Policy & Compliance

  • September 15, 2026

    1st Circ. Suggests Appeal In Drug Rebate Case May Be Moot

    A First Circuit panel raised mootness concerns as it heard arguments Tuesday from drug companies appealing a ruling that prevented them from intervening in a now-dismissed case to defend a rebate model for a federal drug-pricing program. 

  • September 14, 2026

    Albertsons Owes $2.2B For Opioids, Wash. Says As Trial Ends

    Albertsons should pay $2.2 billion to address opioid-related harms in Washington, attorneys for the state argued at the close of a two-month bench trial Monday in contending that the pharmacy failed for years to appropriately identify and review suspicious prescriptions that fueled the state's overdose crisis.

  • September 14, 2026

    DOD's HIV-Positive Enlistee Ban Is 'Irrational,' 4th Circ. Told

    An attorney for people barred from joining the military for being HIV-positive called the policy irrational at a Monday en banc hearing at the Fourth Circuit, as some judges asked why they should scuttle that policy and overstep deference normally afforded to military leaders.

  • September 14, 2026

    9th Circ. Rejects Challenge To Wash. Abortion Coverage Law

    Revisiting a church's First Amendment challenge to a Washington law mandating that certain health insurance plans include abortion coverage, a divided Ninth Circuit panel Monday concluded that the Cedar Park Assembly of God failed to point to evidence that Washington's Reproductive Parity Act targets religious conduct.

  • September 14, 2026

    ERISA Smoking Suit Must Be Arbitrated, Dollar General Says

    The Sixth Circuit should scuttle a proposed Employee Retirement Income Security Act class action against Dollar General by reviving and granting the company's motion to compel individual arbitration, Dollar General argued, saying a Tennessee federal judge didn't follow the right procedure when dispensing with the motion.

  • September 14, 2026

    DOJ Suit Over NY Medicaid Program Is 'Baseless,' Court Told

    New York officials and the state's chosen steward for managing its $10 billion Medicaid home-care program fired back at U.S. Justice Department allegations that the bidding process for that contract was a sham, telling a federal court the suit is politically motivated and legally deficient.

  • September 14, 2026

    Eli Lilly's $200M Fraud Suit Is Still Defective, Church Cos. Say

    Companies affiliated with the Church of God in Christ urged a Florida federal judge to dismiss Eli Lilly's amended lawsuit alleging a $200 million-plus fraud scheme to resell the Trulicity diabetes drug on the secondary market, saying the latest complaint still lacks specificity despite including more claims. 

  • September 14, 2026

    Aetna Tells 5th Circ. DOL Can't Block Aramark Suit Arbitration

    Aetna Life Insurance Co. urged the Fifth Circuit on Monday against the U.S. Department of Labor's argument that uniform company Aramark Services Inc.'s health claims dispute with the insurer should remain in court, arguing a Texas judge erred in declining to enforce the parties' binding arbitration agreement.

  • September 11, 2026

    Dems Demand Info From DeSantis On $10M Fraud

    Democratic federal lawmakers sent a letter to Florida Republican Gov. Ron DeSantis seeking more information on $10 million in misappropriated settlement funds, demanding answers to why the money was diverted to a nonprofit founded by his wife and not allocated to support healthcare in the state. 

  • September 11, 2026

    Tylenol Maker Seeks 2nd Circ. Relook In Autism, ADHD Suits

    Tylenol maker Kenvue and several retailers have urged the Second Circuit to revisit its decision overturning a district court's exclusion of expert testimony for plaintiffs who claim prenatal exposure to the over-the-counter pain reliever causes autism and ADHD, saying the appeals court improperly restricted the trial court's "gatekeeping role."

  • September 11, 2026

    CVS Renews Bid To Escape Investors' AI Use Suit

    CVS Health Corp. wants a second shot at dismissing a lawsuit accusing it of inflating its revenues through the use of artificial intelligence, arguing investors haven't shown it was using the technology to deny prior authorization requests. 

  • September 11, 2026

    11th Circ. Ruling Won't Prevent Qui Tam Constitutional Tests

    The Eleventh Circuit's holding that the False Claims Act's provisions letting private individuals sue on the federal government's behalf pass muster under the U.S. Constitution may do little to halt the growing wave of challenges seeking to knock down those provisions.

  • September 11, 2026

    3 Takeaways From EBSA's New Health Parity Guidance Docs

    The U.S. Department of Labor's recent guidance on how to comply with federal laws requiring parity in health plan coverage between behavioral and physical healthcare provides critical new details on the agency's narrowed set of enforcement priorities. Here are three takeaways from the guidance.

  • September 11, 2026

    Conduent Settles Claims Over Data Breach That Affected 44M

    Conduent Business Services LLC has reached a deal to resolve plaintiffs' claims in a proposed class action alleging it failed to adequately protect sensitive personal and health information of more than 44 million individuals, according to filings from both parties.

  • September 10, 2026

    Insurer Wants Quick 8th Circ. 401(k) Forfeiture Suit Appeal

    UnitedHealth Group asked a Minnesota federal court to allow a quick appeal of the court's June decision refusing to completely toss allegations that the company misallocated forfeitures from an employee 401(k) plan, arguing differing opinions on the validity of the claims nationwide justified early Eighth Circuit review.

