Policy & Compliance
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February 27, 2026
Meta Must Face Worker's Transgender Health Coverage Suit
Meta can't escape a transgender employee's lawsuit claiming the company's health plan unlawfully denied her coverage of gender-affirming surgeries, an Oregon federal judge ruled, rejecting the company's assertion that she hadn't adequately alleged the plan covered her desired procedures.
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February 27, 2026
DOL Extends Comment Window On PBM Transparency Rule
The U.S. Department of Labor said Friday that the public will be given more time to comment on a new proposed rule that would require pharmacy benefit managers to disclose how much money they've received while serving as intermediaries between drugmakers, pharmacies and insurers.
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February 26, 2026
Health Plans Lack Expert In Avandia MDL, 3rd Circ. Told
Counsel for GlaxoSmithKline urged a Third Circuit panel on Thursday to undo an order certifying a class of health plans in the multidistrict litigation over the company's alleged deceptive marketing of the diabetes drug Avandia, arguing the plaintiffs didn't have the experts necessary to support their case.
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February 26, 2026
$95M Kaiser Row Tees Up Challenge For Fund Returns
Kaiser Foundation Health Plan’s lawsuit seeking $95 million in coverage for a recently settled whistleblower action raises an important challenge to policy language that limits coverage for claims related to returning funds received from government agencies, as policyholder attorneys call for a broad interpretation of the policy language.
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February 26, 2026
Feds Back Pharma In 340B Contract Pharmacy Disputes
State laws that block drugmakers from imposing restrictions on federally funded hospitals and the contract pharmacies they use to dispense discounted drugs under the 340B drug discount program are violating federal law, the Trump administration said, siding with manufacturers in their bid to strike down these laws.
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February 25, 2026
Online Abortion Pill Provider Illegally Ships To Texas, AG Says
Texas Attorney General Ken Paxton sued Aid Access, its founder and a California doctor in state court Tuesday alleging they operate an "abortion-by-mail enterprise" that ship abortion-inducing drugs to Texas residents, which is endangering the lives of unborn children and their mothers.
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February 25, 2026
White House Cites Fraud, Freezes $259M In Minn. Medicaid
The Trump administration on Wednesday said it would hold back $259.9 million in Medicaid funding for Minnesota as part of what it called an unprecedented effort to combat fraud in programs that support low-income families.
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February 25, 2026
Fla. Court Blocks Doctor Dispensing Rules For Worker Claims
A Florida panel on Wednesday set aside a state agency's proposed rules that would include doctors in a workers' compensation law that gives patients an "absolute choice" over which pharmacist can fill their prescriptions, saying the proposals go beyond what lawmakers intended.
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February 25, 2026
Centene Says Filed Rate Doctrine Dooms RICO, Fraud Claims
Centene Corp. urged an Illinois federal judge Tuesday to grant it partial judgment in a proposed class action by patients alleging the company violated racketeering laws and cheated them out of billions with bogus policies, arguing the filed rate doctrine bars the refunds they seek for alleged overcharges.
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February 25, 2026
Pakistan Native Pleads Not Guilty To $10M Healthcare Fraud
A native of Pakistan who is living in Texas pled not guilty Wednesday to a Chicago indictment claiming he participated in an alleged $10 million healthcare fraud and money laundering scheme involving fake medical companies that filed claims for items and services they never provided.
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February 25, 2026
9th Circ. Rules K-12 Mental Health Grants Must Continue
The U.S. Department of Education must fund K-12 mental health grants given to public schools to help students cope with school shootings, the Ninth Circuit ruled, denying the agency's emergency request to pause a lower court's permanent injunction pending an appeal.
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February 24, 2026
Ariz., Calif. Lead Suit Over 'Senseless' HHS Vaccine Overhaul
Arizona and California are leading a coalition of states challenging the U.S. Department of Health and Human Services' decision to cut vaccine recommendations for American children, alleging in a lawsuit Tuesday that the "unprecedented attack" stems from HHS Secretary Robert F. Kennedy Jr.'s "unscientific hostility to vaccines."
