Policy & Compliance
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March 10, 2026
A Look At The Real Impact Of The FTC's PBM Settlements
It may all come down to the details in a landmark settlement between the Federal Trade Commission and one of the biggest pharmacy benefit managers in the U.S., as delayed timelines and a key carveout provision threaten to dampen sweeping changes to the larger system.
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March 10, 2026
5th Circ. Revives J&J Sales Rep's Wage Dispute
A Texas federal court did not take into consideration relevant factors to determine whether a former Johnson & Johnson sales representative's failure to retain local counsel in his wage and hour suit represented excusable neglect, the Fifth Circuit ruled on Tuesday.
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March 10, 2026
Sanofi Says Judge Botched Insulin Device Patent Listings
Sanofi-Aventis sparred with drug wholesalers over a Massachusetts federal magistrate judge's pronouncements that the parties should go to trial on claims the pharmaceutical giant used improper insulin device patent listings to anticompetitively protect the blockbuster Lantus insulin pen from competition.
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March 10, 2026
Lab's Aetna Payment Suit Survives, But With Deep Cuts
A Connecticut federal judge ruled Aetna and its parent company, CVS Health Corp., must face a pared down lawsuit from a medical laboratory alleging it is owed $20.6 million in unpaid invoices.
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March 10, 2026
Wash. To Set Its Own Vaccine Schedule Under New State Law
Washington Gov. Bob Ferguson has signed legislation that requires health plans to cover vaccines and other preventive care recommended by the state rather than the federal government, joining a movement toward states setting their own recommendations.
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March 10, 2026
4th Circ. Backs W.Va.'s Trans Care Coverage Exclusion
The Fourth Circuit said Tuesday that West Virginia's Medicaid coverage exclusion for gender-affirming care passes constitutional muster and does not discriminate based on sex, basing its conclusion on a U.S. Supreme Court ruling that upheld Tennessee's ban on gender-affirming care for minors.
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March 10, 2026
CVS Can't 'Relitigate' Price-Gouging Class Cert.
A Rhode Island federal judge refused to narrow the certified classes of health plans alleging CVS schemed with pharmacy benefit managers to overcharge insured health plans for generic drugs, finding that PBM Express Scripts' refusal to produce its contracts changes nothing about how the classes will be assessed.
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March 10, 2026
2nd Circ. Revives Geico's Suit Over Acupuncture Referrals
A lower court erred in granting summary judgment to Geico after the insurer sued over reimbursements to an acupuncturist involved in what Geico said was a kickback scheme, the Second Circuit ruled Tuesday, finding the district court misinterpreted a state law detailing requirements for referrals and no-fault payments.
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March 10, 2026
Minn. Medicaid Funds Case A Test For CMS Tactic
Minnesota’s fight over $243 million in Medicaid funding frozen by the Trump administration sets up an unusual, politically tinged legal clash that may shape the government’s anti-fraud tactics in other states.
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March 10, 2026
Wyoming Abortion Ruling Sets Off Lawmaker Backlash
Lawmakers in Wyoming won't let judges have the final word on abortion and have considered slashing judicial security funding and shrinking the top court. This week, the governor signed a new "heartbeat" abortion ban likely to see new legal challenges.
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March 10, 2026
Former Conn. Prosecutor Can Stay On Generic-Drug Case
Connecticut's former assistant attorney general can continue to represent insurers Humana and Molina Healthcare Inc. in multidistrict litigation over alleged price-fixing of generic drugs, after the Pennsylvania federal judge overseeing the case agreed Monday with a report that the attorney has no information that had not already been shared.
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March 10, 2026
AFSCME Sues Trump Admin Over $600M Health Funding Cuts
The American Federation of State, County and Municipal Employees is seeking to block a federal government directive to cancel more than $600 million in public health grants administered by the Centers for Disease Control and Prevention, alleging that the directive was issued to target Democratic-led states.
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March 10, 2026
Abortion Ban, Drug Pricing: Health Litigation Week In Review
Indiana's abortion ban and religious freedom, a proposed class action over Express Scripts pricing, and a deal over abortion pill ads. Law360 looks at big legal developments from the past week.
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March 09, 2026
Texas AG Gets Temporary Ban On Chest Binder Sales
A Texas state judge has issued a temporary restraining order against a New York-based online retailer of undergarments and chest binders for young women and teens from selling its clothing in the Lone Star State.
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March 09, 2026
Vehicle Manufacturer Strikes Deal In Tobacco Surcharge Suit
Commercial vehicle manufacturer International Motors LLC has agreed to end a proposed class action claiming it unlawfully charges employees who use tobacco products an additional $600 per year for health insurance without providing an alternative to the fee, according to a filing in Illinois federal court.
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March 09, 2026
NC Providers Sue UnitedHealth Over 'Devastating' Cyberattack
UnitedHealth Group Inc. and several of its subsidiaries are facing a proposed class action in North Carolina state court over a 2024 data breach that took its claims processing platform offline and allegedly delayed billions of dollars in reimbursements to providers.
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March 09, 2026
JPMorgan Trims But Can't Escape ERISA Drug Costs Suit
A New York federal judge pared claims Monday against JPMorgan Chase & Co. in a suit from workers who alleged they paid too much for prescription drugs, but opened discovery on allegations that the bank's contract with its pharmacy benefit manager caused transactions prohibited by federal benefits law.
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March 06, 2026
ExThera Exec Hid Patient Deaths To Keep $10M Deal, DOJ Says
Medical device company ExThera concealed the deaths of two U.S. patients treated with its unapproved blood filtration device at a clinic in Antigua, according to federal prosecutors, with the company agreeing to forfeit nearly $5.7 million and one executive facing up to three years in prison.
