Policy & Compliance

  • June 27, 2025

    Patient Monitoring Co. To Pay Feds $1.3M To Settle FCA Suit

    A Georgia healthcare patient monitoring company has agreed to pay nearly $1.3 million to resolve a False Claims Act suit alleging it gave referral kickbacks to doctors' offices in half a dozen states, ripping off Medicare and Medicaid in the process.

  • June 27, 2025

    Judge Lets DOGE Access Go On But Cites 'Grave' Concerns

    A D.C. federal judge Friday voiced his "grave" concerns about the White House's Department of Government Efficiency obtaining personal information, but the district court declined to stop the U.S. Department of Labor and U.S. Department of Health and Human Services from giving this access.

  • June 27, 2025

    Feds Say Transnational Crime Ring Stole $10B From Medicare 

    New York federal prosecutors have charged 11 members of a "transnational criminal organization, based in Russia and elsewhere," with submitting more than $10 billion worth of fraudulent Medicare claims over the last three years and funneling the proceeds overseas, according to a newly unsealed indictment.

  • June 27, 2025

    Pregnancy Loss Draws Police Scrutiny Following Dobbs

    The nation's abortion debate has played out in civil courtrooms and state capitols across the country since the overturning of Roe v. Wade three years ago. But the battle is also emerging in another arena: the criminal courts.

  • June 27, 2025

    Full 5th Circ. To Hear Planned Parenthood Atty Immunity Row

    The full Fifth Circuit will rehear a panel's decision concluding that Planned Parenthood is entitled to attorney immunity in a whistleblower suit accusing the organization of improperly billing Medicaid programs.

  • June 27, 2025

    DC Judge Says Teen Health Projects Can 'Shutter' Temporarily

    Five Planned Parenthood affiliates will not be irreparably harmed by changes to federal guidance for teen health programs instructing grantees to demonstrate alignment with executive orders from the Trump administration rejecting transgender identity and diversity programs, a D.C. federal judge has ruled.

  • June 27, 2025

    Justices Back Task Force That Sets ACA Care Requirements

    The U.S. Supreme Court ruled Friday that the U.S. Department of Health and Human Services' secretary had authority over a preventive care task force, rejecting a constitutional challenge to an Affordable Care Act clause that requires health insurers to cover certain treatments at no cost to patients.

  • June 26, 2025

    Nurse Wins $27M In Retaliation Case Against Dignity Health

    A former chief nursing officer who sued the West Coast hospital system Dignity Health alleging she was illegally terminated for raising serious safety concerns was awarded $27.5 million from a Los Angeles jury, her attorneys announced Thursday. 

  • June 26, 2025

    Hims & Hers Face Investor Suits Over Wegovy Collab

    Telehealth company Hims & Hers Health Inc. has been hit with investors' proposed class actions accusing it of exploiting its partnership with Novo Nordisk, the distributor of weight loss drug Wegovy, to sell "knockoff" drugs, causing Hims shares to fall 35% when Novo Nordisk announced earlier this week the collaboration had been terminated.

  • June 26, 2025

    UHC Accused Of Withholding $2M In Claims From NC Provider

    UnitedHealthcare Insurance Co. siphoned millions of dollars from a North Carolina emergency medicine provider in an "extortionate scheme" by refusing to pay its customers' emergency medical claims, the provider has alleged in North Carolina federal court.

  • June 26, 2025

    6th Circ. Backs Mich. Newborn Blood Testing Program

    A Sixth Circuit panel reversed a win for a group of parents challenging a Michigan newborn health screening program, finding that the way blood samples are stored and used in the program does not violate the parents' right to make medical decisions for their children.

  • June 26, 2025

    Judge Casts Doubt On Plea Deals In Blood Test Defect Case

    A set of plea agreements between Massachusetts federal prosecutors and former Magellan Diagnostics executives has been thrown into uncertainty amid a dispute over whether the executives admitted to fraud related to defective blood tests or merely an intent to mislead, a question a judge said Thursday might be "a very expensive rabbit hole."

  • June 26, 2025

    Ex-FDA Regulator Joins ArentFox Schiff's Pharma Practice

    ArentFox Schiff LLP has hired a career U.S. Food and Drug Administration compliance professional, whose oversight focused on ensuring pharmaceutical industry participants' compliance with drug supply chain rules and other governing regulations, as counsel in the firm's food, drug, medical device and cosmetic practice in Washington.