  • September 10, 2026

    Dompé To Pay $32M Over Foundation Co-Pay Kickback Claims

    The U.S. arm of Italian pharmaceutical company Dompé Farmaceutici SpA has agreed to pay $32 million to resolve allegations that it contributed funds to patient assistance foundations to induce purchases of its prescription eye drops Oxervate, the U.S. Department of Justice announced Thursday.

  • September 10, 2026

    Catholic Charity Fights Bid To Toss Funding Cut Suit

    A Catholic charity said its opposition to abortion and contraception led Michigan to unconstitutionally terminate its decade-long role as a state-designated service provider for women suffering from substance abuse, and it urged a federal judge to reject the state's request to dismiss a civil rights suit filed by the organization.

  • September 10, 2026

    Biosimilars Boast Big Savings But Face IP Risks, Report Says

    There are no biosimilar drugs in development for 90% of biologic products set to lose their patent exclusivity by 2034, according to a report released Thursday by the Association for Accessible Medicines, which warned that current patent policy threatens generic-drug development. 

  • September 10, 2026

    Judge Finds No Standing To Block Ill. Aid-In-Dying Law

    An Illinois federal judge on Thursday refused to block a new law from taking effect that allows patients with terminal illnesses to seek a doctor's assistance in ending their lives, ruling that a challenge brought by disability rights advocates relied on speculative fears rather than imminent legal harm.

  • September 10, 2026

    Colo. Judge Asked To Sanction Hospital In Gender Care Suit

    Transgender adolescent patients of Children's Hospital Colorado urged a state judge on Thursday to sanction the hospital for refusing to resume providing gender-affirming medical care for transgender youth patients, arguing that the hospital can't avoid its obligation to provide the care by blaming its providers.

  • September 10, 2026

    $270M Medi-Cal False Claims Scheme Nets 30-Year Sentence

    An Orange County man with multiple prior fraud convictions has been sentenced in California federal court to 30 years in prison for his role in a $270 million Medi-Cal prescription drug scam, which he orchestrated while awaiting sentencing in a separate tax evasion case, prosecutors said. 

  • September 10, 2026

    Greenberg Traurig Sued Over Ex-Pharma CEO's Indictment

    Greenberg Traurig LLP devised the very business practices that got a former pharmaceutical CEO indicted for fraud and then billed the executive $1.4 million for defending the criminal case, according to a legal malpractice suit accusing the firm of an inherent conflict of interest.

  • September 10, 2026

    Indiana Justices Probe Timing Of Religious Abortion Suit

    Indiana justices sharply questioned both sides Thursday as they wrestled with whether the state's religious freedom law can be used to protect the abortion rights of Jewish women, repeatedly asking whether the case had developed enough to warrant a ruling.

  • September 09, 2026

    NC Justices Probe TikTok's State Contacts In Addiction Case

    The North Carolina Supreme Court grappled Wednesday with whether TikTok and its parent company should have to face the attorney general's suit alleging the app is addictive to young users, with TikTok arguing its general national business practices do not create ties to the Tar Heel State sufficient to be dragged into court there.

  • September 09, 2026

    Humana Says Mylan 'Gamesmanship' Can't Keep Trial Paused

    Humana Inc. asked a Pennsylvania federal judge to restart the countdown to the first trial in the generic-drug price-fixing multidistrict litigation, arguing that Mylan Inc.'s "eleventh-hour delay gambit" of a potential conflict of interest is just the latest in a "carefully choreographed campaign of delaying trial to prevent accountability."

Expert Analysis

  • Justices' FTC Ruling Weakens Qui Tam's Constitutional Base

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    The U.S. Supreme Court’s holding in Trump v. Slaughter, expanding presidential control over those exercising executive power, suggests that courts may be receptive to arguments challenging the constitutional foundations of the False Claims Act’s qui tam mechanism, says Daniel Passeser at Wiggin.

  • Calif. Drug Ruling Affirms Defect-Centric Liability Framework

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    The California Supreme Court's decision in Gilead Tenofovir Cases this week rejects a novel duty-to-innovate theory of negligence that could have reshaped product liability exposure well beyond the pharmaceutical industry, instead signaling that negligence claims premised on nondefective products are unlikely to succeed, say attorneys at Dechert.

  • DOJ's FCA Push Creates Risks For Construction Contractors

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    The construction industry may be uniquely vulnerable to a new generation of False Claims Act enforcement driven by the U.S. Department of Justice's increasing usage of the FCA to target a much broader category of conduct than it has in decades past, specifically compliance certifications and regulatory representations, say attorneys at Cozen O'Connor.

  • Feds' Mixed Cues On Medicaid Fraud Signal States To Step Up

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    While the federal government has recently delivered four distinct and mutually inconsistent messages regarding Medicaid fraud enforcement, states should focus on improving enforcement, regardless of which federal posture proves correct, says Ken Levine at Stone & Magnanini.

  • A Shift In How Policymakers Are Approaching PBM Regulation

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    Recent federal and state legislative and regulatory activity involving pharmacy benefit managers represent a change in focus from transparency to PBM compensation structures, vertical integration and competitive effects, say attorneys at Barclay Damon.

  • Workplace Menopause Laws Demand New HR Playbooks

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    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

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    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

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    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

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    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

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    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

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    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

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    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

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    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.