Policy & Compliance

  • March 27, 2025

    DOJ's Antitrust Unit Targeting Anticompetitive Regulations

    The U.S. Department of Justice launched a task force on Thursday aimed at eliminating state and federal laws and regulations that are hindering competition, with an initial focus on key sectors including housing, food and transportation.

  • March 27, 2025

    EMS Co. Accused Of Failing To Pay Proper Overtime

    A private ambulance company has been hit with a proposed class action in Georgia federal court over allegations that it failed to pay workers overtime wages as required by the Fair Labor Standards Act.

  • March 27, 2025

    HHS To Cut 10,000 Jobs As RFK Jr. Reorganizes Agency

    The U.S. Department of Health and Human Services said Thursday that it would lay off 10,000 employees as part of a "dramatic" plan to restructure the agency and downsize its workforce by about 24%.

  • March 26, 2025

    Sotomayor Urges Caution On Nondelegation Doctrine Revamp

    U.S. Supreme Court Justice Sonia Sotomayor cautioned her colleagues during oral arguments Wednesday against using a challenge to the Federal Communications Commission's administration of a broadband subsidy program as a way to resurrect the long-dormant nondelegation doctrine. Several conservative justices, however, seemed willing to disregard that admonition.

  • March 26, 2025

    Healthcare Providers To Pay $63M Over False Spinal Diagnoses

    California-based Seoul Medical Group, its healthcare management service unit and a radiology center will pay $62.85 million to settle allegations they submitted bogus spinal condition diagnoses to the Centers for Medicare and Medicaid Services to maximize their revenue, federal prosecutors announced Wednesday.

  • March 26, 2025

    Feds Seek 2 Years For Device-Maker's $2.4M Tax Evasion

    A Floridian who made millions of dollars on medical devices and pled guilty to evading $2.4 million in taxes should be sentenced to between 24 and 30 months in prison for tax evasion based on the severity of his offense, the U.S. told a federal court Wednesday.

  • March 26, 2025

    AGs Seek 1st OK For $39M Apotex Deal In Price-Fixing Case

    A coalition of 50 state attorneys general on Wednesday asked a Connecticut federal judge to accept a $39.1 million deal settling claims that pharmaceutical company Apotex Corp. schemed with others to fix generic-drug prices, with 70% earmarked for a restitution fund and 30% for consumer notices and attorney fees.

  • March 26, 2025

    False COVID Cure Claims No Longer Feds' 'Current Priority'

    The Trump administration has abandoned another case targeting allegedly false claims that an over-the-counter product could treat, or even cure, COVID-19 by dropping its case against a one-man herbal tea operation.

  • March 26, 2025

    Hospital To Face Doctor's Libel Claim Over Suspension Report

    A North Carolina federal judge has dismissed claims for breach of good faith and emotional distress from a gynecological oncologist's defamation suit against the hospital where he used to work, but let libel and loss of job opportunity claims continue in line with a magistrate judge's recommendation.

  • March 26, 2025

    BCBS Settlement Opt-Outs Ordered To Disclose Funding Deals

    Four law firms representing hospitals that opted out of the landmark $2.8 billion Blue Cross Blue Shield antitrust settlement must disclose whether their clients were motivated by a "quick payment" from litigation funders, an Alabama federal judge ordered Tuesday.

  • March 26, 2025

    Ex-CEO Says McGuireWoods Can't Rehash Immunity Appeal

    McGuireWoods LLP and one of its former partners are rehashing immunity defenses in a last-ditch effort to dodge a long-running defamation case, the former CEO of a managed care organization told the North Carolina Court of Appeals in seeking to have the case kicked back down to the trial court.

  • March 25, 2025

    UBH Patients On Remand, CMS Audits And J&J Investor Suit

    Patients challenging United Behavioral Health coverage guidelines for mental health treatment filed their first brief in the case since the Ninth Circuit clarified the scope of the remanded proceedings.

  • March 25, 2025

    Anthem Can't Escape Family's Mental Health Parity Claims

    Anthem Blue Cross Blue Shield must face a Virginia family's claim that the company violated a federal benefits law by refusing to cover an adolescent girl's stay in a residential mental health facility, with a Virginia federal judge deeming the suit strong enough to survive a dismissal motion Tuesday.

