Policy & Compliance
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July 29, 2025
Meet Josh Craddock, Fetal Personhood Advocate Joining DOJ
President Donald Trump has named a former BigLaw attorney and outspoken proponent of the fetal personhood legal doctrine to serve as deputy assistant attorney general at the legal arm of the U.S. Department of Justice.
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July 28, 2025
PBMs Can't Escape NY State Law Claims In Opioid MDL
Two UnitedHealth subsidiaries cannot escape claims that they exacerbated the opioid crisis by providing data analytics and consulting services to drugmakers, a federal judge overseeing the multidistrict litigation ruled on Monday, saying the New York state municipalities have adequately alleged RICO by claiming they were part of the same criminal conspiracy.
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July 28, 2025
Express Scripts, Prime Urge Court To Toss Mich. Price-Fix Suit
Two pharmacy benefit managers sought to shake allegations of price-fixing brought by Michigan Attorney General Dana Nessel, arguing Friday that her antitrust suit suffers from several fatal legal flaws, including that the state does not have standing to sue on pharmacies' behalf.
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July 28, 2025
DOJ Probes NewYork-Presbyterian Over Antitrust Allegations
The U.S. Department of Justice has opened an investigation into NewYork-Presbyterian Healthcare System for allegedly violating antitrust laws by cutting deals with insurance companies that have led to rising healthcare costs, according to a subpoena viewed by Law360.
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July 28, 2025
Judge Again Cites Bias In NIH Fund Freeze As Gov't Appeals
A Massachusetts federal judge on Monday reiterated his conclusion that the Trump administration's freeze of $783 million worth of National Institutes of Health grants was based on "palpable" gender and racial discrimination, as he acknowledged a pending request by the government to the U.S. Supreme Court to stay his order that the money be released.
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July 28, 2025
Judge Says Trump Admin Can't Defund Planned Parenthood
A Massachusetts federal judge on Monday blocked President Donald Trump's administration from denying Medicaid reimbursements to Planned Parenthood clinics, expanding an earlier ruling that had applied only to those that do not provide abortions or that receive minimal federal support.
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July 25, 2025
Utah Docs Say Billing Expert's Report Rife With AI Falsehoods
Utah anesthesiologists facing a False Claims Act suit are moving to bar the testimony of a medical billing expert they say used artificial intelligence to draft a report riddled with errors and fake citations, calling it an extraordinary example of AI gone wrong.
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July 25, 2025
Hospital Giant To Pay $3.5M Over Nurse Training Repayments
HCA Healthcare Inc., a major U.S. hospital operator, has agreed to pay roughly $3.5 million to settle claims that it unlawfully trapped new nurses in agreements requiring them to repay training costs if they left their jobs within two years, according to a trio of state attorneys general.
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July 25, 2025
Health Data Co. Investor Fraud Suit Headed To Mediation
The parties in a putative class action claiming a healthcare technology company misled investors about a data platform it claimed to operate, but which didn't actually exist, told a Connecticut federal court that they "agree this case is well suited for mediation."
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July 24, 2025
Trump Admin Asks Justices To Stay Block On NIH Grant Cuts
The Trump administration on Thursday urged the U.S. Supreme Court to stay a district court's preliminary injunction so that the National Institutes of Health can resume terminating $783 million in grants, saying the lower court, under a recent high court ruling, lacked jurisdiction to make the government pay the grants.
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July 24, 2025
Hospital Must Face Claims Of Mismanaging Retirement Funds
A Colorado federal judge on Thursday said a proposed class action will continue against a hospital over allegations of mismanaging employees' retirement funds after an amended complaint added new allegations about the fund's mismanagement.
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July 24, 2025
UnitedHealth Discloses DOJ Medicare Civil, Criminal Probes
UnitedHealth Group Inc. has disclosed that it is complying with formal criminal and civil requests from the U.S. Department of Justice, following media reports about investigations into aspects of the insurance giant's participation in Medicare.
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July 24, 2025
3rd Circ. Rules Philly Injection Site Equals Religious 'Person'
A nonprofit battling government resistance to its planned safe drug injection site in Philadelphia can qualify for religious freedom protections, the Third Circuit said in a precedential opinion on Thursday, reasoning the organization meets the definition of a "person" practicing religion.
