Policy & Compliance

  • September 24, 2025

    4th Circ. Kicks Trans Care Exclusion Suits Back To Trial Court

    A pair of suits challenging health plan coverage exclusions on gender-affirming care for minors are headed to district court after the Fourth Circuit vacated decisions finding those policies discriminatory, in line with a U.S. Supreme Court directive to revisit the cases in light of new precedent.

  • September 24, 2025

    Hall Booth Smith Grows In NJ With Aging Services Expert

    Hall Booth Smith PC built out its aging services practice this week with the hire of a Paramus, New Jersey-based of counsel attorney specializing in litigation and risk management for clients in the acute care and post-acute care fields.

  • September 24, 2025

    States Say Ed Dept. Must Face Suit Over Mental Health Cuts

    A group of 16 states led by Washington has asked a federal judge not to let the U.S. Department of Education escape the states' claims that the agency violated federal law by discontinuing mental health grants given to public schools to help students cope with school shootings.

  • September 24, 2025

    Amtrak Beats Retired Worker's Suit Over Benefits Reversal

    A Rhode Island federal judge dismissed an ex-Amtrak employee's suit claiming the company illegally rolled back medical care reimbursement benefits that the rail service said it mistakenly granted him in retirement, finding he wasn't entitled to the extra credits under the plan's terms.

  • September 23, 2025

    Fed. Vaccine Panel Prompts Legal, Health Confusion

    It's been days since a Centers for Disease Control and Prevention committee updated recommendations for a common childhood vaccine and the COVID-19 booster. But healthcare and legal experts are still trying to understand the implications of the meeting and the votes that came out of it.

  • September 23, 2025

    Kansas Abortion Mandates On Trial: What You Need to Know

    The largest provider of reproductive healthcare in Kansas will face off with state officials this week at a long-awaited trial focused on a 24-hour abortion waiting period, among other state requirements.

  • September 23, 2025

    Tylenol MDL In Spotlight After Trump Blasts Use In Pregnancy

    The Trump administration's attack on the use of acetaminophen during pregnancy drew on the work of a Harvard expert whose analysis is central to a legal clash now before a federal appeals court. The president's broadside promises to energize plaintiffs.

  • September 23, 2025

    State Medicaid Cuts Mean 'Financial Squeeze' For Providers

    Law360 Healthcare Authority talks with Gayland Hethcoat of ArentFox Schiff LLP about the rationale behind major cuts coming to Medicaid state-directed payments and what they will mean for providers and patients.

  • September 23, 2025

    NC Sens. Vote To Cut Planned Parenthood's Medicaid Funds

    Republican state senators in North Carolina have greenlit a bill that would revoke Medicaid funding for Planned Parenthood, aligning the Tar Heel state with the president's "One Big Beautiful Bill," which prohibits Medicaid funding for nonprofit groups that provide abortion services.

  • September 23, 2025

    Long Time Limits In Trans Care Laws Expand Doctors' Liability

    State lawmakers are including lengthy statutes of limitations — some of them decades-long — in new bans on transgender care for minors. Advocates say long time frames for prosecutions or civil suits make sense when a child is involved. Others see a "chilling" effect for providers.

  • September 23, 2025

    EX-CTA Worker's $425K Vaccine Bias Award Capped At $300K

    An Illinois federal judge lowered a former Chicago Transit Authority employee's $425,000 jury award to $300,000 Tuesday for the ex-worker's claim that he was wrongly fired for refusing the COVID-19 vaccine, entering a judgment the judge said he'll later amend with awards that include back and front pay.

  • September 23, 2025

    Two Longtime HHS Attys Depart Posts For Crowell & Moring

    Two prominent U.S. Department of Health and Human Services attorneys have left their posts for Crowell & Moring LLP after more than two decades in the federal government.

  • September 23, 2025

    Burns White Launches Correctional Healthcare Practice Group

    Pittsburgh-based Mid-Law firm Burns White LLC has launched a practice group focused on helping clients navigate liability risk from providing healthcare in prisons and other correctional settings.

