Policy & Compliance

  • June 25, 2026

    Texas Faces Tough Questions In Tylenol Autism Appeal

    A Texas appellate court seemed skeptical Thursday of an argument that the parent entities of the company that sells Tylenol should have to defend claims that the pain reliever causes autism, suggesting that the companies don't have enough ties to Texas.

  • June 25, 2026

    Netflix Urges Justices Not To Disturb 9th Circ. ERISA Docs Ruling

    Netflix urged the U.S. Supreme Court Thursday not to take up a petition from an employee health plan participant who alleged the company failed to provide him access to plan documents in violation of federal benefits law, arguing the Ninth Circuit's ruling in the case should remain in place.

  • June 25, 2026

    Wash. Therapist Seeks Bar On 'Conversion Therapy' Ban

    A Washington therapist has urged a federal court to bar the state from enforcing its ban on what is commonly known as conversion therapy, arguing that a U.S. Supreme Court decision this year has "vindicated" his right to provide counseling targeted by the ban.

  • June 25, 2026

    Novo Nordisk Gets 401(k) Investment Suit Narrowed

    A New Jersey federal judge dismissed allegations accusing Novo Nordisk of unlawfully keeping underperforming investment options in its employee 401(k) plan, handing the pharmaceutical company a partial win by concluding workers hadn't identified comparable funds that performed significantly better.

  • June 24, 2026

    NY Judge Halts DOJ Bid For Trans Youth Medical Records

    A New York federal judge Wednesday barred the U.S. Department of Justice from seeking medical records of transgender patients who received gender-affirming care as minors in the wake of a grand jury subpoena to NYU Langone Health System, saying the government's investigation doesn't outweigh the patients' privacy interests.

  • June 24, 2026

    Delta Dental Says Wash. Antitrust Suit Echoes Faulty Claims

    Delta Dental of Washington said Tuesday an Evergreen State dentist targeting the dental insurer in a proposed antitrust class action has excluded its national affiliates from the case to "escape from a federal court's rejection of identical arguments" that the companies conspired to stifle insurer competition and suppress reimbursement rates.

  • June 24, 2026

    Wholesalers Say Novo Can't Duck GLP-1 Antitrust Suits

    Drug buyers want a New York federal judge to preserve proposed class claims accusing Novo Nordisk of paying Teva to delay generic competition with its Victoza GLP-1 drug, arguing that whatever the underlying deal was, no generic version materialized when it could have.  

  • June 24, 2026

    Doc's Defamation Claim Against Cigna Barred By ERISA

    In a precedential opinion dealing with an issue of first impression, the Third Circuit on Wednesday held that the Employee Retirement Income Security Act preempts a doctor's defamation claim against Cigna because the statements stemmed from the administration of his patients' health plans.

  • June 24, 2026

    11th Circ. Urged To Toss Convictions In $1.4B Hospital Fraud

    Two brothers convicted in a $1.4 billion scheme to bill insurers inflated rates for drug tests told the Eleventh Circuit on Wednesday that there was insufficient evidence to support their convictions and that they should have been allowed an evidentiary hearing after potential juror misconduct emerged following the trial.

  • June 24, 2026

    3rd Circ. Extends Lenient Retaliation Test To ADA, FMLA Suits

    The Third Circuit declared Wednesday that the long-standing, worker-friendly standard used to evaluate Title VII retaliation claims also applies to analogue allegations under the Americans with Disabilities Act and the Family and Medical Leave Act, kickstarting a former Marine's suit over a leaner-than-expected bonus and pay raise.

  • June 24, 2026

    UnitedHealthcare Turns Blame On MassHealth In Fraud Case

    UnitedHealthcare said it plans to defend itself against accusations that it overcharged Massachusetts for senior care, claiming the state's Medicaid program was not properly administered as it moved the case to federal court. 

  • June 23, 2026

    Kaiser Owes LA County Hospital $82M In Out-Of-Network Suit

    Kaiser Permanente's health coverage arm must pay more than $82 million to Pomona Valley Hospital Medical Center to cover unreimbursed emergency medical services, a California state judge ordered Tuesday, after a state appeals court backed a jury's verdict concerning payment for roughly 4,000 disputed medical service claims.

  • June 23, 2026

    Texas Woman Says ERs Violated EMTALA Amid Miscarriage

    A Texas woman urged the U.S. Centers for Medicare & Medicaid Services to investigate two providers over their alleged violations of the Emergency Medical Treatment and Labor Act, or EMTALA, when she sought treatment for a miscarriage, arguing her case "is not an isolated incident."

  • June 23, 2026

    What To Know About State-Level PBM Reform

    Healthcare attorneys are keeping a close eye on new laws focused on the vertical integration of pharmacy benefit managers.

  • June 23, 2026

    FTC Tells 4th Circ. Court Got It Wrong In J&J Stelara Case

    The Federal Trade Commission has told the Fourth Circuit that a Virginia federal court messed up when it ruled in an antitrust suit against Johnson & Johnson that the company bringing the suit needed to show specific intent in order to prop up a monopolization claim over the immunosuppressive drug Stelara.

  • June 23, 2026

    What To Know About The Missouri Abortion Law Ruling

    Nearly two years after Missouri residents enshrined reproductive rights into the state constitution, a judge ruled that more than three dozen state laws conflicted with the 2024 ballot amendment. Law360 Healthcare Authority looks at the case and what it means for abortion law in the Show-Me State.

  • June 23, 2026

    BCLP Health Atty Talks False Claims Act, Move From DOJ

    A former leader of False Claims Act enforcement at the U.S. Department of Justice has joined Bryan Cave Leighton Paisner LLP. Susan Carney Lynch spoke to Law360 Healthcare Authority about the move and trends in FCA enforcement.

