Policy & Compliance

  • June 04, 2026

    Policyholder Attys Praise Kaiser's Damages Bid In FCA Row 

    Kaiser Foundation Health Plan's call for coverage of any multiplied damages in a $581 million False Claims Act settlement with the U.S. Department of Justice grabbed the attention of policyholder attorneys, who see a smart strategy to simplify litigation and are curious about how an AIG unit may respond. 

  • June 04, 2026

    Feds Tout Medicaid Fraud Crackdown In Ohio, Slam Hawaii

    The Trump administration on Thursday praised Ohio's fight against Medicaid fraud and said Hawaii was doing too little, as federal officials pushed states to ramp up anti-fraud prosecutions or risk the loss of federal funding.

  • June 04, 2026

    Cities, Doctors' Group Seek Bar On ACA Marketplace Reforms

    Several cities and groups representing doctors and small businesses urged a Maryland federal court to strike down recently finalized Affordable Care Act marketplace reforms, arguing they will strain community resources by increasing the population of underinsured and uninsured Americans.

  • June 04, 2026

    NC Doctor Seeks Probation In $11M Medicare Fraud Case

    A North Carolina doctor convicted of making false statements as part of an $11 million Medicaid fraud scheme has asked a federal judge in the state to not send her to federal prison and instead give her probation after a jury found her guilty.

  • June 03, 2026

    AbbVie Loses Miss. Discount Drug Law Challenge For Good

    A Mississippi federal judge on Wednesday threw out a suit brought by AbbVie and other pharmaceutical manufacturers that participate in Medicaid challenging a law barring their interference with the distribution of discounted prescriptions to pharmacies serving low-income patients.

  • June 03, 2026

    Judge Questions Terms Of Student Loan Forgiveness Change

    A Massachusetts federal judge considering whether to block a new Trump administration rule that could kick millions of public sector and nonprofit employees out of a student loan forgiveness program repeatedly pressed a government lawyer Wednesday on the precise criteria the U.S. Department of Education would use to decide who is no longer eligible.

  • June 03, 2026

    Treatment Providers Can't DQ Participants' Atty In Wage Suit

    Several Texas-based addiction recovery program operators cannot remove a worker's attorney from a proposed wage class action over his prior involvement with the programs, a federal judge found, saying the operators failed to show the attorney had a conflict of interest or was a necessary witness.

  • June 03, 2026

    Medical Equipment Co. Inks $14.3M Deal In Overbilling Suit

    Pennsylvania-based AdaptHealth Corp. will pay $14.3 million to settle claims that it violated the North Carolina Debt Collection Act by overcharging and trying to collect debts from patients who had returned medical equipment to the company, according to details of a deal released this week.

  • June 03, 2026

    Bankrupt Hospital Can't Exit $3B BCBS Antitrust Deal

    A bankrupt Alabama hospital with "settler's remorse" can't bail on a multibillion-dollar antitrust settlement with Blue Cross Blue Shield, a federal judge ruled Tuesday.

  • June 03, 2026

    Ill. Court Blocks Fla. Suit Targeting Gender Care Policies

    An Illinois federal judge blocked the Florida attorney general's lawsuit targeting medical groups' policies on youth gender-affirming care, saying there's sufficient jurisdiction over Sunshine State officials because of a potential nationwide chilling effect the enforcement action caused.

  • June 03, 2026

    Trans Youth Sue NYU Langone, DOJ To Bar Records Release

    A group of transgender minors and young adults who received gender dysphoria care at NYU Langone urged a New York federal court to bar the U.S. Department of Justice from accessing their sensitive health records through a criminal subpoena.

  • June 03, 2026

    HHS Says Bronx Facility $31M Payback Suit Filed Prematurely

    The U.S. Department of Health and Human Services says a nursing center in New York City should have pursued administrative remedies before fighting the collection of $31 million in Medicare overpayments with a lawsuit.

  • June 03, 2026

    EEOC Sues Health System Over Female Van Driver's Firing

    A Maryland healthcare system discriminated against a female driver by firing her after a wheelchair-bound nursing home resident fell from her transport van, whereas a male van driver was not disciplined after a similar episode, the U.S. Equal Employment Opportunity Commission said in a new suit.