  • September 23, 2025

    Pa. Health Network To Pay $1.15M In 401(k) Forfeiture Suit

    A Pennsylvania health system agreed to pay workers $1.15 million to resolve a federal suit alleging it unlawfully used forfeited retirement plan funds to satisfy its contribution obligations and allowed workers to be overcharged for plan administrative fees.

  • September 22, 2025

    2nd Circ. Undoes $25M Restitution In Horse-Doping Case

    A veterinarian convicted of conspiracy in a sprawling horse-doping scheme has escaped $25 million in restitution and is also off the hook for the $10.3 million forfeiture of funds tied to the sale of undetectable, performance-enhancement drugs, the Second Circuit said Monday.

  • September 22, 2025

    Family Sues For $100M In Child's Hyperbaric Chamber Death

    The family of a 5-year-old boy who died in a hyperbaric chamber explosion in January sued the center that was treating the child and the manufacturer of the chamber for more than $100 million in damages Monday, alleging the Michigan clinic concealed the dangers of using the chamber. 

  • September 22, 2025

    Anthem's $12.9M ERISA Deal Clears First Hurdle

    A New York federal judge has granted preliminary approval to a nearly $12.9 million settlement resolving claims that Anthem wrongfully denied coverage for residential behavioral health treatment under employer-sponsored health plans.

  • September 22, 2025

    Mayo Clinic Can't Fully Nix Suit Over Withheld Benefits Info

    The Mayo Clinic and its benefits administrator can't entirely escape a worker's suit claiming they pushed her to work with pricey out-of-network providers and wouldn't provide reimbursement estimates, after a Minnesota federal judge said she supported some federal benefits law claims with enough detail to remain in court.

  • September 19, 2025

    Ga. Providers Seek Exit From 'Conspiratorial' BCBS Fraud Suit

    Healthcare consulting firm HaloMD and several providers urged a federal judge Friday to toss a lawsuit from Blue Cross Blue Shield of Georgia accusing them of abusing a federal dispute resolution process for surprise medical bills, arguing the insurer's suit offers little more than "inflammatory, conspiratorial rhetoric."

  • September 19, 2025

    CDC Panel Urges Caution On COVID Vax, Punts On Hep B

    A panel of advisers at the Centers for Disease Control and Prevention on Friday voted unanimously to recommend that people receiving the COVID-19 vaccine this season do so only after discussing it with their health providers.

  • September 18, 2025

    Brothers Blame Associate For $90M HIV Drug Fraud Scheme

    Two Maryland brothers accused of selling $90 million worth of mislabeled HIV drugs told a Florida federal jury on Thursday that their charges stem from an associate hired for his pharmaceutical industry connections, but who instead lied about the medication's black market origins and told them it was purchased legitimately.

  • September 18, 2025

    Mich. Top Court To Weigh Medicare's Role In No-Fault Cases

    Michigan's highest court will weigh whether an injured driver who opted out of personal injury protection due to his Medicare coverage must offset his damages by billing the insurance program for accident-related medical expenses in a no-fault dispute. 

  • September 18, 2025

    HHS Shutters Miami Organ Donor Org. For 'Unsafe' Practices

    Federal health officials have decertified a Miami-based organ procurement organization that arranges organ donations after an investigation found a pattern of "unsafe" practices, marking the first time the federal government has revoked the certification of such a group, according to an announcement Thursday from Health Secretary Robert F. Kennedy Jr. 

  • September 18, 2025

    Elevance Won't Cover Zepbound To Treat Apnea, Patient Says

    Elevance Health, formerly known as Anthem Inc., arbitrarily excludes coverage of FDA-approved Zepbound to treat moderate to severe obstructive sleep apnea and refuses to consider requests for exceptions by maintaining that the medication is for weight loss, alleges a proposed class action filed by an enrollee in Indiana federal court Tuesday.

  • September 18, 2025

    Senate Confirms Trump's Pick To Lead DOL Benefits Arm

    The Senate confirmed fiduciary liability insurance expert Daniel Aronowitz on Thursday to lead the U.S. Department of Labor's employee benefits division, which oversees regulation and enforcement of employer-provided health and retirement plans.