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February 24, 2026
6th Circ. Affirms Dismissal Of Sotera Toxic Gas Investor Suit
The Sixth Circuit on Tuesday affirmed a lower court's dismissal of an investor lawsuit accusing Sotera Health Co. of concealing the carcinogenic nature of a gas used at its sterilization plants, finding Sotera did not make any actionable false or misleading statements to investors.
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February 24, 2026
Texas Panel Skeptical That Doctor's Hands Are Property
A Texas appellate court appeared dubious at a claim that a doctor's hands count as personal property in a case accusing a state-owned hospital of healthcare negligence, asking Tuesday what to do with the state Supreme Court's instruction to narrowly construe waivers of sovereign immunity.
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February 24, 2026
Abortion Pill Access, Tariff Questions And More In Court
Law360 Healthcare Authority looks at drugmakers' intervention in federal litigation concerning mail-order abortion medication, questions left open by the U.S. Supreme Court's decision striking down tariffs and other significant litigation developments this week.
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February 24, 2026
How To Read FDA's Flip-Flop On Moderna Flu Vaccine
An unusual FDA reversal on a new flu vaccine is raising alarm bells for health experts and attorneys.
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February 24, 2026
Ariz. Bill To Limit 'No Surprises' Arbitration Offers Put On Hold
A powerful Arizona state lawmaker this week agreed to pause his proposal to establish limits on how much medical providers can seek under the No Surprises Act arbitration system, saying the legislation needs more work and he'll bring it back next year.
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February 24, 2026
FDA Expert Panels May Exploit A Legal 'Loophole,' Atty Says
Law360 Healthcare Authority talks to attorney Joseph Daval about the rise of FDA expert panels, federal law, and blurring the lines between expert and stakeholder.
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February 24, 2026
Mallinckrodt's Ch. 11 Blocks Antitrust Payouts, Judge Rules
A Connecticut federal judge has ruled that drugmaker Mallinckrodt PLC shrugged off monetary claims brought by states in a sprawling generic drug antitrust enforcement action when the company emerged from bankruptcy in 2022.
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February 24, 2026
United Wants Partial Fraud Suit Win Against Billing Co.
TeamHealth has been submitting fraudulent claims to get UnitedHealthcare to overpay it by more than $100 million, the insurer argued as it asked a Tennessee federal judge to grant it a partial early win in its suit against the emergency room staffing and billing company.
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February 24, 2026
Philips Unit Escapes CPAP Machine Whistleblower Case
Philips Respironics, a unit of Koninklijke Philips NV, fended off a whistleblower suit alleging it provided kickbacks to CPAP suppliers that bought its products, with a Pennsylvania federal judge ruling that a former Philips manager failed to show that the company willfully engaged in illegal conduct.
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February 24, 2026
PE-Owned Doc Staffing Raises ER Fraud Risk
As private equity firms scoop up physician staffing companies, healthcare litigators say emergency rooms and referrals are fertile ground for fraud and False Claims Act enforcement.
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February 24, 2026
AbbVie Tests Exclusion Strategy In Drug Price Fight
Following a series of drugmaker losses in suits challenging Medicare drug price negotiations, AbbVie Inc. is trying something new in a challenge focused on Botox and a legal exclusion for drugs made from human plasma.
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February 24, 2026
AstraZeneca Drug Price Challenge Falls Short In Hawaii
A federal judge in Hawaii temporarily upheld the state's law that prevents drug manufacturers from blocking safety-net hospitals from contracting with an unlimited number of outside pharmacies to dispense discounted prescription drugs under the 340B Drug Discount Program.
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February 24, 2026
Mintz Lands IP Pro From Wilson Sonsini In San Francisco
Mintz Levin Cohn Ferris Glovsky and Popeo PC. announced Tuesday that it has added a patent litigation attorney who was at Wilson Sonsini Goodrich & Rosati PC for more than two decades to bolster its intellectual property division.
Expert Analysis
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What Rescheduling Means For Cannabis Labels, Marketing
The proposed reclassification of cannabis is expected to bring heightened scrutiny of labeling, advertising and marketing from the U.S. Food and Drug Administration and the Federal Trade Commission, but the brands that tighten evidence, standardize operations and professionalize marketing controls now will see fewer surprises and better outcomes, say attorneys at Wilson Elser.