  • June 02, 2026

    NJ Sues GEO Group Over Denial Of Detention Center Access

    New Jersey sued the owner and operator of immigration detention center Delaney Hall in state court on Tuesday, accusing the contractor of violating state law by blocking health officials from inspecting the center.

  • June 02, 2026

    NC Doctor Says 'Acquitted' Conduct Skews Sentencing

    A doctor convicted of making false statements in connection with an $11 million Medicare fraud scheme is urging a North Carolina federal court to exclude conduct she says she was acquitted of from her sentencing calculation, while the government argues she's mischaracterizing the outcome of the case. 

  • June 02, 2026

    No Surprises Act's New Rule Hands Win To Providers

    A long-awaited update to the No Surprises Act includes technical changes to dispute resolutions that attorneys say add up to a win for providers seeking to navigate a complex process.

  • June 02, 2026

    John Oliver Dodges Defamation Suit Over Medicaid Segment

    A physician highlighted in a "Last Week Tonight" segment on Medicaid who sued host John Oliver for defamation lost his case Tuesday, after a New York federal judge found the challenged statements were protected speech.

  • June 02, 2026

    3 State Drug Pricing Bills Attys Should Know

    State lawmakers continue to debate bills aimed at controlling the prices of prescription drugs. In recent weeks, high-profile bills in Illinois, Virginia and Minnesota all saw movement. Here, Law360 breaks down what attorneys need to know about these three bills. 

  • June 02, 2026

    4 Things To Know Before Feds Fight Rhode Island's 340B Law

    With the federal government's support, drug companies will try to persuade the First Circuit on Wednesday to strike down a Rhode Island law blocking them from constraining federally funded hospitals and contract pharmacies that use the 340B program. Here what you need to know about the legal battles surrounding the program ahead of the hearing.

  • June 02, 2026

    Generics Makers Tell 3rd Circ. Buyers Too Few For Class

    Two pharmaceutical companies embroiled in decadelong litigation over the alleged price-fixing of generic drugs told a Third Circuit panel on Tuesday that groups of drug buyers either didn't have the numbers necessary to support class certification or were not clearly identifiable.

  • June 02, 2026

    Nonnetwork Insurance Plans Could Spur Legal Challenges

    A new Centers for Medicare & Medicaid Services rule will bring more high-deductible, low-premium plans to the Affordable Care Act marketplace. Some legal experts believe the inclusion of insurers without provider networks may run afoul of the law. .

  • June 01, 2026

    Albertsons Had Duty To Curb Opioid Diversion, Judge Rules

    As providers of controlled substances, pharmacy giants Albertsons and Safeway had legal duties to prevent the diversion of opioid drugs, a Washington state judge ruled on Monday, though whether the companies failed to fulfill those duties will be determined at trial.

  • June 01, 2026

    DC Circ. Says Military Trans Ban Flouts Constitutional Rights

    A divided D.C. Circuit panel Monday said the Trump administration illegally banned transgender individuals from military service, then narrowed a preliminary injunction to prevent the government's exclusion of transgender people presently serving in the military but not those desiring to enlist.

  • June 01, 2026

    DOJ Says Ohio Health System Can't Duck Antitrust Case

    The U.S. Department of Justice defended its antitrust case accusing OhioHealth Corp. of blocking competition through its contracts with insurers, telling an Ohio federal court the health system is depriving consumers of lower-cost health plans.

  • June 01, 2026

    NC Biz Court Bulletin: Referee Tapped, CEO To Be Deposed

    The North Carolina Business Court rounded out May by appointing a discovery referee in a healthcare antitrust class action and ordering the deposition of a top executive in a trade secrets battle, in addition to fielding a new complaint alleging unpaid capital contributions for a captive insurance company.

Expert Analysis

  • How Oregon Ruling Affects Federal Gender Care Crackdown

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    In a favorable development for healthcare providers, an Oregon federal court recently vacated certain U.S. Department of Health and Human Services restrictions on gender-affirming care for minors, but the government's broader campaign against this care, including proposed rulemaking and agency investigations, leaves significant uncertainty, say attorneys at Arnold & Porter.