  • June 23, 2026

    UnitedHealth Trims But Can't Escape 401(k) Forfeiture Suit

    UnitedHealth Group won dismissal of some claims in a proposed class action alleging the company mismanaged its employee 401(k) and profit sharing plan by misallocating forfeitures, but couldn't escape allegations that the way the company spent the funds breached fiduciary duties and caused transactions prohibited by federal benefits law.

  • June 23, 2026

    Judge Flags Flaws In Rule Capping Health Student Loans

    A D.C. federal judge appeared to agree with health worker organizations challenging new federal student loan caps that there were problems with how the U.S. Department of Education defined "professional degrees" in a recent rulemaking, but suggested that "taking over the job" of the department would be inappropriate.

  • June 23, 2026

    BioNTech Accused Of Firing Nurse Over Drug Trial Concerns

    A former senior clinical trial manager at BioNTech US Inc. told a North Carolina federal court Monday that she was wrongfully fired after complaining to higher-ups about an "epidemic of safety issues and protocol deviations" in clinical trials.

  • June 23, 2026

    Feds Tout AI's Role In $6.5B Healthcare Fraud Crackdown

    Federal authorities said Tuesday that artificial intelligence and sophisticated data analysis helped them detect and prosecute healthcare fraud as part of a national crackdown that resulted in charges against 455 defendants.

  • June 23, 2026

    ACA Ruling May Forecast Future Trouble For CMS Changes

    Recent pushback by a Baltimore federal judge on Affordable Care Act changes made through agency rulemaking could presage more legal defeats for the Trump administration.

  • June 22, 2026

    FTC Requires Fix For Aurobindo's $250M Lannett Deal

    The Federal Trade Commission is allowing Aurobindo Pharma Ltd. to move ahead with its planned $250 million acquisition of Lannett Co. Inc., after the pharmaceutical company agreed to unload four generic drug products to prevent potential overlaps.

  • June 22, 2026

    Sodexo Can't Wipe Out Worker's Nicotine Fee Suit

    A California federal judge refused to toss a Sodexo worker's proposed class action alleging the global food services company wrongly charged nicotine-using employees $1,200 more a year for health insurance, opening discovery on allegations that a wellness program implementing the surcharge didn't meet all federal requirements.

  • June 18, 2026

    RFK Jr. Urges 1st Circ. To Reinstate His Vaccine Advisers

    U.S. Health Secretary Robert F. Kennedy Jr. told the First Circuit a Boston federal judge's decision to freeze his vaccine committee appointments lacks a legal foundation and has left the government paralyzed when it comes to vaccine policy.

Expert Analysis

  • What's New In FDA's Latest Cell And Gene Therapy Guidance

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    New draft guidance from the U.S. Food and Drug Administration, along with other recent initiatives, come together to promote cell and gene therapy product development by streamlining development and review pathways, say attorneys at Holland & Knight.

  • Adapting To Enforcement Focus On Wound Care Fraud

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    As federal agencies target wound care industry fraud as a top enforcement priority, attorneys advising industry stakeholders should evaluate business relationships for Anti-Kickback Statute violations, emphasize appropriate product use and documentation, and use internal data analytics to monitor billing patterns, say David Tarras at Tarras Defense and Jay McCormack at Verrill Dana.

  • AG Watch: Illinois A Key Player In State-Level Enforcement

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    Illinois Attorney General Kwame Raoul has systematically strengthened his office to fill federal enforcement gaps, oppose Trump administration mandates and advance state policy objectives, particularly by aggressively pursuing labor-related issues, say attorneys at Troutman.

  • Organ Transplant System Reforms Mark Regulatory Overhaul

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    Recent oversight, enforcement and operational developments in the U.S. organ procurement and transplantation system, alongside challenges like the federal shutdown, highlight heightened regulatory scrutiny and the need for compliance to maintain public trust, say attorneys at Hall Render.

  • Federal Grantees May Soon Face More Limitations On Speech

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    If courts accept the administration’s new interpretation of preexisting case law, which attempts to graft onto grant recipients the existing limitations on government contractors' free speech, a more deferential standard may soon apply in determining whether an agency’s refusal or termination of a grant was in violation of the First Amendment, say attorneys at Venable.

  • HHS Wound Care Report Highlights Need For Payment Reform

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    The U.S. Department of Health and Human Services' recent report on potential abuse in Medicare Part B payments for skin substitutes highlights specific fraud schemes, but more importantly emphasizes that broader changes are needed for the wound care sector's fundamentally flawed payment system, say attorneys at Paul Hastings.

  • Assessing The Future Of The HIPAA Reproductive Health Rule

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    In light of a Texas federal court's recent decision to strike down a U.S. Department of Health and Human Services rule aimed to protect the privacy of patients seeking abortions and gender-affirming care, entities are at least temporarily relieved from compliance obligations, but tensions are likely to continue for the foreseeable future, says Liz Heddleston at Woods Rogers.

  • DOJ's Tracing Rule For Pandemic Loan Fraud Is Untenable

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    In conducting investigations related to COVID-19 relief fraud, the government's assertion that loan proceeds are nonfungible and had to have been segregated from other funds is unsupported by underlying legislation, precedent or the language establishing similar federal relief programs, say Sharon McCarthy, Jay Nanavati and Lasya Ravulapati at Kostelanetz.

  • New Health AI Guidance Features A Provider-Centric Approach

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    New guidance from the Joint Commission and Coalition for Health AI regarding the responsible use of artificial intelligence in healthcare deviates from preexisting guidance by recommending a comprehensive framework for using AI tools, focusing on healthcare provider organizations rather than on AI developers, say attorneys at Ropes & Gray.

  • 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.