Policy & Compliance

  • February 12, 2026

    Feds Charge 2 Foreign Nationals Over $10M Healthcare Fraud

    Federal officials in Chicago announced healthcare fraud charges Thursday against two natives of Pakistan who allegedly made $10 million by using fake medical companies to submit Medicare and other health benefit claims for items and services they never provided.

  • February 12, 2026

    DC Circ. Judge Rips Into Insurer In CMS Rating Case

    A Louisiana insurer found a tough critic in one D.C. Circuit judge Thursday as it argued that the Centers for Medicare & Medicaid Services used an unfair method to assess its "star ratings" for insurance plans, with the jurist saying the company seemed like it "just wanted whatever interpretation will give you a higher score."

  • February 12, 2026

    Ex-Pharma Exec Fights AGs' Quick Win Bid In Antitrust Case

    A former pharmaceutical marketing executive urged a Connecticut federal court to reject summary judgment sought against him by state attorneys general pursuing wider price-fixing litigation against most of the generic drug industry, arguing key cooperating witnesses' questionable credibility makes a trial necessary.

  • February 12, 2026

    Goodwin Expands Healthcare Team With Ex-Reed Smith Atty

    A healthcare attorney specializing in guiding clients through regulatory and transactional matters has moved her practice to Goodwin Procter LLP's Philadelphia office after more than 11 years with Reed Smith LLP.

  • February 11, 2026

    AbbVie Sues Medicaid, HHS Over Botox Fair Price Controls

    AbbVie Inc. on Wednesday asked a D.C. federal court to block the Centers for Medicare and Medicaid Services from controlling the price of Botox under the Inflation Reduction Act, arguing the cosmetic drug and migraine treatment should be excluded from the controls because it's a "plasma-derived" product.

  • February 11, 2026

    Ex-Lt. Col. Sues Hegseth Over Son's Benefits Denial

    A former U.S. Army lieutenant colonel sued Defense Secretary Pete Hegseth and the Defense Health Agency on Wednesday, alleging his son was wrongfully denied health care coverage for continued inpatient mental health treatment, leaving in limbo more than $270,000 in costs. 

  • February 11, 2026

    Anesthesia Group Looks To End FTC Rollup Suit

    U.S. Anesthesia Partners has urged a Texas federal court to end the Federal Trade Commission's case accusing the group of buying competing practices through a so-called rollup strategy, asserting that enforcers have no evidence of any harm to competition.

  • February 11, 2026

    Judge Won't Review Tossed ERISA Claim In Benefits Dispute

    An Ohio federal court refused Wednesday to reconsider a recent decision dismissing a woman's Employee Retirement Income Security Act claims against her husband's employer and several UnitedHealth Group Inc. companies that administered the couple's employee health benefits.

  • February 11, 2026

    HHS Says RFK Jr. Trans Care Policy View Not Legally Binding

    Health and Human Services Secretary Robert F. Kennedy Jr.'s declaration supporting the Trump administration's move to cut funding to hospitals that provide gender-affirming care is a nonbinding policy view, his agency told an Oregon federal court, and doesn't trigger provider exclusions from federal health programs.

  • February 11, 2026

    Organ Donor Network Must Face Veteran's Waitlist Bias Suit

    A Black veteran who alleges his kidney transplant timeline was delayed because the United Network for Organ Sharing artificially inflated his kidney function scores can proceed with his Title VI lawsuit, a Georgia federal judge ruled, denying the network's bid to have the suit tossed.

  • February 11, 2026

    Trans Health And Pediatric Groups Challenge FTC Subpoenas

    A major transgender medical group and a pediatric healthcare organization are seeking to end what they call "unlawful" consumer protection investigations from the Federal Trade Commission that want information pertaining to the medical groups' claims made in their marketing and advertising for gender-affirming care for minors. 

  • February 11, 2026

    Mass. AG Charges Medical Transport Co. With Billing Fraud

    A nonemergency medical transportation provider and its former owner are facing criminal charges for allegedly billing Massachusetts' Medicaid program for tens of thousands of fake rides and laundering the proceeds to accounts in Uganda, according to a Wednesday announcement.

