Policy & Compliance

  • August 14, 2026

    United, Ga. Providers Settle Out-Of-Network Benefits Pay Fight

    United Healthcare has settled claims that three Georgia medical providers that are outside the insurer's network requested "exorbitantly high" reimbursements for care provided to United customers, according to documents filed in Georgia federal court.

  • August 14, 2026

    NC County Sues Bankrupt Hospital Operator For $10M

    North Carolina's Martin County has sued CHS/Community Health Systems Inc. for $10 million in North Carolina federal court, alleging the company failed to honor its obligations to run Martin General Hospital after its affiliate filed for Chapter 7 in 2023.

  • August 14, 2026

    Idaho Abortion Ban Needs Health Exceptions, Judge Finds

    An Idaho federal judge barred the state from criminalizing abortions in cases where continuing a pregnancy puts a patient at risk of lasting harm or death via self-harm, finding that the 14th Amendment establishes a fundamental right to health- and life-preserving abortion care.

  • August 13, 2026

    Albertsons Didn't Flag Suspicious Opioid Orders, Judge Hears

    Albertsons failed to report its pharmacies' unusual opioid orders to the U.S. Drug Enforcement Administration despite explicit instructions from the agency to do so, the retailer's vice president of pharmacy compliance testified Thursday during a bench trial in Washington's lawsuit accusing the chain of exacerbating the state's opioid epidemic.

  • August 13, 2026

    Blue Cross Affiliates Get Trim Of Aramark Health Benefits Row

    A Pennsylvania federal judge on Thursday trimmed but refused to toss a federal benefits lawsuit from food service giant Aramark against a Blue Cross affiliate that administered the company's employee health benefit plans, opening discovery on allegations that improper claims management cost tens of millions and breached fiduciary duties.

  • August 13, 2026

    J&J Says No To Reviving Stelara Case

    Johnson & Johnson has asked the Fourth Circuit not to revive CareFirst's antitrust suit alleging the company tried to monopolize the market for the immunosuppressive drug Stelara.

  • August 13, 2026

    Wash. Halts Conversion Therapy Ban For Therapist Amid Suit

    Washington state has agreed not to enforce its ban on a practice commonly known as conversion therapy against a therapist while his First Amendment challenge to the prohibition plays out in federal court, according to a stipulation entered Thursday.

  • August 13, 2026

    Vaccine Challengers Slam Connecticut's 'One-Party Rule'

    Challengers to Connecticut's mandatory school vaccination laws have accused political leaders of exercising "one-party rule" over state government, claiming the House speaker, governor and attorney general, who are all Democrats, tweaked or defended state laws specifically to stymie their religious freedom claims.

  • August 13, 2026

    Employers Expecting Bump In Health Plan Costs, Survey Says

    GLP-1 medications and catastrophic coverage claims are two leading factors employers anticipate will push health plan costs up 10% in 2027, according to new data released Thursday by the International Foundation of Employee Benefit Plans.

  • August 13, 2026

    Glenmark Will Pay $15.3M To End Humana's Price-Fixing Claims

    The U.S. arm of Glenmark Pharmaceuticals Ltd. has agreed to settle generic-drug price-fixing claims brought by Humana Inc. in three lawsuits centralized in Pennsylvania-based multidistrict litigation, according to a filing with Indian stock exchanges.

  • August 13, 2026

    NC Biz Court Bulletin: Judges Retire, HCA Suit Heads To Trial

    The North Carolina Business Court dropped a host of heavy-hitting opinions in July ahead of two judicial retirements and a new chief judge rising in the ranks.

  • August 12, 2026

    Full 5th Circ. Rejects Planned Parenthood's Immunity Appeal

    The full Fifth Circuit Wednesday tossed an appeal over whether Planned Parenthood is entitled to attorney immunity in a whistleblower suit accusing the organization of improper Medicaid billing, reversing a panel's decision that went in favor of Planned Parenthood.

  • August 12, 2026

    Albertsons Judge Hears Testimony On Rx Opioid, Abuse Link

    An "undeniable" causal link exists between excess prescription opioids and problem use of drugs such as heroin and fentanyl, an expert witness testified during a bench trial Wednesday in Washington's lawsuit accusing Albertsons of fueling the state's overdose crisis by irresponsibly dispensing opioids.