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March 06, 2026
Health Groups Back Bid To Bar Noncitizen Benefit Restrictions
A group of public health organizations and scholars Friday urged a Rhode Island federal court to make permanent its order blocking the Trump administration from enacting a policy change basing access to a host of federally funded services on immigration status.
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March 06, 2026
FDA Vaccine Chief Prasad To Exit Agency For 2nd Time
Dr. Vinay Prasad, the U.S. Food and Drug Administration's top vaccine regulator, will leave the agency in the coming weeks, FDA Commissioner Marty Makary said Friday.
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March 06, 2026
9th Circ. Mulls Whether Politics Tainted DOJ Trans Care Probe
A Ninth Circuit panel on Friday grappled with where to draw the line between a legitimate law enforcement investigation and a politically motivated crusade, as the U.S. Department of Justice sought to revive a subpoena against a telehealth provider of gender-affirming medical care.
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March 06, 2026
Mass. Judge Told Vax Committee Must Be Fairly Balanced
A key federal vaccine committee remains subject to statutory requirements that its membership be fairly balanced, a Massachusetts federal judge heard from both U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. and medical organizations challenging his overhaul of the group.
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March 06, 2026
Dentist Says She Was Fired For Exposing Medicaid Fraud
A dentist filed suit against several West Michigan dental practices and a dental management company, claiming she was fired after reporting that the clinics billed Medicaid for dental procedures that were never performed.
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March 05, 2026
Telehealth Co. Swaps In Gordon Rees In Novo's GLP-1 Fight
A telehealth platform facing allegations from Novo Nordisk that it falsely advertised Ozempic alternatives has picked new counsel in the dispute, withdrawing attorneys from Foley & Lardner LLP and Miller Nash LLP and substituting in two lawyers from Gordon Rees Scully Mansukhani LLP.
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March 05, 2026
Pharma Co. Investors Secure Class Cert. Over FDA Obstacles
A Pennsylvania federal judge has granted certification to a group of Verrica Pharmaceuticals Inc. investors who claim the company defrauded them by hiding obstacles it faced in obtaining approval from the U.S. Food and Drug Administration for its lead product, though she made a slight change to the class definition to avoid what she called a "heads I win, tails you lose strategy."
Expert Analysis
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Unpacking Key Themes From NY's New Healthcare Strategy
New York Gov. Kathy Hochul's 2026 State of the State agenda, read together with the state's fiscal year 2027 executive budget, reflect a clear framework to utilize Medicaid as the state's operating platform for healthcare reform, say attorneys at Sheppard.
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Trans Care Enforcement Landscape Is Evolving Quickly
The recent coordinated federal effort to reshape pediatric gender-affirming care through enforcement and funding pressure has created a rapidly evolving regulatory environment marked by shifting risk assessments and potential downstream market effects for healthcare institutions and life sciences companies, say attorneys at Arnall Golden.
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11th Circ. May Bring Tectonic Shift To FCA Qui Tam Actions
The Eleventh Circuit's upcoming decision in Zafirov v. Florida Medical Associates, assessing whether the False Claims Act permits ordinary citizens to stand as officers of the federal government, could significantly limit private relators' ability to bring FCA actions, say attorneys at Saul Ewing.
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To Survive FCA Actions, Small Cos. Must Take Offensive Steps
A fumbled response to False Claims Act allegations can doom lower-middle-market businesses, and with FCA enforcement hitting record levels for two years, smaller companies must have offensive strategies ready that focus their limited resources on defeating civil qui tam and federal criminal actions, says Derrelle Janey at Olshan Frome.
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Record FCA Recoveries Signal Intensified Healthcare Focus
In its recently released False Claims Act statistics, the U.S. government's emphasis on record healthcare recoveries and government-initiated healthcare matters last year indicates robust enforcement ahead, though the administration's focus on current policy objectives also extends beyond the healthcare sector, say attorneys at Epstein Becker.
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A Potential Shift In FDA's Approach To Drug Trial Design
Recent guidance released by the U.S. Food and Drug Administration clarifying how Bayesian approaches — which combine prior knowledge with new data — may be used in clinical trials reflects the agency's continued interest in innovative trial designs that may accelerate drug approvals, say attorneys at Alston & Bird.
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What FDA Guidance Means For Future Of Health Software
Two significant final guidance documents released by the U.S. Food and Drug Administration last month reflect a targeted effort to ease innovation friction around specific areas, including singular clinical decision support recommendations and sensor-based wearables, while maintaining established regulatory boundaries, say attorneys at Covington.
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How State FCA Activity May Affect Civil Fraud Enforcement
A growing trend of state attorneys general enforcing their False Claims Act analogues independently of the U.S. Department of Justice carries potential repercussions for civil fraud enforcement and qui tam litigation considerations, say Li Yu at Bernstein Litowitz, Ellen London at London & Naor and Gwen Stamper at Vogel Slade.
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Wage-Based H-1B Rule Amplifies Lottery Risks For Law Firms
Under the wage-based H-1B lottery rule taking effect Feb. 27, law firms planning to hire noncitizen law graduates awaiting bar admission should consider their options, as the work performed by such candidates may sit at the intersection of multiple occupational classifications with differing chances of success, says Jun Li at Reid & Wise.
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Assessing Compliance Risks Around TrumpRx Participation
As there are novel compliance obligations and potential political opposition related to the new TrumpRx online drug platform, companies intending to participate on the site should consider the pressure points that are likely to draw enforcement scrutiny, say attorneys at Sheppard.
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Predicting Actual Impact From CDC's New Vaccine Guidance
Recent federal changes to the childhood immunization schedule, reducing the number of vaccine recommendations from 18 to 11, do not automatically create enforceable obligations for parents, schools or healthcare providers, but may spur litigation and other downstream effects on school policies and state guidelines, says Mehdi Sinaki at Michelman & Robinson.
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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.