Policy & Compliance

  • June 11, 2026

    Stop & Shop Parent Pays $40M On Inflated Drug Price Claims

    Stop & Shop's parent company will pay $40 million to resolve allegations it violated the False Claims Act by failing to report discounted prescription drug prices as "usual and customary" in claims submitted to federal Medicare, Medicaid and TRICARE programs, which resulted in overcharges, the U.S. Department of Justice announced Wednesday.

  • June 11, 2026

    HHS OIG Reports 'Concerning' Medicare Advantage Denials

    A pair of reports released by the inspector general for the U.S. Department of Health and Human Services on Thursday found that UnitedHealth Group, Humana and CVS Health logged some of the highest prior authorization denial rates among their Medicare Advantage peers for post-acute care.

  • June 11, 2026

    Braidwood Files New Challenge To ACA Birth Control Mandate

    For-profit healthcare company Braidwood Management and several individuals sued the government in Texas federal court to challenge no-cost contraception coverage requirements under the Affordable Care Act, arguing that the court should enjoin enforcement of the policy because it burdened their faith in violation of federal religious freedom law.

  • June 10, 2026

    Morgan & Morgan Atty Again Blocked From Harvard Suit

    A Massachusetts judge rebuffed a Morgan & Morgan PA attorney's second attempt to appear in a lawsuit over the theft of body parts from a Harvard Medical School morgue, saying he would not reconsider his earlier decision to bar the attorney over an incident in a separate court involving fake AI-generated case citations.

  • June 10, 2026

    Judge Won't Certify Class Of Health Workers In No-Poach Suit

    An Illinois federal judge on Wednesday refused to certify a class of former healthcare employees claiming that their wages were suppressed by alleged no-poach agreements among DaVita, UnitedHealth Group's Surgical Care Affiliates and Tenet Healthcare Corp. unit United Surgical Partners International, ruling that the proposed class is too diverse.

  • June 10, 2026

    Abbott Offered Faulty Health Plan Option, Ex-Worker Says

    Abbott Laboratories violated federal benefits law by offering a health plan option with higher premiums and lower deductibles without disclosing that participants would always pay less if they chose a high-deductible plan, according to a proposed class action filed Wednesday in Illinois federal court.

  • June 10, 2026

    NJ High Court Says Nonprofit Hospital Gets Limited Immunity

    The New Jersey Supreme Court unanimously concluded Wednesday that a nonprofit federally qualified health center isn't immune from a patient's negligence suit under a statute shielding nonprofits organized "exclusively" for charitable or educational purposes, reversing a lower court's finding to the contrary.

  • June 10, 2026

    Insurance Cos. Score Dismissal Of Zepbound Coverage Case

    A D.C. federal judge Wednesday agreed to toss a proposed class action against CVS Caremark and CareFirst BlueCross BlueShield from a worker who challenged coverage denials for Zepbound to treat sleep apnea, holding an exclusion in his employee health plan that the companies administered complied with federal benefits law.

  • June 10, 2026

    Lab To Pay $4.9M To Settle AGs' COVID Test Pricing Suit

    Eighteen states' attorneys general have entered into a $4.87 million settlement with GS Labs to resolve claims that the defunct testing company overcharged consumers for COVID-19 tests, according to statements issued Wednesday.

  • June 10, 2026

    Houston Hospital System Settles Retirement Fee, Fund Fight

    A Texas hospital system agreed to settle a proposed class action from ex-workers alleging the healthcare nonprofit failed to curb excessive recordkeeping fees and remove underperforming funds from its $2.8 billion employee retirement plan, after a magistrate judge recommended denying its motion to dismiss an amended complaint in May.

  • June 09, 2026

    Novartis, AbbVie Lose Bid To Halt Wash. 340B Pharmacy Law

    A Washington federal judge declined Tuesday to block a state law passed to protect prescription drug access for low-income and uninsured patients, rejecting arguments from AbbVie and Novartis that the new measure illegally adds to pharmaceutical manufacturers' obligations under the federal 340B Drug Pricing Program.

  • June 09, 2026

    Trans Care In Court: 7th Circ. Appeal, Atty Discipline And More

    Law360 Healthcare Authority looks at an emergency request related to the American Academy of Pediatrics, a Rhode Island judge's referral of Justice Department attorneys to a disciplinary committee, and other top news of the past week.