  • February 11, 2026

    Kaiser Will Pay $30M To End DOL Mental Health Investigations

    Kaiser Permanente has agreed to fork over at least $30 million and change its practices to end multiple U.S. Department of Labor investigations into the adequacy of the healthcare organization's mental health and substance use disorder treatment networks in California, the DOL said.

  • February 10, 2026

    US Says Abbott Lied, Must Repay Funds Spent On Formula

    Abbott Laboratories must face the federal government's lawsuit over the 2022 infant formula crisis caused by the discovery of potentially deadly bacteria in a facility that made baby formula, prosecutors told a Michigan federal court, saying the company "repeatedly lied" about the cleanliness of its plant.

  • February 10, 2026

    Ex-DOJ Fraud Prosecutors Launch DC White Collar Boutique

    Two former U.S. Department of Justice fraud prosecutors are opening their own Washington, D.C., boutique firm to represent clients in complex fraud and white collar cases, they said Tuesday.

  • February 10, 2026

    PBMs Enter New Era Of Legal Scrutiny

    The recent government funding bill includes extensive reforms for the embattled pharmacy benefit manager industry. It may presage a new wave of agency scrutiny, regulatory action and lawsuits, including from PBMs.

  • February 10, 2026

    Abortion Rules, Vaccine Recommendations And More In Court

    Abortion restrictions in Arizona are facing a new legal challenge, and an interstate clash over abortion pills is heating up. Here, Law360 Healthcare Authority takes a look at the week's top healthcare news.

  • February 10, 2026

    Wash. Panel Says Healthcare Cost-Share Group Is An Insurer

    A Utah-based healthcare cost-sharing nonprofit operates as and must register as an insurer under Washington state law, a state appeals panel ruled, upholding a $50,000 fine from the state's insurance commissioner that found the nonprofit ran afoul of Washington insurance law. 

  • February 10, 2026

    Pa. Emerges As Battleground Over State False Claims Laws

    Momentum is growing to pass a False Claims Act law in Pennsylvania, the most populous U.S. jurisdiction without one already on the books. It's also reigniting debate over the value of anti-fraud statutes around the country.

  • February 10, 2026

    Hospitals Face 'Perfect Storm' Of Fed. Cuts, Revenue Strains

    Facing federal budget cuts, soaring labor costs and a rising tide of uninsured patients, U.S. hospitals are approaching a financial cliff that could trigger a wave of closures nationwide.

  • February 10, 2026

    Fresenius Can't Knock Out 401(k) Forfeiture Suit

    A Massachusetts federal judge narrowed but declined to dismiss a suit claiming dialysis company Fresenius violated federal benefits law by using forfeited 401(k) funds to pay for match contributions instead of plan fees, ruling the workers behind the suit adequately explained that the move may have flouted their interests.

  • February 09, 2026

    Anti-Abortion Groups Say Mich. Law Impedes 1st Amendment

    Two Michigan-based anti-abortion organizations are suing several officials, alleging recent amendments to Michigan's civil rights law will force them to hire employees and volunteers who do not share or may openly oppose their religious beliefs and stance on abortion.

  • February 09, 2026

    Medical Equipment Co. Nets Tentative Deal In Overbilling Suit

    Medical supply giant AdaptHealth Corp. has tentatively settled an overbilling suit brought by a proposed class of patients who claim they were overcharged for home healthcare equipment, according to a North Carolina court order pausing upcoming deadlines in the case.

  • February 06, 2026

    Ga. Panel Backs Sperm Bank Win In 'Wrongful Birth' Case

    A Georgia appeals court backed a win for sperm bank Xytex Corp. in consolidated litigation alleging the company sold sperm under false pretenses about the medical, psychological and social history of the donors.

  • February 06, 2026

    'Very Bizarre': Trump's Funding Freeze Appeal Vexes DC Circ.

    D.C. Circuit judges struggled Friday with whether to unblock a federal funding freeze carrying multitrillion-dollar implications, as a Trump administration lawyer disclaimed interest in a vast spending halt but also dodged opportunities to rule it out unequivocally.