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July 23, 2025
FTC Wants PE Firm's Medical Device Coating Deal Put On Ice
Private equity firm GTCR BC Holdings' $627 million merger with Surmodics will bring the previously fierce competition for medical device coatings to a grinding halt, the FTC says, which is all the more reason a federal court should block the deal while an agency challenge plays out.
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July 23, 2025
Symbria Workers' $5.9M ESOP Deal Gets Ill. Judge's Final OK
An Illinois federal judge gave his final blessing Tuesday to a $5.9 million settlement between Argent Trust Co. and a group of Symbria Inc. employees who accused the company of mismanaging their employee stock ownership plan.
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July 23, 2025
Bird Marella And Bioscience Client Accused Of $87M Fraud
An investment group that includes a "Toy Story" screenwriter is suing a Culver City, California-headquartered bioscience company and its Bird Marella attorneys in California state court, accusing them of manipulating the valuation of a company whose acquisition they funded, in order to defraud investors of $87 million.
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July 23, 2025
Co., Lenders Hit With Suit Over Medical Spa Financing Scam
A medical device manufacturer and several financing companies worked together to manipulate boutique clinics and medical spas into purchasing expensive cosmetic devices based on inflated revenue projections and false promises of marketing support, according to a proposed class action filed Monday in California federal court.
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July 22, 2025
FCA Draws Heavy Constitutional Fire After $1.6B J&J Verdict
Reeling from a record fraud verdict tied to drug promotion practices, Johnson & Johnson is pursuing a sweeping constitutional challenge to the False Claims Act, and in filings this week at the Third Circuit, major industry allies rallied behind its views of whistleblower litigants usurping executive branch power.
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July 22, 2025
Healthcare In Court: NIH Grant Cuts, Flo Health Trial And More
A First Circuit panel refused to hit pause on a Massachusetts federal judge's order voiding cuts by the National Institutes of Health to hundreds of grant programs. Meanwhile, in California, a jury trial kicked off over allegations of unlawful information sharing between menstrual app developer Flo Health Inc. and Meta Platforms.
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July 22, 2025
Sandoz Loses 'Nonsense' Bid To Avoid DOJ Deal In AGs' Case
A Connecticut federal judge has given dozens of state attorneys general a small but important win in a sprawling price-fixing litigation against generic-drug makers, applying previous admissions of criminal wrongdoing and flatly rejecting "ridiculous" efforts by Sandoz, Taro Pharmaceuticals and a former Sandoz official to avoid that application.
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July 22, 2025
Ohio Justices Accept AG's Bid To Limit Care For Trans Youths
The Ohio Supreme Court on Tuesday agreed to review an appeals court's finding that portions of a state law restricting gender-affirming care for transgender youths are unconstitutional.
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July 22, 2025
Employers, Plans Force Freeze Of Iowa's PBM Law
A federal judge slapped a temporary hold on parts of an Iowa law that aims to limit pharmacy benefit managers' power to set drug prices, ruling that provisions barring discrimination against certain pharmacies and pushing cost-saving strategies are preempted by federal benefits law.
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July 22, 2025
4th Circ. Backs Medicaid Fraud Conviction, 17-Year Sentence
A North Carolina lab owner lost his bid Tuesday to overturn his healthcare fraud conviction after the Fourth Circuit found evidence against him to be sufficient and the terms of his sentence reasonable.
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July 22, 2025
NC Hospital Says Dropped Malpractice Claim Dooms 2004 Suit
A North Carolina hospital is asking state appellate judges to determine whether a hospital can face claims of negligently credentialing a doctor if the plaintiffs have dropped the underlying medical malpractice allegation against the physician.
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July 22, 2025
Medicaid Cuts To Raise Staffing Pressure On Nursing Homes
Massive changes coming to Medicaid are expected to push more seniors reliant on state-supported services into nursing homes, adding pressure to a system already struggling with staffing and quality of care issues.
Expert Analysis
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FDA's Data Monitoring Guidance Reveals Future Expectations
As the world of clinical research grows increasingly complex, the U.S. Food and Drug Administration's recent draft guidance on the use of data monitoring committees in clinical trials reveals how the agency expects such committees to develop, say Melissa Markey and Carolina Wirth at Hall Render.
