Policy & Compliance

  • September 23, 2026

    Vein Tech Maker Escapes Suit Over DOJ Kickback Probe

    A New York federal judge has tossed, for now, a proposed investor class action alleging that vein disease device maker Inari Medical Inc.'s share price fell after it disclosed an investigation into its compliance with federal anti-kickback laws, finding the suit does not plausibly show Inari was paying healthcare providers unlawful kickbacks, among other things.

  • September 23, 2026

    Healthcare Co. Trims But Can't Escape Retirement Plan Suit

    Nonprofit healthcare system Virtua Health can't avoid a proposed class action alleging its 401(k) plan unlawfully offered a risky and underperforming investment option that provided excessive compensation to plan service providers, a New Jersey federal judge ruled.

  • September 23, 2026

    NYU Langone Inks $5.75M Deal In IT Workers' OT Suit

    NYU Langone agreed to pay $5.75 million to end a proposed class and collective action claiming it misclassified IT support workers, according to a filing in New York federal court.

  • September 23, 2026

    DOJ Pressed On Gender Care Ban In Federal HIV Program

    A Massachusetts federal judge on Wednesday skeptically questioned the Trump administration's authority to prohibit doctors from providing gender-affirming care as part of a longstanding, federally funded HIV program.

  • September 23, 2026

    Health Workers Win OK Of $4M Deal In Time-Rounding Suit

    Workers at an Indiana hospital network secured final approval of a $4 million settlement to resolve their claims that the company systematically shaved time from their pay through a biased rounding system, with a federal judge finding the deal fair and reasonable.

  • September 22, 2026

    Courts Rule On Doc's Prison Term, No Surprises Act And More

    Law360 Healthcare Authority looks at a First Circuit decision backing criminal penalties on a psychiatrist convicted for submitting $19 million in fraudulent claims, the Second Circuit's conclusion that the No Surprises Act doesn't provide a private right of action for enforcing independent dispute resolutions awards, and other appellate rulings affecting the healthcare industry over the last week.

  • September 22, 2026

    FDA Must Revisit MiMedx Wound Care Powder Classification

    A Georgia federal judge vacated the Food and Drug Administration's classification of biomedical company MiMedx's wound care treatment as a biological product, which carries heightened regulatory requirements, finding the agency's determination was arbitrary because it had classified similar products as devices.

  • September 22, 2026

    RI Judge Vacates Feds' Noncitizen Benefit Restrictions

    New York and other states applauded a Rhode Island federal judge's finding that the Trump administration flouted rulemaking requirements when it reinterpreted a 30-year-old welfare reform bill to try to subject a slew of federally funded benefit programs to immigration status verification requirements.

  • September 22, 2026

    Feds Cut 760K Enrollees From ACA Exchanges, Claim Fraud

    The Trump administration on Tuesday said it's kicking about 760,000 enrollees off the Affordable Care Act insurance marketplace, saying they aren't eligible for subsidies or don't exist at all.

  • September 22, 2026

    Dialysis Co., Workers Agree To Resolve 401(k) Forfeiture Suit

    Dialysis company Fresenius has agreed to resolve a proposed class action accusing it of unlawfully using forfeited 401(k) funds to cover its obligations to the plan rather than pay for the plan's administrative fees, according to a Tuesday filing in Massachusetts federal court.

  • September 22, 2026

    HHS Economist Warns Regulation Raises Medicare Spending

    Patient and consumer choice are crucial to driving down healthcare costs, while overregulation tends to increase insurance costs and Medicare spending, the chief economist and regulatory officer of the U.S. Department of Health and Human Services told an economic conference. 

  • September 22, 2026

    8th Circ. Questions Iowa's Bid To Unblock Parts Of PBM Law

    The Eighth Circuit on Tuesday appeared skeptical of the state of Iowa's bid to have the appellate court unblock parts of its law limiting pharmacy benefit managers' power to set drug prices, with multiple judges questioning different aspects of the state's standing and federal preemption analysis.

  • September 21, 2026

    Fla. Judge Keeps Publix Autism Claims Dispute In Fed. Court

    A Florida federal judge has denied a medical services provider's bid to send its lawsuit alleging that Publix Super Markets Inc. underpaid billing claims for children's autism healthcare back to state court, saying their claims are preempted by a federal law regulating employee benefits plans. 