  • NY Opioid Antagonist Mandate Leaves Employers Guessing

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    A recently enacted New York law will require employers that are federally mandated to maintain first-aid supplies to now include an opioid antagonist, but being that it is subject to a complicated Occupational Safety and Health Administration analysis, employers face several unanswered compliance questions, say attorneys at Conn Maciel.

  • Calif. Case Raises Questions For Medical Practice Investors

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    The California attorney general's amicus brief in Art Center v. WCE and the California Medical Association's response highlight how the California appeals court's ruling could significantly affect the structure and enforceability of succession arrangements in medical practice ownership, say attorneys at Ropes & Gray.

  • Previewing FDA Preapproval Access In Psychedelics EO

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    The second of two pathways for psychedelic drug access outlined in President Donald Trump's recent executive order constitutes an unprecedented expansion of the Right to Try Act, which could fundamentally alter the psychedelic access landscape while presenting significant regulatory, operational and legal challenges, say attorneys at Husch Blackwell.

  • Previewing FDA National Priority Vouchers In Psychedelics EO

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    President Donald Trump's recent executive order on psychedelic drug access represents a watershed moment in federal drug policy, but its significance lies in two distinct regulatory pathways, the first being the Commissioner's National Priority Vouchers, which offer a significant opportunity to compress U.S. Food and Drug Administration review, say Kimberly Chew at Husch Blackwell and Odette Hauke at Odette Alina.

  • AG Watch: Texas Charts A Course On Investigative Authority

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    The Texas Supreme Court's recent decision in Texas v. PFLAG affirmed, and arguably expanded, the Texas attorney general's civil investigative demand authority, providing a road map that other courts evaluating state attorney general CIDs may find instructive, amid a lack of precedent, say attorneys at Kelley Drye.

  • Initial Virginia AG Actions Signal Focus On Multistate Efforts

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    Now that Virginia Attorney General Jay Jones has reached the 100-day mark in office, his first set of actions reveals a clear preference for coalition with regional and national counterparts, which means the primary risk for businesses is no longer just the fact of enforcement, but the speed at which investigations can escalate, says Lauren Cooper at Hogan Lovells.

  • How CMS Fraud Priorities Complicate Provider Acquisitions

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    As the Centers for Medicare & Medicaid Services steps up usage of its affiliates authority and post-transaction audits, parties contemplating the acquisition or sale of home health and hospice providers should take steps to avoid the potential suspension of Medicare billing privileges, say attorneys at Alston & Bird.

  • Mapping Philly US Atty's White Collar Enforcement Push

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    Attorneys at Blank Rome discuss the U.S. Attorney for the Eastern District of Pennsylvania David Metcalf’s commitments and priorities, survey early results from his first year, and suggest practical action items for companies operating under the office's jurisdiction.

  • How The Coming Months Will Shape State Drug Price Boards

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    The future of state prescription drug affordability boards may be determined in the next few months, between an upcoming court decision in a challenge against state authority to set drug prices, and pending state decisions about whether to use federal Medicare maximum fair prices as reference, say Michael Kolber, Steven Chen and Kelechi Ezealaji at Manatt.

  • Steps To Consider As DOJ Launches Fraud Division

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    The establishment this month of the National Fraud Enforcement Division within the U.S. Department of Justice is a significant reorganization that suggests an increase in enforcement activity involving federally funded programs but leaves a number of important questions unanswered, say attorneys at Crowell & Moring.

  • Court's HRSA Policy Reversal Leaves 340B Rules Murky

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    A D.C. federal court's recent decision in Premier v. U.S. Department of Health limits the Health Resources and Services Administration's ability to enforce long-standing Section 340B interpretations through subregulatory guidance, leaving open core statutory questions about purchasing models, inventory classification and program oversight, says Martha Cramer at Hooper Lundy.

  • Fresenius Ruling May Shift Anti-Kickback Enforcement

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    The Ninth Circuit's recent decision in Fresenius v. Bonta suggests that businesses have a First Amendment right to donate to certain charities, even if those donations are motivated by economic self-interest, potentially calling into question years of Anti-Kickback Statute proceedings against pharmaceutical manufacturers for making similar donations, says Jonah Knobler at Patterson Belknap.