Policy & Compliance
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March 03, 2026
NC Doctor's Bid For New Trial Is Too Late, Judge Says
A North Carolina federal judge has refused to order a new trial for a doctor convicted of participating in an $11 million Medicare fraud scheme, finding that because the motion did not contain new evidence, the deadline to request another trial has passed.
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March 03, 2026
Elevance Sanction Adds To Medicare Advantage Troubles
Amid slowing enrollment rates and rising enforcement interest in private Medicare plans, insurer Elevance Health is being barred from signing up new patients to some prescription drug plans. It's not the only bad news for Elevance or the MA market.
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March 03, 2026
Florida Man Pleads Guilty In $24M HIV Drugs Fraud Scheme
The owner of a marketing company in Florida has pled guilty to receiving kickbacks as part of a $24 million scheme to sign up Medicare and Medicaid beneficiaries for HIV prophylactic medications they did not need.
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March 03, 2026
Wells Fargo Escapes Ex-Workers' Prescription Cost Suit
Former Wells Fargo workers on the employer healthcare plan failed to show that the company violated federal benefits law by allowing them to overpay for prescription drugs, a Minnesota federal judge found Tuesday, tossing the proposed class action.
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March 03, 2026
Pharma In Uphill Fight With Contract Pharmacy Laws
Silence in the federal law governing the 340B discount drug program on the issue of contract pharmacies is working against drugmakers in their effort to stop states from protecting provider agreements with pharmacies.
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March 03, 2026
3 Argument Sessions For Healthcare Attys To Watch In March
Ohio defends a gender transition ban and Janssen seeks to shed a $1.64 billion False Claims Act judgment. Law360 looks at the healthcare oral arguments to watch for in March.
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March 03, 2026
States Can't Duck Regeneron Counterclaims In FCA Case
Eleven states pursuing a False Claims Act case against Regeneron Pharmaceuticals over what they say were inflated reimbursements for an eye drug can't block counterclaims by the drugmaker on sovereign immunity grounds, a Massachusetts federal judge has ruled.
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March 03, 2026
Judge Won't Rely On DOJ 'Decency' In Trans Records Case
A Pennsylvania federal judge blocked the U.S. Department of Justice from getting patient-specific records of gender-affirming care at the University of Pittsburgh Medical Center Children's Hospital, excoriating the government's request and its reasoning for demanding the data.
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March 03, 2026
1st Circ. Won't Revive Boston's Opioid Claims Against PBMs
Boston lost its bid to revive opioid crisis-related claims against two pharmacy benefit managers, as a First Circuit panel affirmed that the suit came years too late.
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March 03, 2026
Fla. Billing Co. To Settle With Feds Over $15M Medicare Fraud
The U.S. government has settled its False Claims Act lawsuit with a medical coding and billing business it accused of aiding a Miami-based laboratory in fraudulently billing Medicare for more than $15 million in genetic tests.
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March 02, 2026
High Court Blocks California's Gender Privacy Rule
The U.S. Supreme Court on Monday reinstated a lower court order that barred California public schools from allowing transgender and gender-nonconforming students to use different names and pronouns at school without their parents' knowledge or consent while the order is appealed.
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March 02, 2026
Texas AG Says Gender Care Ban Includes Mental Health
Mental-health professionals in Texas risk losing their licenses and public funding if they "facilitate" the gender-affirming care banned under state law, said an opinion issued Friday by Attorney General Ken Paxton, which calls them the "gatekeepers."
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March 02, 2026
Anthem Avoids Patients' Ghost Network Suit In NY
A New York federal judge on Monday granted Anthem escape from a proposed class action from patients who alleged inaccuracies in the insurer's mental health provider directory violated New York state laws, holding their claims were preempted by federal employee health benefits law.
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March 02, 2026
J&J Unit Wins Bid To Revive Talc Libel Suit With New Basis
A New Jersey federal judge has revived a bankrupt Johnson & Johnson talc subsidiary's trade libel claim over a 2020 scientific article linking asbestos in talc to mesothelioma, finding that new evidence and allegations concerning the authenticity of the author's data are enough to survive a motion to dismiss.
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March 02, 2026
Drugmakers Warn Justices Oregon Pricing Law Risks Secrets
Pharmaceutical manufacturers have asked the U.S. Supreme Court to overturn Oregon's drug‑pricing transparency law, arguing it forces companies to publicly justify their pricing decisions and give up valuable trade secrets in violation of the First Amendment and the Constitution's takings clause.
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February 27, 2026
Recovery Provider Asks For Halt To Anthem's Claims Practices
A Colorado mental health and substance use treatment facilities operator and its patients asked a Colorado federal judge to stop Anthem Blue Cross and Blue Shield's claims practices, alleging its process violates federal benefits and mental health parity laws and disrupts access to lifesaving care.
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February 27, 2026
3rd Circ. Preview: Janssen, Penn State Prof. Seek Relief
A packed March argument calendar will put several high‑stakes disputes before the Third Circuit, including a billion‑dollar False Claims Act judgment and challenges at the intersection of academic freedom, DEI programming, cannabis‑sector finance and campus Title IX procedures.
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February 27, 2026
Credit Bureaus Fight Bid To Add Plaintiffs, Claims To Suit
Medical providers and a collection agency in a proposed class action accusing Equifax, Experian and TransUnion of conspiring to exclude less than $500 in medical debt from consumer credit reports lack good cause to again amend their complaint, the credit reporting agencies told a federal court.