  • June 26, 2025

    Former Hoops Star Telfair Gets 6 Mos. For Violating Release

    A Manhattan federal judge sentenced former high school basketball star and ex-NBA player Sebastian Telfair to six months in prison Thursday for violating the terms of his supervised release, after sparing him prison last year for defrauding the league's health plan.

  • June 26, 2025

    Justices Say SC Medicaid Patient Can't Sue To Pick Provider

    The U.S. Supreme Court on Thursday ruled that a patient can't challenge South Carolina's decision to kick Planned Parenthood from the state Medicaid program because it includes abortions among its services.

  • June 25, 2025

    Cigna Says Bristol-Myers Delayed Cancer Drug Generic

    Cigna has launched an antitrust suit in New York federal court accusing Bristol-Myers Squibb Co. and its Celgene subsidiary of fraudulently obtaining patents, filing sham litigation and paying off generic-drug makers to maintain a monopoly on their blockbuster blood-cancer drug Pomalyst.

  • June 25, 2025

    Trans Worker Says Metal Co.'s Health Plan Discriminatory

    A subsidiary of Kaiser Aluminum discriminated against transgender employees by including an exclusion in its health plan barring coverage for medical treatments related to gender-affirming care, according to a new suit filed in Washington federal court.

  • June 25, 2025

    CVS PBM Hit With $95M Judgment For Overbilling Medicare

    A Pennsylvania federal judge on Wednesday ruled that CVS's pharmacy benefits manager owes the government $95 million for overbilling Medicare Part D-sponsored drugs, leaving the door open for the amount to be tripled later.

  • June 24, 2025

    Arkansas Insurance Dept. Fights Teamsters Plan's ERISA Suit

    The Arkansas Insurance Department is looking to sink a challenge to a state insurance regulation filed by a Teamsters healthcare plan, telling an Illinois federal judge that the regulation isn't preempted by the Employee Retirement Income Security Act and, besides, the plan can't sue the department.

  • June 24, 2025

    Health Data Co. Must Face Revised Investor Fraud Suit

    A Connecticut federal judge won't toss an amended class action claiming a healthcare technology company misled investors about a data platform it claimed to operate that didn't actually exist, ruling that statements about the platform's capabilities are not inactionable, forward-looking statements.

  • June 24, 2025

    4th Circ. Tosses Trans Man's Appeal Over Canceled Surgery

    The Fourth Circuit declined to revive a transgender man's constitutional claims against a religious hospital run by the University of Maryland Medical System over a canceled hysterectomy for gender dysphoria, concluding Tuesday that it couldn't grant further relief, and refused to consider a "late-breaking" argument for emotional distress damages.

  • June 24, 2025

    Calif. AG Asks 9th Circ. To Undo Limits On Pay-For-Delay Ban

    California enforcers on Monday asked the Ninth Circuit to overturn a district court's decision that a state law restricting "reverse payment" settlements between brand-name and generic-drug makers cannot be used to regulate deals that were struck outside the Golden State.

  • June 24, 2025

    Healthcare In Court: 5 Rulings You May Have Missed

    A D.C. federal judge rejected a challenge to the federal government's approval of an audit by Johnson & Johnson into five hospitals' compliance with the 340B drug discount program. In Texas, a state appellate court has blocked San Antonio from going forward with a program that could fund travel for residents to access abortion care in other states. Here, Law360 Healthcare Authority looks at those and other healthcare rulings you may have missed over the last week.

  • June 24, 2025

    Nichols Liu Co-Founder Andy Liu Launches Solo Venture

    Boutique firm Nichols Liu LLP's co-founding partner Andy Liu has launched a solo practice to continue representing government contractors and healthcare industry clients in civil and criminal enforcement matters, telling Law360 Pulse Tuesday he wanted to go out on his own for greater control.

  • June 24, 2025

    Docs Navigate 'Legal Thicket' Of Pregnancy Exclusion Laws

    A first-of-its-kind lawsuit in Kansas challenges a state law that plaintiffs say undermines a woman's right to make critical end-of-life decisions while pregnant and leaves doctors legally vulnerable.