  • March 25, 2025

    Trans Military Ban Rests On 'Unconvincing' Proof, Judge Says

    A Washington federal judge hinted Tuesday he might block the Trump administration's ban on transgender troops later this week, expressing doubt that the U.S. Department of Defense has evidence to back its stance that gender dysphoria alone makes people unfit for military service.

  • March 25, 2025

    ND Justices Weigh Liberty Rights In Abortion Ban Challenge

    North Dakota's top court on Tuesday wrestled with whether a recently passed anti-abortion law violates personal liberty rights and questioned both sides about the meaning of exceptions to the ban written into the law.

  • March 25, 2025

    Amid Abortion Fight, Idaho Bolsters Moral Objection Rights

    A new law in Idaho — already the epicenter of a national clash over emergency abortion care — expands the conscientious objection rights of doctors and health professionals.

  • March 25, 2025

    Antitrust In Healthcare: 3 Cases To Watch

    Amid a Congressional probe into a long-standing antitrust exemption for a national medical resident matching system, a handful of healthcare groups are in court with allegations that trade organizations have violated antitrust laws.

  • March 25, 2025

    Experts Warn Of 'Slippery Slope' In Judge Shopping Sanctions

    A federal judge's judge shopping sanctions on lawyers challenging an Alabama transgender care ban were unusually harsh, legal experts said, and raise concerns about a chilling effect on advocates litigating similar cases in other jurisdictions.

  • March 25, 2025

    BU Law Prof On The Evolution Of Med Mal Standard Of Care

    Boston University law professor Christopher Robertson talks about the American Law Institute's first update on medical malpractice law in 60 years and the state law evolution towards a “reasonable” care standard.

  • March 25, 2025

    Hartford HealthCare Fights Disclosure Of Antitrust Settlement

    Hartford HealthCare Corp. says it cannot be forced to reveal a confidential January antitrust settlement with another Connecticut hospital at the behest of a Teamsters health plan and a public transit agency separately accusing the consortium of creating a monopoly.

  • March 25, 2025

    Unnecessary Surgeries Drive Rare Va. Hospital Criminal Case

    An unusual indictment in Virginia details grave allegations against a former doctor, including unnecessary surgeries and bogus cancer diagnoses. With former OB-GYN Javaid Perwaiz already in federal prison, the hospital where many of the procedures occurred is now facing criminal charges.

  • March 24, 2025

    Trump Picks Acting CDC Head After Weldon Nomination Fails

    President Donald Trump on Monday nominated acting Centers for Disease Control and Prevention head Susan Monarez to take over as the agency's director, a move that comes after Trump pulled his nomination of Dr. Dave Weldon for the position when it became clear Weldon lacked needed support.

  • March 24, 2025

    Wells Fargo Prescription Cost Suit Axed Over Standing

    Wells Fargo has beaten back allegations that it violated federal benefits law by letting workers on its healthcare plan overpay for prescription drugs, with a Minnesota federal judge ruling Monday that the ex-workers behind the proposed class action lacked standing to sue.

  • March 24, 2025

    Investors Blame Electrotherapy Co.'s Practices For Stock Drop

    Electrotherapy device maker Zynex Inc. faces a proposed investor class action claiming it harmed shareholders after it was booted from at least one insurer network for U.S. military members, allegedly due to oversupplying its customers.

  • March 24, 2025

    Patients Say UBH Limits On Mental Health Violated ERISA

    Employee health benefit plan participants who sought coverage for mental health and substance use disorder treatments from United Behavioral Health urged a California federal court to rule that the company violated federal benefits law by implementing overly restrictive guidelines, arguing the insurer's interest in narrowing coverage wrongly limited patients' access.

Expert Analysis

  • Skirting Anti-Kickback Causation Standard Amid Circuit Split

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    Amid the federal circuit court split over the causation standard applicable to False Claims Act cases involving Anti-Kickback Statute violations, which the First Circuit will soon consider in U.S. v. Regeneron, litigators aiming to circumvent the heightened standard should contemplate certain strategies, say Matthew Modafferi and Terence Park at Frier Levitt.

