Policy & Compliance

  • October 06, 2026

    Anthem BCBS Accused Of Failing To Reimburse 7 Hospitals

    Anthem Blue Cross and Blue Shield is facing claims in Georgia federal court filed by acute care hospitals in six states alleging the insurer failed to cover claims at agreed-upon rates and denied claims for reasons not allowed by their contracts.

  • October 06, 2026

    What To Know About Challenge To Utah Constitutional Court

    A Utah abortion rights group says the state's attempt to transfer its abortion ban challenge to a newly created court tasked with hearing constitutional challenges is forbidden. 

  • October 06, 2026

    Hospitals Face New Reality Of Medicaid Coverage Cuts

    The first tranche of cuts to Medicaid took effect this month, booting certain categories of lawfully present immigrants. Hospitals are bracing for the bigger cuts to come.

  • October 06, 2026

    FDA Accuses 10 Retailers Of Selling Unapproved STI Meds

    Federal regulators have accused Amazon, Walmart and other online retailers of selling unapproved drugs to treat herpes and other sexually transmitted infections, according to warning letters disclosed to the public Tuesday.

  • October 06, 2026

    La. Abortion Pill Suit A Stretch For Nuisance Laws

    A lawsuit led by Louisiana officials targeting those sending abortion pills across state lines is a novel — and likely difficult — new approach to public nuisance law.

  • October 06, 2026

    7th Circ. Judge Hints Precedent Dooms Worker's Vax Fight

    A Seventh Circuit judge appeared disinclined Tuesday to restart a religious discrimination suit brought by a hospital pharmacy technician who was fired for refusing to get the COVID-19 vaccine, emphasizing that the same employer's recent win in a similar appeal is "binding authority."

  • October 05, 2026

    Air Ambulance Co. Says Pilot's 'Inattention' Wasn't Willful

    A pilot's actions in the cockpit during a patient transport flight that crashed in the mountains of North Carolina don't rise to the level of gross negligence or warrant punitive damages, an operator of air ambulance helicopters said in seeking to purge those claims from a personal injury suit.

  • October 05, 2026

    Boston Health Worker Says Firing Followed Fraud Concerns

    A former program director in Boston's health department says he was fired after refusing to enroll new clients until his concerns about fraud in a home visiting program were addressed, according to a lawsuit filed in Massachusetts state court.

  • October 05, 2026

    5th Circ. Hints CMS Medicare Advantage Rule May Violate APA

    A Fifth Circuit panel seemed hesitant to buy an argument that a rule from the Centers for Medicare & Medicaid Services dealing with Medicare Advantage plan overpayments went through proper rulemaking steps, asking Monday if the agency's argument that it can change its rationale "upends" rulemaking procedures.

  • October 05, 2026

    Securities Roundup: 7 Rulings You May Have Missed

    Federal judges from California to New York and several states in between issued a slew of decisions last week that determined the fates of shareholder lawsuits against a major health insurer, a New York bank that nearly failed in 2024 and a diagnostic company accused of hiding its challenges as COVID testing demand ebbed. 

  • October 05, 2026

    Catholic Org. Funding Cut Wasn't About Faith, Mich. Says

    A Catholic charity is improperly attempting to insert a prior religious liberty case over Michigan's foster care policies into current litigation challenging the charity's de-designation as a provider of treatment for substance use disorder, state officials have argued in a brief seeking dismissal.

  • October 05, 2026

    High Court Won't Review Medical Tape Antitrust Case

    The U.S. Supreme Court refused Monday to review a case accusing medical supplies group purchasing giant Vizient Inc. of locking in hospital customers, after the lower courts found a medical tape supplier failed to define a market that Vizient allegedly monopolized.

  • October 05, 2026

    1st Circ. Doubts Harvard Grant Fight Belongs In Claims Court

    The First Circuit Monday appeared skeptical that a lower court erred in backing Harvard University in a suit over the Trump administration's bid to freeze more than $2 billion in grant funding, suggesting that the case had been decided in the proper venue.

  • October 05, 2026

    Justices Won't Review Pregnancy Center Vandalism Case

    The U.S. Supreme Court on Monday said it will not review the conviction of a Florida woman for conspiring to violate a federal statute that prohibits intimidation and obstruction of people trying to access reproductive health facilities.