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February 27, 2026
Judge Says RFK Jr.-Tied Group Can't Join Childhood Vax Suit
A Massachusetts judge said an anti-vaccine advocacy group with ties to U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. cannot join a lawsuit over the federal government's new childhood vaccine schedule, a day after the government said it opposed the group intervening in the case.
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February 27, 2026
Minn. State Sens. Introduce Medical Psilocybin Bill
A pair of Minnesota state senators have introduced a bill to create and regulate a medical psilocybin use program, which would allow residents over 21 with qualifying medical conditions to cultivate and use the drug to treat their conditions.
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February 27, 2026
121-Year-Old Ruling Still A Shot In The Arm For Vax Mandates
Having already withstood five global pandemics, 21 presidencies and more than a century of developments in both the law and public health policy, the U.S. Supreme Court's most durable precedent blessing mandatory vaccination is well positioned to survive a new wave of challenges, experts say.
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February 27, 2026
NYC Health Center Sues HHS Over $31M Medicare Repayment
The U.S. Department of Health and Human Services is unlawfully attempting to recoup more than $31 million in Medicare overpayments made during the COVID-19 pandemic, a New York City skilled nursing center told a federal court, saying it shouldn't have to repay the money.
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February 27, 2026
Meta Must Face Worker's Transgender Health Coverage Suit
Meta can't escape a transgender employee's lawsuit claiming the company's health plan unlawfully denied her coverage of gender-affirming surgeries, an Oregon federal judge ruled, rejecting the company's assertion that she hadn't adequately alleged the plan covered her desired procedures.
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February 27, 2026
DOL Extends Comment Window On PBM Transparency Rule
The U.S. Department of Labor said Friday that the public will be given more time to comment on a new proposed rule that would require pharmacy benefit managers to disclose how much money they've received while serving as intermediaries between drugmakers, pharmacies and insurers.
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February 26, 2026
Health Plans Lack Expert In Avandia MDL, 3rd Circ. Told
Counsel for GlaxoSmithKline urged a Third Circuit panel on Thursday to undo an order certifying a class of health plans in the multidistrict litigation over the company's alleged deceptive marketing of the diabetes drug Avandia, arguing the plaintiffs didn't have the experts necessary to support their case.
Expert Analysis
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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.
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Courts' Rare Quash Of DOJ Subpoenas Has Lessons For Cos.
In a rare move, three federal courts recently quashed or partially quashed expansive U.S. Department of Justice administrative subpoenas issued to providers of gender-affirming care, demonstrating that courts will scrutinize purpose, cabin statutory authority and acknowledge the profound privacy burdens of overbroad government demands for sensitive records, say attorneys at ArentFox Schiff.
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Remote Patient Monitoring Is At Regulatory Inflection Point
With remote patient monitoring at the center of new federal pilot programs and a recent report from the U.S. Department of Health and Human Services' Office of Inspector General examining Medicare billing for those services, it is clear that balancing innovation and risk will be a central challenge ahead for digital health stakeholders, say attorneys at Morgan Lewis.
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Utah's AI Prescription Renewal Pilot Could Inform Policy
Utah recently became the first state to approve an artificial intelligence system for autonomously renewing certain prescription medicines, providing a test case for how regulators may be able to draw boundaries between administrative automation and medical judgment, say Jashaswi Ghosh at Holon Law Partners and Bryant Godfrey at Foley Hoag.
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Ramped Up Psychedelic Production Carries Opportunity, Risk
Kimberly Chew at Husch Blackwell discusses the key legal implications of the U.S. Drug Enforcement Administration's recent dramatic increases in the production quotas for a range of psychedelic substances, offering guidance on compliance, risk management and strategic opportunities for practitioners navigating this rapidly evolving landscape.
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New Biotech Nat'l Security Controls May Have Blunted Impact
While the newly enacted federal prohibition against contracting with certain biotechnology providers associated with countries of concern may have consequences on U.S. companies' ability to develop drugs, the restrictions may prove to be less problematic for the industry than the significant publicity around their passage would suggest, say attorneys at Wilson Sonsini.
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Takeaways From The DOJ Fraud Section's 2025 Year In Review
Former acting Principal Deputy Chief Sean Tonolli of the U.S. Department of Justice's Fraud Section, now at Cahill Gordon, analyzes key findings from the section’s annual report — including the changes implemented to adapt to the new administration’s priorities — and lays out what to watch for this year.
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Traditional FCA Enforcement Surges Amid Shifting Priorities
The U.S. Department of Justice’s January report on False Claims Act enforcement in fiscal year 2025 reveals that while the administration signaled its intent to expand FCA enforcement into new areas such as tariffs, for now the greatest exposure remains in traditional areas like healthcare — in which the risk is growing, say attorneys at Debevoise.
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3 Key Ohio Financial Services Developments From 2025
Ohio's banking and financial services sector saw particularly notable developments in 2025, including a significant Ohio Supreme Court decision on creditor disclosure duties to guarantors in Huntington National Bank v. Schneider, and some major proposed changes to the state's Homebuyer Plus program, says Alex Durst at Durst Kerridge.
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Rescheduling Cannabis Marks New Tax Era For Operators
As the attorney general takes steps to move cannabis from Schedule I to Schedule III of the Controlled Substances Act, operators and advisers should prepare by considering the significant changes this will bring from tax, state, industry and market perspectives, says Michael Harlow at CohnReznick.