  • August 12, 2026

    Feds Enter FCA Suit, Say 3 Health Cos. Overbilled Medicare

    The federal government has intervened in a False Claims Act suit accusing a trio of Colorado healthcare companies of conspiring to file inflated claims for services they never rendered in order to get more money from Medicare and Tricare.

  • August 12, 2026

    Full 5th Circ. Invalidates Part Of No Surprises Act Rules

    The full Fifth Circuit partially unraveled federal regulations that implemented an arbitration system between insurers and out-of-network providers that Congress established in a 2020 law called the No Surprises Act, holding aspects of how the rules calculated payment amounts for disputed claims were unlawful.

  • August 12, 2026

    DC Physician Group Settles ERISA Plan Mismanagement Suit

    A George Washington University-affiliated physician group has agreed to settle a suit claiming it allowed its $345 million retirement plan to be bogged down by underperforming and pricey investment funds, according to a filing Tuesday in D.C. federal court.

  • August 12, 2026

    9th Circ. Says Aetna Must Face Benefit Misrepresentation Suit

    The Ninth Circuit revived allegations that Aetna misrepresented how much it would pay toward a patient's $150,000 surgery, finding that federal benefits law didn't preempt a claim brought under state law because the dispute centered on the payment commitments rather than the health plan itself.

  • August 12, 2026

    CMS Ends Medicaid Funds For Youth Transgender Care

    Medicaid will no longer cover the cost of some gender-affirming care for minors, including gender reassignment surgery and hormone treatments, the Centers for Medicare and Medicaid Services announced after issuing a final rule set to take effect this year. 

  • August 11, 2026

    CMS Fraud Concerns Drive Call For Autism Therapy Audits

    Healthcare providers who work with autistic people are facing greater scrutiny from the federal government over fraud concerns. Experts say the drivers of ballooning costs are complex.

  • August 11, 2026

    Fed. Circ. Revives Man's Vax Injury Case, Citing Mail Delay

    The Federal Circuit reversed a U.S. Court of Federal Claims decision that rejected a man's case seeking vaccine injury compensation, concluding that the court wrongly faulted him for the late arrival of his petition.

  • August 11, 2026

    Judge Probes 7th Circ. Fallout Of Ending Gender Care Fight

    An Illinois federal judge questioned Tuesday what would become of a pending appeal before the full Seventh Circuit if he allows the American Academy of Pediatrics to voluntarily dismiss, without prejudice, its challenge to a Florida racketeering probe over the medical group's gender-affirming care guidelines, an issue one attorney predicted would be "hotly contested."

  • August 11, 2026

    What To Know About Hartford HealthCare Privilege Row

    Hartford HealthCare, a Teamsters health insurance plan and a transit district are heading to court to argue over whether Hartford must produce documents in an antitrust lawsuit accusing the hospital group of exercising monopoly power.

  • August 11, 2026

    DOJ Drops 3rd Circ. Bid For Pa. Hospital Trans Patient Info

    The U.S. Department of Justice has dropped its request for the Third Circuit to review a district court's order quashing its demand for records on patients who received gender-affirming care at a University of Pittsburgh Medical Center children's hospital, effectively ending its subpoena fight in the district.

  • August 11, 2026

    Ga. Justices Call For Balancing Privacy Rights In Herpes Suit

    Georgia's top court ruled Tuesday that the privacy rights of a man accused of giving his ex-girlfriend genital herpes must be balanced against her interest in obtaining medical records to support her claims, resolving what the justices called a novel question.

  • August 10, 2026

    Spa Fights 9th Circ.'s 'Swinging Dicks' Order At High Court

    The Ninth Circuit's rejection of a spa's religious objections to serving transgender customers is incompatible with several major precedents, according to a U.S. Supreme Court petition filed Monday in litigation that soared in prominence when dozens of circuit judges decried a salacious dissent.

Expert Analysis

  • Noncompete Laws Show States Focusing On Bans, Healthcare

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    The first half of 2026 confirms that state legislatures are driving the most consequential changes in noncompete law, including a few state bans and several healthcare-specific laws, making a one-size-fits-all approach increasingly untenable for multistate employers, say attorneys at Faegre Drinker.