  • October 05, 2026

    Justices Won't Hear Minn. Indian Child Welfare Act Case

    The U.S. Supreme Court declined Monday to hear two foster parents' challenge to the Indian Child Welfare Act after the Minnesota Supreme Court determined they don't have standing to take on the bedrock law on claims of constitutional equal protection rights.

  • October 02, 2026

    Teva Ruling Creates Medicare Drug 'Chaos,' Full DC Circ. Told

    The federal government asked the full D.C. Circuit on Friday to reconsider a panel ruling allowing Teva to challenge Medicare's rules for deciding which drugs qualify for price negotiations, arguing the decision invites litigation that could create drug-pricing "chaos" and cause drug prices to quickly leap by more than 550%.

  • October 02, 2026

    Pa. Justices Reject Federal Limits On Agency Deference

    Pennsylvania courts do not have to follow federal precedents that limit deference to a state agency's interpretation of unclear regulations, with a majority of the state's highest court finding Thursday that an agency interpretation can be one of multiple factors for analyzing an ambiguous regulation.

  • October 02, 2026

    Judge OKs Provider Not Telling Clients Of Deal End, For Now

    A Colorado state judge granted Friday a home personal care services company's bid to delay notifying clients of a state regulatory agency's decision to terminate its provider agreement amid an upcoming administrative appeal hearing, citing a potential care gap for the providers' clients — all of them insured by Medicaid.

  • October 02, 2026

    NY-Presbyterian Can't Nix Union Funds' Antitrust Suit

    A New York federal judge ruled three union benefit funds can pursue an antitrust suit against New York Presbyterian Hospital without first proving it holds a large market share in the city, rejecting the hospital's motion to toss the suit on Friday.

  • October 02, 2026

    Pa. Hospital Workers Sue Over Biased Time Rounding

    A patient registration worker sued the University of Pittsburgh Medical Center in federal court Friday, alleging the hospital system's timekeeping software rounds time in the company's favor, while requiring patient services staff to work off the clock before and after their shifts and during meal breaks without compensation.

  • October 02, 2026

    DOJ Envisions 'Full-Fledged Law Firm' To Combat Gov't Fraud

    The National Fraud Enforcement Division was created less than six months ago, but it is rapidly reshaping the U.S. Department of Justice and spurring an uptick in internal corporate investigations, white collar experts say.

  • October 02, 2026

    6th Circ. Blocks 100s Of Opioid MDL Cases Targeting PBMs

    The Sixth Circuit on Friday overturned a pivotal decision in multidistrict opioid litigation that had dramatically expanded claims against the nation's largest pharmacy benefit managers, saying the MDL's presiding judge "clearly abused" his authority by belatedly allowing hundreds of new cases in one fell swoop.

  • October 02, 2026

    5 Supreme Court Cases To Watch This Fall

    The U.S. Supreme Court will convene Monday to begin its 2026 October term, which includes several cases that could determine the future of climate change tort litigation, expand religious freedoms and parental rights, and grant states authority to require proof of citizenship when individuals register for presidential elections using state forms. 

  • October 02, 2026

    4 Argument Sessions Benefits Attys Should Watch In October

    Former Intel workers' bid to convince the U.S. Supreme Court to revive their suit alleging shoddy retirement plan investments tops the list of oral arguments slated for October that benefits attorneys may want to keep an eye on. Here's a look at that case and three others teed up for argument this month.

  • October 01, 2026

    Home Health Co. Seeks Pause Of Colo. Agency's Backout

    A Colorado home personal care services company exclusively serving those insured by Medicaid urged a state judge Thursday to pause a Colorado regulatory agency's decision to terminate its provider agreement, contending any transition of clients to other providers should come after an administrative court hearing later this month.

Expert Analysis

  • 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.

  • Correctional Healthcare Requires Clearer Legal Standards

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    As the correctional healthcare industry increasingly faces financial instability due to litigation, the U.S. Bureau of Prisons should develop clear standards for constitutionally adequate care for incarcerated patients, says Susanne Moore at Blackstone Trial Group.

  • How Home Infusion Providers Can Adapt To Enrollment Pause

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    Recent Centers for Medicare & Medicaid Services moratoria on new enrollments of home health agencies, medical equipment companies and hospices make home infusion providers' compliance obligations more complex and ambiguous, requiring new careful consideration of specific enrollment requirements and limitations, say attorneys at Quarles & Brady.