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What's At Stake In Possible Circuit Split On Medicaid Rule
A recent Eleventh Circuit decision, reviving Florida's lawsuit against a federal rule that reduces Medicaid funding based on agreements between hospitals, sets up a potential circuit split with the Fifth Circuit, with important ramifications for states looking to private administrators to run provider tax programs, say Liz Goodman, Karuna Seshasai and Rebecca Pitt at FTI Consulting.
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Courts' Rare Quash Of DOJ Subpoenas Has Lessons For Cos.
In a rare move, three federal courts recently quashed or partially quashed expansive U.S. Department of Justice administrative subpoenas issued to providers of gender-affirming care, demonstrating that courts will scrutinize purpose, cabin statutory authority and acknowledge the profound privacy burdens of overbroad government demands for sensitive records, say attorneys at ArentFox Schiff.
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Remote Patient Monitoring Is At Regulatory Inflection Point
With remote patient monitoring at the center of new federal pilot programs and a recent report from the U.S. Department of Health and Human Services' Office of Inspector General examining Medicare billing for those services, it is clear that balancing innovation and risk will be a central challenge ahead for digital health stakeholders, say attorneys at Morgan Lewis.
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Utah's AI Prescription Renewal Pilot Could Inform Policy
Utah recently became the first state to approve an artificial intelligence system for autonomously renewing certain prescription medicines, providing a test case for how regulators may be able to draw boundaries between administrative automation and medical judgment, say Jashaswi Ghosh at Holon Law Partners and Bryant Godfrey at Foley Hoag.
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Ramped Up Psychedelic Production Carries Opportunity, Risk
Kimberly Chew at Husch Blackwell discusses the key legal implications of the U.S. Drug Enforcement Administration's recent dramatic increases in the production quotas for a range of psychedelic substances, offering guidance on compliance, risk management and strategic opportunities for practitioners navigating this rapidly evolving landscape.
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New Biotech Nat'l Security Controls May Have Blunted Impact
While the newly enacted federal prohibition against contracting with certain biotechnology providers associated with countries of concern may have consequences on U.S. companies' ability to develop drugs, the restrictions may prove to be less problematic for the industry than the significant publicity around their passage would suggest, say attorneys at Wilson Sonsini.
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Takeaways From The DOJ Fraud Section's 2025 Year In Review
Former acting Principal Deputy Chief Sean Tonolli of the U.S. Department of Justice's Fraud Section, now at Cahill Gordon, analyzes key findings from the section’s annual report — including the changes implemented to adapt to the new administration’s priorities — and lays out what to watch for this year.
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Traditional FCA Enforcement Surges Amid Shifting Priorities
The U.S. Department of Justice’s January report on False Claims Act enforcement in fiscal year 2025 reveals that while the administration signaled its intent to expand FCA enforcement into new areas such as tariffs, for now the greatest exposure remains in traditional areas like healthcare — in which the risk is growing, say attorneys at Debevoise.
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3 Key Ohio Financial Services Developments From 2025
Ohio's banking and financial services sector saw particularly notable developments in 2025, including a significant Ohio Supreme Court decision on creditor disclosure duties to guarantors in Huntington National Bank v. Schneider, and some major proposed changes to the state's Homebuyer Plus program, says Alex Durst at Durst Kerridge.
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Rescheduling Cannabis Marks New Tax Era For Operators
As the attorney general takes steps to move cannabis from Schedule I to Schedule III of the Controlled Substances Act, operators and advisers should prepare by considering the significant changes this will bring from tax, state, industry and market perspectives, says Michael Harlow at CohnReznick.
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Justices' Med Mal Ruling May Spur Huge Shift For Litigators
The U.S. Supreme Court’s recent decision in the medical malpractice suit Berk v. Choy, holding that a Florida procedural requirement does not apply to medical malpractice claims filed in federal court, is likely to encourage eligible parties to file claims in federal court, speed the adjudicatory process and create both opportunities and challenges for litigators, says Thomas Kroeger at Colson Hicks.
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5 Drug Pricing Policy Developments To Watch In 2026
2026 may prove to be a critical year for drug pricing in the U.S., with potential major shifts including several legislative initiatives moving forward after being in the works for years, and more experimentation on the horizon concerning GLP-1s and Section 340B pricing, say attorneys at Manatt.