  • September 21, 2026

    Calif. Health Group Accuses SEIU Of 'Shakedown' In RICO Suit

    A group representing California community health clinics has accused a Service Employees International Union affiliate of violating the federal anti-racketeering law, claiming in a new lawsuit that the union places manipulative ballot initiatives before California voters and only withdraws them if the clinics concede to its demands.

  • September 21, 2026

    HHS Can Claw Back $195M In Medicaid Payments From Mich.

    A D.C. federal judge on Monday said Michigan must return almost $200 million in Medicaid payments made to two state-operated psychiatric facilities, agreeing with a finding from the U.S. Department of Health and Human Services' appeals board that the institutions did not meet federal requirements.

  • September 21, 2026

    Ex-NFL Player Gets New Trial In $328M Medicare Fraud Case

    A Texas federal judge has granted a new trial for a former NFL player convicted in a $328 million Medicare billing scheme, finding that the government presented unreliable testimony and did not identify the alleged lies the defendant used to influence physicians.

  • September 21, 2026

    Medical Orgs Target Rule On Medicaid Work 'Frailty' Exclusion

    Federal regulation implementing a statutory "medical frailty" exclusion from Medicaid work requirements violates the Administrative Procedure Act, burdens healthcare providers and threatens to cause millions of people to lose their coverage, medical groups told a Maryland federal court in a complaint.

  • September 21, 2026

    HHS Defends Move To Limit Noncitizen Medicaid Benefits

    The U.S. Department of Health and Human Services has urged a Washington federal court not to block provisions in the 2025 federal budget bill generally denying Medicaid benefits to noncitizens receiving supplemental security income, countering claims of conflicting statutory language.

  • September 18, 2026

    NJ Seeks Quick Win On TikTok's Money Transfers

    New Jersey's attorney general urged a state court Friday to find TikTok liable for operating an unlicensed money transmission business via its livestreaming service, arguing the platform receives users' money, converts it into virtual currency and ultimately pays creators in cash.

  • September 18, 2026

    Colo. Judge Mulls Sanction For Hospital In Gender Care Suit

    Transgender adolescent patients of Children's Hospital Colorado told a state judge the court must sanction the hospital for refusing to resume providing gender-affirming medical care for transgender youth patients, saying Friday that "nothing has changed" since the patients filed their January lawsuit.

  • September 18, 2026

    Disney Plan Must Cover Trans Child's Mental Health Treatment

    Disney's benefits plan must reimburse an employee for her transgender child's medical care at a residential treatment facility for major depressive disorder, suicidal ideations and instances of self-harm, after a California federal judge ruled such care was necessary, "appropriate, and not feasible at a lower level of care."

  • September 18, 2026

    Employers See Moving Targets With H-1B Fee, And New Limits

    The Trump administration on Friday ordered federal agencies to scrutinize H-1B employers that have laid off U.S. workers, adding another layer of uncertainty for employers seeking to recruit highly skilled foreign workers.

  • September 18, 2026

    Texas Pregnancy Center Shutters To End Birth Tourism Suit

    A Texas-based pregnancy center on Friday agreed to shut down to resolve allegations by state Attorney General Ken Paxton that it helped Chinese nationals give birth in the U.S. while on tourist visas so their children could obtain birthright citizenship.

  • September 18, 2026

    NJ Justices Say No To Mass Tort For No Surprises Act Suits

    The New Jersey Supreme Court has rejected an application from five health insurers to designate 160 pending cases seeking the enforcement of alleged independent dispute resolution payment determinations issued under the federal No Surprises Act as multicounty litigation.

  • September 18, 2026

    NY Surgeons Say Elevance Penalty Policy Is Anticompetitive

    A practice group for independent neurosurgeons lobbed an antitrust suit against Elevance Health Inc. in New York federal court alleging the insurer is impeding their ability to compete for patients by threatening to financially penalize and terminate in-network facilities that work with them.

Expert Analysis

  • 5 Practice Tips After DOJ's Healthcare Fraud Declination

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    In light of the U.S. Department of Justice's decision to not prosecute Campus Eye Management under the agency's new corporate enforcement and voluntary self-disclosure policy, healthcare companies should keep several considerations in mind when weighing their risk and self-disclosure strategy, including the distinctions between reporting to the DOJ versus other government agencies, say attorneys at Haynes Boone.