Expert Analysis

  • What To Expect Next From Federal Health Tech Regulation

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    Healthcare organizations should pay close attention to federal health information technology regulators' recent guidance concerning barriers to accessing electronic health information, which signals that more enforcement in this area is likely forthcoming, say attorneys at Ropes & Gray.

  • 5 Areas Congress May Investigate After GOP Election Wins

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    With Republicans poised to take control of Congress in addition to the executive branch next year, private companies can expect an unprecedented uptick in congressional investigations focused on five key areas, including cryptocurrency and healthcare, say attorneys at Cahill Gordon.

  • Takeaways From State Votes On Abortion In The 2024 Election

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    Attorneys at Epstein Becker discuss how 10 states voted on ballot initiatives to either protect or restrict access to abortion in the 2024 general election, and analyze overarching trends.

  • Loper Bright Offers New Materiality Defense To FCA Liability

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    The U.S. Supreme Court's decision in Loper Bight Enterprises v. Raimondo, ending Chevron deference, may have created a new defense to False Claims Act liability by providing the opportunity to argue that a given regulation is not material to the government's payment decision, says Tanner Cook at Husch Blackwell.

  • How Expanded Birth Control Coverage May Affect Employers

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    Employers should consider the potential impact of recently proposed regulations that would expand group health plans' required coverage of preventive services and contraceptives, including questions about how the agencies would implement their plans to eliminate the prescription requirement and alter the exceptions process, says Jennifer Rigterink at Proskauer.

  • Legislation Most Likely To Pass In Lame Duck Session

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    As Congress begins its five-week post-election lame duck session, attorneys at Greenberg Traurig break down the legislative priorities and which proposals can be expected to pass.

  • Preserving The FCA Is Crucial In Trump's 2nd Term

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    While the Trump administration may pursue weaker False Claims Act enforcement, it remains an essential tool in safeguarding public funds and maintaining corporate accountability, so now is not the time to undermine ethical behavior, or reduce protections and incentives for whistleblowers, says Adam Pollock at Pollock Cohen.

  • PREVAIL Bill Is Another Misguided Attempt To Restrict PTAB

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    The decade-long campaign against the U.S. Patent and Trademark Office's Patent Trial and Appeal Board — currently focused on the PREVAIL Act that's slated for markup in the Senate — is not really about procedural issues, and it is not aimed at securing more accurate patentability decisions, says Clear IP's Joseph Matal, former acting director at the USPTO.

  • Justices Face Tough Question On HHS Hospital Pay Formula

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    In Advocate Christ Medical Center v. Becerra, the U.S. Supreme Court will determine whether the U.S. Department of Health and Human Services properly applied certain Medicare reimbursement adjustments to hospitals — a decision that could significantly affect hospitals' ability to seek higher Medicare reimbursement for low-income patients, say attorneys at Sheppard Mullin.

  • Key Healthcare Issues That Hinge On The Election Outcome

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    The 2024 presidential race, while not heavily dominated by healthcare issues compared to past elections, holds significant implications for the direction of healthcare policy in a potential Harris or Trump administration, encompassing issues ranging from Medicare to artificial intelligence, says Miranda Franco at Holland & Knight.

  • The Key To Solving High Drug Costs Is Understanding Causes

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    One-sided views on who or what contributes to the high cost of pharmaceuticals render possible solutions much harder to discover and implement, and a better approach would be to examine history and learn why costs have increased and what legislation has and hasn't helped, says Nancy Linck at NJ Linck Consulting.

  • Next Steps For FCA Defendants After Fla. Qui Tam Ruling

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    Because a Florida federal court's recent decision in Zafirov v. Florida Medical Associates could eventually prove to be a watershed event for False Claims Act suits, defendants should consider potential next steps to ensure that their litigation benefits from the court's reasoning and further developments, says Scott Gallisdorfer at Bass Berry.

  • A Look At Calif.'s New AI Law For Health Insurers

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    A newly enacted California law prohibits artificial intelligence tools from making medical necessity determinations for healthcare service plans or disability insurers, addressing core questions that have arisen around AI's role in coverage decisions, say attorneys at DLA Piper.