific terms, as the Federal Trade Commission seeks to expand its access to settlements before the Patent Trial and Appeal Board, say Shannon McGowan and David Munkittrick at Proskauer.
-
Agencies Should Reward Corporate Cyber Victim Cooperation
The increased regulatory scrutiny on corporate victims of cyberattacks — exemplified by the U.S. Securities and Exchange Commission's case against SolarWinds — should be replaced with a new model that provides adequate incentives for companies to come forward proactively and collaborate with law enforcement, say attorneys at McDermott.
-
Strategies To Defend Against Healthcare Nuclear Verdicts
The healthcare industry is increasingly the target of megaclaims, particularly those alleging medical malpractice, but attorneys representing providers can use a few tools to push back on flimsy litigation and reduce the likelihood of a nuclear verdict, says LaMar Jost at Wheeler Trigg.
-
What Drug Cos. Must Know About NY Price Transparency Law
Drug manufacturers must understand the contours of New York's recently implemented law requiring self-reporting of drug price increases, as well as best practices for compliance and challenges against similar laws in other states, say Elizabeth Bierut and Angie Garcia at Friedman Kaplan.