Expert Analysis

  • Expect State Noncompete Reforms, FTC Scrutiny In 2026

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    Employer noncompete practices are facing intensified federal scrutiny and state reforms heading into 2026, with the Federal Trade Commission pivoting to case-by-case enforcement and states continuing to tighten the rules, especially in the healthcare sector, say attorneys at DLA Piper.

  • CMS 2027 Proposal Is Mixed Bag For Medicare Advantage

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    The Centers for Medicare and Medicaid Services' recent proposed rule for the Medicare Advantage and Part D programs gives small organizations reason for optimism, although certain elements may be inconsistent with the Centers' desire to enhance competition, says Christine Clements at Sheppard Mullin.

  • 3 Key Takeaways From Planned Rescheduling Of Cannabis

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    An executive order reviving cannabis rescheduling represents a monumental change for the industry and, while the substance will remain illegal at the federal level, introduces several benefits, including improving state-legal cannabis operators' tax treatment, lowering the industry's legal risk profile, and leaving state-regulated markets largely intact, say attorneys at Dentons.

  • 6 Issues That May Follow The 340B Rebate Pilot Challenge

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    Though the Health Resources and Services Administration withdrew a pending case to reconsider the controversial 340B rebate pilot program, a number of crucial considerations remain, including the likelihood of a rework and questions about what that rework might look like, say attorneys at Spencer Fane.

  • 2026 State AI Bills That Could Expand Liability, Insurance Risk

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    State bills legislating artificial intelligence that are expected to pass in 2026 will reshape the liability landscape for all companies incorporating AI solutions into their business operations, as any novel private rights of action authorized under AI-related statutes signal expanding exposures, say attorneys at Wiley.

  • How 11th Circ.'s Zafirov Decision Could Upend Qui Tam Cases

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    Oral argument before the Eleventh Circuit last month in U.S. ex rel. Zafirov v. Florida Medical Associates suggests that the court may affirm a lower court's opinion that the qui tam provisions of the False Claims Act are unconstitutional — which could wreak havoc on pending and future qui tam cases, say attorneys at Morgan Lewis.

  • Key Trends For Life Sciences Cos. To Watch In 2026

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    Following a year of drastic change at the U.S. Food and Drug Administration, two themes are likely to drive the coming year — a commitment to lowering the cost of drugs and an inherent tension between the priorities of the health agencies and the broader administration, say attorneys at Sheppard Mullin.

  • The Next Pressure Point In Digital Health: Informed Consent

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    Two new federal digital health initiatives will usher in a new era where virtual care, software-enabled devices and home-based monitoring are integrated into care and reimbursement models, with the impact of shifting rules and opportunities felt most immediately in the context of informed consent, says Kimberly Chew at Husch Blackwell.

  • 4 Trends Shaping Drug And Medical Device Law For 2026

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    2025 saw some significant legal developments with potential impact for drug and device manufacturers, ranging from growing skepticism in science and regulatory entities to new regulation of artificial intelligence, say attorneys at Faegre Drinker.

  • Preparing For Congressional Investigations In A Midterm Year

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    2026 will be a consequential year for congressional oversight as the upcoming midterm elections may yield bolder investigations and more aggressive state attorneys general coalitions, so companies should consider adopting risk management measures to get ahead of potential changes, say attorneys at Morgan Lewis.

  • A Meaningful Shift In FDA's Biosimilarity Analysis

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    The U.S. Food and Drug Administration's potential pivot away from routinely requiring comparative efficacy studies for interchangeable biosimilar applications would not lower regulatory standards, but instead allow applicants to allocate resources toward establishing more probative evidence, says Theodore Thompson at Stinson.

  • Top 5 Antitrust Issues For In-House Counsel To Watch In 2026

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    With Trump administration enforcement policy having largely taken shape last year, antitrust issues that in-house counsel should have on the radar range from scrutiny of technology-assisted pricing to the return of merger remedies, say attorneys at Squire Patton.

  • 2025 Legal Milestones That Will Shape Psychedelics Sector

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    As 2025 draws to a close, psychedelic drug development stands at an inflection point, experiencing unprecedented momentum through recent sweeping regulatory changes and landmark clinical milestones, amid rapidly evolving regulatory expectations, say Odette Hauke at Odette Alina LLC and Kimberly Chew at Husch Blackwell.