  • June 09, 2026

    Calif. Judge Blocks DOJ's Bid For Trans Patients' Medical Info

    A California federal judge ordered Stanford Medicine hospital not to disclose medical information belonging to trans adolescents who received gender-related care in response to a Texas grand jury subpoena, and blocked the U.S. Department of Justice from taking further steps to obtain their patient records.

  • June 09, 2026

    Eli Lilly Wins Order Halting Alleged Trulicity Fraud

    A Florida federal judge signed off Tuesday on a preliminary injunction pausing a prescription cost share program purportedly for Church of God in Christ members that pharmaceutical giant Eli Lilly and Co. says is actually a fraud scheme to resell GLP-1 drug Trulicity on the secondary market.

  • June 09, 2026

    Loper Battle Looms For Medicaid Frailty Work Exemption

    New federal work requirements for people on Medicaid take a strict view of who's too sick to work. They're almost certain to face legal challenges contending that the Trump administration went too far.

  • June 09, 2026

    4th Circ. Lets Hartford Unit Off The Hook For Drug Test Fight

    A Hartford unit doesn't owe coverage to a drug testing company accused of reporting false positive drug tests due to substandard quality control, the Fourth Circuit ruled Tuesday, saying the suit is related to an earlier claim that was covered by another insurer.

  • June 09, 2026

    The Law360 400: A Look At The Top 100 Firms

    The race to build the legal industry's largest law firm accelerated in 2025, with major firms leaning on mergers, lateral hiring and strategic expansion to climb the ranks of the Law360 400.

  • June 09, 2026

    Georgia County, Trans Deputy OK End To Surgery Bias Fight

    A Georgia county and a transgender sheriff's deputy who sued over her employee health plan's coverage exclusions for gender-affirming surgery have struck a deal to resolve her case, nine months after the en banc Eleventh Circuit issued a ruling that sided with the county. 

  • June 08, 2026

    Kaiser Member Seeks Class Cert. In Microsoft Site Tracker Suit

    A Kaiser Permanente member has called on a federal judge in Seattle to greenlight a series of national classes and California subclasses in her privacy lawsuit accusing Microsoft and Qualtrics of secretly intercepting millions of patients' private health information through tracking technologies embedded in the healthcare system's website.

  • June 08, 2026

    NC Doctor Avoids Prison For Role In $11M Medicaid Fraud

    A North Carolina doctor received five years of probation with eight months of house arrest for making false statements in an $11 million Medicaid fraud scheme, after a federal judge said he was struggling to balance the need to deter others with unwarranted sentencing disparities.

  • June 08, 2026

    Cleveland Clinic Deal With DOJ Bars Trans Care For Minors

    The Cleveland Clinic Foundation will pay over $2.3 million under agreements with the U.S. Department of Justice and the Ohio attorney general to prohibit the provision of puberty blockers and other forms of medical care for minors going through gender transition.

  • June 08, 2026

    Class Attys Want $11.6M In Fees From $35M Teva Inhaler Deal

    Berman Tabacco, Sperling Kenny Nachwalter LLC, Hilliard Shadowen LLP and five other firms have asked a Massachusetts federal judge for $11.55 million in attorney fees from a $35 million antitrust settlement resolving claims that Teva abused patent protections to delay generic competition for its QVAR asthma inhalers.

  • June 08, 2026

    HCA Unit To Pay $200K In EEOC Promotion Denial Suit

    An HCA Healthcare subsidiary has agreed to pay $200,000 to end a U.S. Equal Employment Opportunity Commission suit claiming it refused to promote a researcher because he was an Asian man in his 50s, the federal agency told a Tennessee federal court.

  • June 08, 2026

    Trump's $100K H-1B Fee Is Unauthorized Tax, Judge Rules

    A Massachusetts federal judge ruled Monday that President Donald Trump's $100,000 H-1B visa payment constitutes a tax that Congress did not authorize the president to impose, declaring the fee unlawful and vacating it in its entirety.

  • June 05, 2026

    HHS Can Issue Medicare Fines Without Jury, 4th Circ. Says

    The Fourth Circuit ruled Friday that the U.S. Department of Health and Human Services can seek monetary penalties from Medicare participants for violating program requirements without a jury trial, rejecting a Maryland nursing home operator's argument that Medicare participants are guaranteed that right.