  • Gilead Ruling Signals That Innovating Can Lead To Liability

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    A California appeals court's ruling last month in Gilead Life Sciences v. Superior Court of San Francisco that a drug manufacturer can be held liable for delaying the introduction of an improved version of its medication raises concerns about the chilling effects that expansive product liability claims may have on innovation, says Gary Myers at the University of Missouri School of Law.

  • Health Policy Legislative Landscape May Remain Frozen

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    With Congress again delaying the full resolution of fiscal year 2024 federal spending legislation, there is now an additional window in which Congress could work through several priority issues for healthcare stakeholders, though these issues are unlikely to be resolved in time, say attorneys at Faegre Drinker.

  • Despite HHS Opinion, Gift Card Giveaways Require Caution

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    Though the U.S. Department of Health and Human Services' Office of Inspector General recently determined that a healthcare consulting firm's gift card plans do not violate the Anti-Kickback Statute, the opinion does not suggest blanket approval for providing gift cards in exchange for referrals, say Ragini Acharya and Matthew Deutsch at Husch Blackwell.

  • DOJ's Biopharma Settlement Raises Anti-Kickback Questions

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    In the aftermath of the U.S. Department of Justice's settlement with Ultragenyx over genetic testing programs, it may be prudent to reevaluate genetic tests through the lens of the Anti-Kickback Statute and reconsider whether it is proper for free testing programs to be treated like patient assistance programs, says Mary Kohler at Kohler Health Law.

  • Where Justices Stand On Chevron Doctrine Post-Argument

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    Following recent oral argument at the U.S. Supreme Court, at least four justices appear to be in favor of overturning the long-standing Chevron deference, and three justices seem ready to uphold it, which means the ultimate decision may rest on Chief Justice John Roberts' vote, say Wayne D'Angelo and Zachary Lee at Kelley Drye.

  • Bracing For Calif.'s New Health Transaction Framework

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    As California's new cost and market impact review regulations' April 1 date for its updated notice and review process approaches, healthcare entities should ready themselves for dramatic changes to the state's regulatory landscape and prepare for potentially substantial transaction delays, say Jordan Grushkin and Matthew Goldman at Sheppard Mullin.

  • Uncharted Waters Ahead For FCA Litigation In 2024

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    Following a year of significant court decisions, settlements, recoveries and proposed amendments, 2024 promises to be a lively year for False Claims Act actions and litigation, and one that will hopefully provide more clarity as FCA jurisprudence evolves, say attorneys at Crowell & Moring.

  • OIG Report Has Clues For 2024 Healthcare Fraud Enforcement

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    A recent report from the Health Department's Office of the Inspector General reveals healthcare fraud and abuse enforcement trends that will continue in 2024, from increased telehealth oversight to enhanced policing of managed care, say attorneys at Sheppard Mullin.

  • FOIA Exemption Questions On Redacted HHS Cannabis Letter

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    The U.S. Department of Health and Human Services' recent recommendation letter concerning the rescheduling of cannabis was heavily redacted, and based on an analysis on the applicability of Freedom of Information Act Exemption 5 to the letter, it's likely that we will see successful legal challenges to those redactions, say attorneys at Troutman Pepper.

  • A Primer On New Calif. Health Transaction Reporting Rules

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    New California regulations regarding the reporting of certain transactions involving healthcare entities, which took effect on Jan. 1, address some industry feedback about overly broad requirements but still leave several areas of concern, says Andrew Demetriou at Husch Blackwell.

  • In The CFPB Playbook: Rulemaking Rush Before Election Year

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    In this quarterly Consumer Financial Protection Bureau activity recap by former bureau personnel, attorneys at McGuireWoods explain the regulator's recent push to finalize new rules about data aggregators, digital payment apps and more before the election-year Congressional Review Act window opens.

  • What The Law Firm Of The Future Will Look Like

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    As the legal landscape shifts, it’s become increasingly clear that the BigLaw business model must adapt in four key ways to remain viable, from fostering workplace flexibility to embracing technology, say Kevin Henderson and Eric Pacifici at SMB Law Group.