  • FDA Closeout Letter Suggests Relaxing Stance On Wearables

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    The U.S. Food and Drug Administration's recent decision not to pursue enforcement action against Whoop's wearable blood pressure tracker, read together with guidance released earlier this year, suggests a softer shift in the FDA's approach to regulating wearables, say attorneys at Arnold & Porter.

  • Teva MDL Loss Shows DPAs Can Return To Haunt Civil Suits

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    Teva’s recent partial summary judgment loss in antitrust multidistrict litigation reinforces the importance of carefully scrutinizing any statement of facts a company admits to in a deferred prosecution agreement, and illustrates the potential costs of resolving a criminal investigation this way, say attorneys at Sheppard.

  • 11th Circ. FCA Qui Tam Revival Queues Up Next Challenges

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    Though the Eleventh Circuit on Sept. 1 upheld the constitutionality of the False Claims Act's qui tam provision, it will probably face continued litigation since the appellate court declined to rule on other constitutional challenges and the decision will likely be petitioned to the U.S. Supreme Court, say attorneys at Sheppard.

  • Prepping Health Businesses For Sale In A Data-Driven Market

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    In a thinner market for healthcare transactions, with both regulators and buyers using artificial intelligence to inspect data in great detail, the margin for error in sellers' financials and legal diligence has narrowed, requiring more proactive compliance efforts, says Cody Dumas at FBFK Law.

  • NY Ethics Opinion Warns Attys On Qui Tam Deception

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    A recent New York State Bar Association ethics opinion cautions that counsel representing whistleblowers may not induce, supervise or facilitate a client's deceptive prefiling investigations, creating a potential vulnerability for qui tam complaints built on questionable evidence-gathering methods, say attorneys at Sidley.

  • DOJ Fraud Declination Highlights Self-Disclosure Tradeoffs

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    As exemplified by the U.S. Department of Justice's declination of charges against Campus Eye Management under its new corporate enforcement policy, self-disclosure can be an attractive option for healthcare companies navigating criminal exposure, but should be weighed against potential costs, say attorneys at Morgan Lewis.

  • What DOJ Fraud Division Rule Resolves, And What It Doesn't

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    The U.S. Department of Justice’s recently published final rule answers many outstanding questions about the newly created National Fraud Enforcement Division, but overlapping mandates could result in parallel investigations and diverging viewpoints between multiple sets of prosecutors, say attorneys at Gibson Dunn.

  • Youth Center Investigation Shows Rising Governance Scrutiny

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    A recent New Hampshire attorney general report following its investigation into the state's Sununu Youth Services Center shows how organizations serving vulnerable populations can face scrutiny of their governance, safety practices and preparedness, even when investigators find no abuse, say attorneys at Morgan Lewis.

  • Target's ERISA Win Doesn't Ax Tobacco Surcharge Questions

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    Though a Minnesota federal court's recent dismissal of a putative class action challenging Target's tobacco surcharge wellness program offers employers a defense road map, courts' differing conclusions about the Employee Retirement Income Security Act versus U.S. Department of Labor requirements leave the legal landscape unsettled, say attorneys at McGuireWoods.

  • How 'Most Favored Nation' Regime Affects Biopharma Deals

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    As M&A activity surges in the biopharma space, companies will need to account for the Trump administration's most-favored-nation pricing proposals — durable in concept, if unsettled in detail — when drafting deals, say attorneys at Gibson Dunn.

  • Where DOJ's Fraud Priorities Memo May Actually Matter

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    The U.S. Department of Justice’s recently released memo outlining priorities for its newly created fraud division will shape how cases are identified, staffed and sequenced, meaning white collar defense work must begin earlier, say David Tarras at Tarras Defense and Trevor Jones at Dynamis.

  • DOJ Healthcare Declination Offers Self-Disclosure Checklist

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    The U.S. Department of Justice's declination of criminal charges against Campus Eye Management signals that its new self-disclosure policy provides a real path for healthcare companies to avoid criminal exposure, but that path is paved with speed, transparency and operational remediation, says Jonathan Porter at Husch Blackwell.