Expert Analysis

  • In The CFPB Playbook: Making Good On Bold Promises

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    The U.S. Supreme Court's decision upholding the Consumer Financial Protection Bureau's funding structure in the second quarter cleared the way for the bureau to resume a number of high-priority initiatives, and it appears poised to charge ahead in working toward its aggressive preelection agenda, say Andrew Arculin and Paula Vigo Marqués at Blank Rome.

  • Critical Questions Remain After High Court's Abortion Rulings

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    The U.S. Supreme Court's decisions in two major abortion-related cases this term largely preserve the status quo for now, but leave federal preemption, the Comstock Act and in vitro fertilization in limbo, say attorneys at Jenner & Block.

  • Navigating FDA Supply Rule Leeway For Small Dispensers

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    As the November compliance deadline for the U.S. Food and Drug Administration's new pharmaceutical distribution supply chain rules draws closer, small dispensers should understand the narrow flexibilities that are available, and the questions to consider before taking advantage of them, say attorneys at Faegre Drinker.

  • 1st Gender Care Ban Provides Context For High Court Case

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    The history of Arkansas' ban on gender-affirming medical care — the first such legislation in the U.S. — provides important insight into the far-reaching ramifications that the U.S. Supreme Court's decision in U.S. v. Skrmetti next term will have on transgender healthcare, says Tyler Saenz at Baker Donelson.

  • 6 Lessons From DOJ's 1st Controlled Drug Case In Telehealth

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    Following the U.S. Department of Justice’s first-ever criminal prosecution over telehealth-prescribed controlled substances in U.S. v. Ruthia He, healthcare providers should be mindful of the risks associated with restricting the physician-patient relationship when crafting new business models, says Jonathan Porter at Husch Blackwell.

  • After Chevron: Scale Tips Favor Away From HHS Agencies

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    The loss of Chevron deference may indirectly aid parties in challenging the U.S. Department of Health and Human Services' interpretations of regulations and could immediately influence several pending cases challenging HHS on technical questions and agency authority, say attorneys at Ropes & Gray.

  • After Chevron: FDA Regulations In The Crosshairs

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    The U.S. Supreme Court's overturning of the Chevron doctrine is likely to unleash an array of challenges against the U.S. Food and Drug Administration, focusing on areas of potential overreach such as the FDA's authority under the Federal Food, Drug and Cosmetic Act, say attorneys at Debevoise.

  • USPTO Disclaimer Rule Would Complicate Patent Prosecution

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    The U.S. Patent and Trademark Office's proposed changes to terminal disclaimer practice could lead to a patent owner being unable to enforce a valid patent simply because it is indirectly tied to a patent in which a single claim is found anticipated or obvious in view of the prior art, say attorneys at Sterne Kessler.

  • Navigating Scrutiny Of Friendly Professional Corps. In Calif.

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    In light of ongoing scrutiny and challenges to private equity participation in the California healthcare marketplace, particularly surrounding the use of the friendly professional corporation model, management services organizations should consider implementing four best practices, say attorneys at Holland & Knight.

  • Takeaways From New HHS Substance Use Disorder Info Rules

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    A new U.S. Department of Health and Human Services rule continues the agency's efforts to harmonize complex rules surrounding confidentiality provisions for substance use disorder patient records, though healthcare providers will need to remain mindful of different potentially applicable requirements and changes that their compliance structures may require, say attorneys at Ropes & Gray.

  • Calif. Banking Brief: All The Notable Legal Updates In Q2

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    The second quarter of 2024 in California, which saw efforts to expand consumer protection legislation and enforcement actions in areas of federal focus like medical debt and student loans, demonstrated that the state's role as a trendsetter in consumer financial protection will continue for the foreseeable future, say attorneys at Sheppard Mullin.

  • How Cannabis Rescheduling May Affect Current Operators

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    The U.S. Drug Enforcement Agency's proposal to reschedule marijuana to Schedule III provides relief in the form of federal policy from the stigma and burdens of Schedule I, but commercial cannabis operations will remain unchanged until the federal-state cannabis policy gap is remedied by Congress, say Meital Manzuri and Alexis Lazzeri at Manzuri Law.

  • Air Ambulance Ruling Severely Undermines No Surprises Act

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    A Texas federal court's recent decision in Guardian Flight v. Health Care Service — that the No Surprises Act lacks a judicial remedy when a health insurer refuses to pay the amount established through an independent review — likely throws a huge monkey wrench into the elaborate protections the NSA was enacted to provide, says Mark DeBofsky at DeBofsky Law.