Policy & Compliance

  • August 18, 2026

    DOJ Targets Small Pharmacies With Novel FCA Claims

    The Justice Department in recent weeks has indicated that it's willing to use the False Claims Act to bring stronger charges and levy stiffer fines against smaller pharmacies accused of violating controlled substances laws by contributing to the opioid crisis, legal experts say.

  • August 18, 2026

    Aetna Says It Doesn't Use Repricing Tools In Antitrust Case

    Aetna Inc. urged a Massachusetts federal court to toss it from an antitrust case accusing insurance companies of using repricing tools to reduce reimbursements paid to healthcare providers, arguing that a subsidiary, not Aetna, used the tools at issue.

  • August 18, 2026

    NC Doc Gets Prison For Opioid Recovery Prescription Scheme

    A federal judge has sentenced a North Carolina doctor to half a year in prison for letting administrative staff at a nonprofit where he worked as medical director use his credentials to prescribe the opioid use disorder medication buprenorphine to thousands of patients.

  • August 18, 2026

    CMS Aims To Sidestep Past Setbacks In New Trans Care Rule

    A new Medicaid rule that bars federal funding for minors’ gender-affirming care is likely to ignite a swift legal fight over discrimination law, procedural requirements and the reach of last year’s landmark Supreme Court decision in U.S. v. Skrmetti, experts say.

  • August 18, 2026

    Marriott Gets Trim Of Worker's Tobacco Health Fee Suit

    A Maryland federal judge on Tuesday refused to completely toss a Marriott worker's proposed class action alleging the hotel giant's $15 weekly health fee on employees who use tobacco violated federal benefits law, but trimmed the dispute of some claims as insufficiently backed up. 

  • August 18, 2026

    What To Know: AMA Faces Medical Coding Copyright Suit

    A healthcare transparency group is asking a judge for permission to publish the medical codes that help determine the billing for medical procedures, setting up a confrontation with the American Medical Association, which developed the coding system. Here, Law360 takes a closer look at the case and the broader transparency debate.

  • August 17, 2026

    Albertsons Judge Hears $44B Opioid Abatement Plan In Wash.

    Addressing harm caused by prescription opioid abuse in Washington would cost nearly $44.4 billion, an expert testified Monday during a bench trial in the state's case accusing Albertsons and its Safeway subsidiary of exacerbating Washington's overdose crisis by failing to curb the flow of controlled substances.

  • August 17, 2026

    Blue States Say FTC Can't Regulate Trans Youth Health

    A group of left-leaning states, including Massachusetts and California, asked a Texas federal court to toss a Federal Trade Commission suit against the World Professional Association for Transgender Health, saying Monday that the FTC's suit constitutes a "federal attack on state-regulated transgender healthcare."

  • August 17, 2026

    AIG Exclusion Doesn't Bar Multiplied Damages, Judge Says

    A California federal judge in a narrow ruling declared that a portion of Kaiser Foundation Health Plan's insurance policy does not automatically bar coverage for a portion of a $581 million False Claims Act settlement attributable to multiplied damages, but will decide later whether the agreement actually included such damages. 

  • August 17, 2026

    Hospital Employees Seek Class Cert. In Retirement Funds Suit

    Employees of a faith-based nonprofit Colorado hospital urged a federal judge to grant class certification in their lawsuit alleging the hospital mismanaged employees' retirement funds and ultimately cost participants tens of millions of dollars.

  • August 17, 2026

    Mass. Judge Vacates ACA Gender-Affirming Care Restriction

    A Massachusetts federal judge handed a coalition of 21 states a win on their claim that the U.S. Department of Health and Human Services unlawfully issued Affordable Care Act reforms barring marketplace plans from requiring coverage for medical procedures used in gender-affirming care.

  • August 17, 2026

    7th Circ. Reverses Alcoa Union Retirees' Lifetime Benefits Win

    The Seventh Circuit reversed an Indiana federal court's decision holding that certain union retirees of aluminum giant Alcoa and their beneficiaries had a vested right to health benefits for life, finding error with the lower court's judicial estoppel analysis that formed the basis for its judgment on liability.

  • August 14, 2026

    AstraZeneca Joins States Aiming To Block Ill. 340B Drug Law

    AstraZeneca on Friday joined some other large pharmaceutical companies in urging an Illinois federal court to block a new state law that prohibits drugmakers from restricting the types or number of pharmacies healthcare providers can contract with to provide medications under a federal discount drug program.

  • 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.

Expert Analysis

  • Workplace Menopause Laws Demand New HR Playbooks

    Author Photo

    A recent wave of state and local legislation that makes menopause an expressly protected condition in the workplace creates new compliance obligations amid an already ambiguous federal framework, and demands a workplace culture where employees feel safe asking for support, says Elliot Griffin at Ballard Spahr.

  • States Should Reconsider Forced PBM Divestiture Laws

    Author Photo

    State legislatures are attempting to enact policies intended to force pharmacy benefit managers to divest from pharmacies, but these laws would have the practical effect of reducing patient access and competition, potentially violating the U.S. Constitution in the process, says former Utah Attorney General John Swallow.

  • Noncompete Laws Show States Focusing On Bans, Healthcare

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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

    Author Photo

    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.