Expert Analysis

  • Mass. Ruling May Pave New Avenue To Target Subpoenas

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    A Massachusetts federal court’s recent decision to quash a subpoena seeking information on gender-affirming care at Boston Children’s Hospital is a significant departure from courts' deferential approach to subpoena enforcement, and may open a new pathway for practitioners challenging investigative tools in the future, say attorneys at Gibson Dunn.

  • What To Expect After FDA Warnings To GLP-1 Compounders

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    The U.S. Food and Drug Administration's recent warning letters to companies advertising compounded versions of GLP-1 medications raise questions not just about the enforcement outlook for marketing such products, but also about the future of drug compounding as a whole, say attorneys at Spencer Fane.

  • How Financial Cos. Can Prep As NYDFS Cyber Changes Loom

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    Financial institutions supervised by the New York State Department of Financial Services can prepare for two critical cybersecurity requirements relating to multifactor authentication and asset inventories, effective Nov. 1, by conducting gap analyses and allocating resources to high-risk assets, among other steps, say attorneys at Pillsbury.

  • How Courts May Interpret Data-Driven Healthcare Fraud Suits

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    As the U.S. Department of Justice and other agencies increasingly turn to data mining as an enforcement tool, courts will have to determine how far data alone can take a fraud case, and sound theory, clinical expertise and institutional context will play an important role, say Jaime Jones at Sidley and Andrée-Anne Fournier and Atang Gilika at Analysis Group.

  • How Gov't Shutdown Will Affect Federal Health Agencies

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    Federal health agencies' contingency plans indicate that many major programs will remain insulated from disruption during the ongoing government shutdown, but significant policy proposals will likely be delayed and the Trump administration's emphasis on reduction-in-force plans distinguishes this shutdown from past lapses, says Miranda Franco at Holland & Knight.

  • Assessing Legal, Regulatory Hurdles Of Healthcare Offshoring

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    The offshoring of administrative, nonclinical functions has emerged as an increasingly attractive option for healthcare companies seeking to reduce costs, but this presents challenges in navigating the web of state restrictions on the access or storage of patient data outside the U.S., say attorneys at McDermott.

  • 5 Years In, COVID-19 Fraud Enforcement Landscape Is Shifting

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    As the government moves pandemic fraud enforcement from small-dollar individual prosecutions to high-value corporate cases, and billions of dollars remain unaccounted for, companies and defense attorneys must take steps now to prepare for the next five years of scrutiny, says attorney David Tarras.

  • Courts Keep Upping Standing Ante In ERISA Healthcare Suits

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    As Article III standing becomes increasingly important in litigation brought by employer-sponsored health plan members under the Employee Retirement Income Security Act, several recent cases suggest that courts are taking a more scrutinizing approach to the standing inquiry in both class actions and individual matters, say attorneys at Crowell & Moring.

  • Calif. Bill May Shake Up Healthcare Investment Landscape

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    If signed by the governor, newly passed California legislation would significantly expand the Office of Health Care Affordability's oversight of private equity and hedge fund investments in healthcare companies and management services organizations, and raise several questions about companies' data confidentiality and filing burdens, say attorneys at Ropes & Gray.

  • Pharma Copay Programs Raise Complex Economic Questions

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    The growing prevalence of copay accumulator and maximizer programs in the pharmaceutical industry is drawing increased scrutiny from patients, advocacy groups, lawmakers and courts, bringing complex questions about how financial responsibility for prescription drug purchases is determined and complicating damages assessments in litigation, say analysts at Analysis Group.

  • When AI Denies, Insurance Bad Faith Claims May Follow

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    Two recent rulings from Minnesota and Kentucky federal courts signal that past statements about claims-handling practices may leave insurers using artificial intelligence programs in claims administration vulnerable to suits alleging bad faith and unfair trade practices, say attorneys at Cozen O'Connor.

  • Health Insurance Kickback Cases Signal Greater Gov't Focus

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    A series of recent indictments by federal prosecutors in California suggests that the Eliminating Kickbacks in Recovery Act is gaining momentum as an enforcement tool against illegal inducement of patient referrals in the realm of commercial health insurance, say attorneys at BakerHostetler.

  • FDA Transparency Plans Raise Investor Disclosure Red Flags

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    The U.S. Food and Drug Administration’s recently announced intent to publish complete response letters for unapproved drugs and devices implicates certain investor disclosure requirements under securities laws, making it necessary for life sciences and biotech companies to adopt robust controls going forward, say attorneys at Arnold & Porter.