  • Where The Justices Aligned In Appellate Authority Ruling

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    The real story of the U.S. Supreme Court’s recent ruling in T.M. v. University of Maryland Medical System Corp., finding that a doctrine designed to curtail duplicative litigation prevents federal district courts from reviewing state court decisions, is in how the justices together revisited an obscure, century-old jurisdictional doctrine, says Alex Dimitrief at Zeughauser Group.

  • Rare DOJ Military Bias Suit Shows Peril Of Co. Admissions

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    Although the government rarely litigates Uniformed Services Employment and Reemployment Rights Act claims against private employers, Opara v. UV Memory Care demonstrates that it will do so when an employer's own admissions build the case, potentially resulting in significant compliance obligations and long-term consequences, says Bradford Kelley at Littler.

  • Mass. UHC Fraud Suit Signals States' Medicaid FCA Push

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    Massachusetts' recently filed False Claims Act suit alleging UnitedHealthcare misrepresented the health status of enrollees in a Medicaid senior care organization plan it managed pushes forward a new phase of state-level scrutiny of managed care data and Medicaid payment mechanisms, say Li Yu at Bernstein Litowitz, Ellen London at London & Naor and Gwendolyn Stamper at Vogel Slade.

  • FDA Draft Guidance Maps Payor Strategy For Psychedelics

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    Recently revised guidance from the U.S. Food and Drug Administration will operationalize a framework permitting drug developers to share product information with insurance companies, giving psychedelic therapeutics developers a road map for building a successful payor infrastructure before approval, says Kimberly Chew at Husch Blackwell.

  • Denying Emergency Abortion Care Is A Liability Oversight

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    Health systems in states with abortion bans should consider that refusing to provide emergency abortion care carries greater legal risk than the risk of prosecution under post-Dobbs laws for providing treatment, say Kimberly Chernoby at FemInEM and Rachel Rebouché at the University of Texas, Austin School of Law.

  • Carbon Health Settlement Highlights Why Evidence Is Key

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    The California Attorney General's Office's first-of-its-kind settlement with Carbon Health, imposing penalties for alleged corporate practice of medicine violations, shows that friendly professional corporation challenges usually hinge not on the parties' management services agreement, but on whether the operational record matches it, says Ben Dubin at VC Expert Services.

  • Remote Work Rulings Show ADA Fights Hinge On Process

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    Two opposite outcomes in recent Fifth Circuit and D.C. federal court cases underscore that the legality of denying employees' disability accommodation requests for remote work depends less on broad policy and more on how it's applied, says Paul Sweeney at Ice Miller.

  • How Justices' TPS Ruling Affects Workforce Planning

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    The U.S. Supreme Court’s recent holding in Mullin v. Doe that courts lack jurisdiction to review temporary protected status determinations greenlights the end of TPS for thousands of Syrian and Haitian nationals, and means employers must reevaluate TPS-designees' employability while avoiding discriminatory document practices, says attorney Richard Herman.

  • A New Regulatory Environment For PE In Calif. Healthcare

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    The California Office of Health Care Affordability's proposed revisions to its cost and market impact review regulations, amid broader state scrutiny of private equity-backed healthcare arrangements, represent a qualitative shift in California's regulatory posture toward institutional healthcare investment, say attorneys at Ropes & Gray.

  • FDA Moves Leave Peptides In A Legal Gray Zone

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    While the U.S. Food and Drug Administration has taken a concrete step forward on reclassifying certain peptides, the practical consequence of their interim status cannot be overstated — these substances are no longer designated as posing a significant safety risk, but they have not been affirmatively authorized for compounding, say attorneys at Sheppard.

  • NY Banking Brief: All The Notable Legal Updates In Q2

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    The year's second quarter brought several notable banking law developments to New York, including a proposal to align state stablecoin rules with the federal Genius Act, fresh fair lending and cybersecurity guidance from state regulators, and a significant Second Circuit holding on preemption, say attorneys at Ashurst Perkins Coie.

  • A New Defense For Medicaid Fraud Cases In Texas

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    The Texas Supreme Court decision in LabCorp v. Texas last month, finding that the state's False Claims Act requires proof that an omission is material, is among the first to establish that the government's lack of reaction to the defendant's disclosures rendered alleged omissions immaterial, say attorneys at Sheppard.