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FDA Warning Indicates Scrutiny Of Regenerative Health Cos.
The U.S. Food and Drug Administration's recent warning letter to Akan Biosciences is a quintessential example of the agency's enforcement priorities for certain products involving human cells and tissues, and highlights ongoing scrutiny placed on manufacturers, say Dominick DiSabatino and Cortney Inman at Sheppard Mullin.
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2 Regulatory Approaches To Psychedelic Clinical Trials
Comparing the U.S. and Canada's regulatory frameworks for clinical trials of psychedelic drugs can be useful for designing trial protocols that meet both countries' requirements, which can in turn help diversify patient populations, bolster data robustness and expedite market access, say Kimberly Chew at Husch Blackwell and Sabrina Ramkellawan at AxialBridge.
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'Food As Health' Serves Up Fresh Legal Considerations
The growth of food as medicine presents a significant opportunity for healthcare organizations and nontraditional healthcare players to improve patient outcomes and reduce costs, though these innovative programs also bring compliance considerations that must be carefully navigated, say attorneys at McDermott.
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DC Circ. Ruling Heightens HHS Contract Pharmacy Challenges
The D.C. Circuit's recent ruling that the Section 340B program does not bar manufacturers from restricting deliveries of discounted drugs to contract pharmacies represents a second strike against the U.S. Department of Health and Human Services' current contract pharmacy policy and raises the stakes surrounding an upcoming Seventh Circuit ruling on the same issue, say attorneys at Foley Hoag.
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FTC Focus: Exploring The Meaning Of Orange Book Letters
The Federal Trade Commission recently announced an expansion of its campaign to promote competition by targeting pharmaceutical manufacturers' improper Orange Book patent listings, but there is a question of whether and how this helps generic entrants, say Colin Kass and David Munkittrick at Proskauer.
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3rd Circ.'s Geico Ruling May Encourage Healthcare Arbitration
The Third Circuit's recent decision in Geico v. Mount Prospect, finding that claims under New Jersey's Insurance Fraud Prevention Act can be arbitrated, strengthens arbitration as a viable alternative to litigation, even though it is not necessarily always a more favorable forum, say Khaled Klele and Jessica Osterlof at McCarter & English.
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Proposed Cannabis Reschedule Sidesteps State Law Effects
The U.S. Department of Justice's recent proposal to move cannabis to Schedule III of the Controlled Substances Act provides certain benefits, but its failure to address how the rescheduling would interact with existing state cannabis laws disappointed industry participants hoping for clarity on this crucial question, says Ian Stewart at Wilson Elser.
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A Changing Regulatory Landscape For Weight Loss Drugs
As drugs originally approved to treat diabetes become increasingly popular for weight loss purposes, federal and state regulators and payors are increasing their focus on how these drugs are prescribed, and industry participants should pay close attention to rapidly evolving compliance requirements, say attorneys at Goodwin.
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Opioid Suits Offer Case Study In Abatement Expert Testimony
Settlements in the opioid multidistrict litigation provide useful insight into leveraging expert discovery on abatement in public nuisance cases, and would not have been successful without testimony on the costs necessary to lessen the harms of the opioid crisis, says David Burnett at DiCello Levitt.
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How HHS Discrimination Rule Affects Gender-Affirming Care
The U.S. Department of Health and Human Services' new final rule, which reinterprets the Affordable Care Act's anti-discrimination provision, greatly clarifies protections for gender-affirming care and will require compliance considerations from sponsors and administrators of most group health plans, say attorneys at McDermott.
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FTC Noncompete Rule's Impact On Healthcare Nonprofits
Healthcare entities that are nonprofit or tax-exempt and thus outside of the pending Federal Trade Commission noncompete rule's reach should evaluate a number of potential risk factors and impacts, starting by assessing their own status, say Ben Shook and Tania Archer at Moore & Van Allen.
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Key Takeaways From FDA Final Rule On Lab-Developed Tests
Michele Buenafe and Dennis Gucciardo at Morgan Lewis discuss potential consequences of the U.S. Food and Drug Administration's recently finalized rule regulating lab-developed tests as medical devices, and explain the rule's phaseout policy for enforcement discretion.