Policy & Compliance

  • 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.

  • August 12, 2026

    Albertsons Judge Hears Testimony On Rx Opioid, Abuse Link

    An "undeniable" causal link exists between excess prescription opioids and problem use of drugs such as heroin and fentanyl, an expert witness testified during a bench trial Wednesday in Washington's lawsuit accusing Albertsons of fueling the state's overdose crisis by irresponsibly dispensing opioids.

  • August 12, 2026

    Feds Enter FCA Suit, Say 3 Health Cos. Overbilled Medicare

    The federal government has intervened in a False Claims Act suit accusing a trio of Colorado healthcare companies of conspiring to file inflated claims for services they never rendered in order to get more money from Medicare and Tricare.

  • August 12, 2026

    Full 5th Circ. Invalidates Part Of No Surprises Act Rules

    The full Fifth Circuit partially unraveled federal regulations that implemented an arbitration system between insurers and out-of-network providers that Congress established in a 2020 law called the No Surprises Act, holding aspects of how the rules calculated payment amounts for disputed claims were unlawful.

  • August 12, 2026

    DC Physician Group Settles ERISA Plan Mismanagement Suit

    A George Washington University-affiliated physician group has agreed to settle a suit claiming it allowed its $345 million retirement plan to be bogged down by underperforming and pricey investment funds, according to a filing Tuesday in D.C. federal court.

  • August 12, 2026

    9th Circ. Says Aetna Must Face Benefit Misrepresentation Suit

    The Ninth Circuit revived allegations that Aetna misrepresented how much it would pay toward a patient's $150,000 surgery, finding that federal benefits law didn't preempt a claim brought under state law because the dispute centered on the payment commitments rather than the health plan itself.

  • August 12, 2026

    CMS Ends Medicaid Funds For Youth Transgender Care

    Medicaid will no longer cover the cost of some gender-affirming care for minors, including gender reassignment surgery and hormone treatments, the Centers for Medicare and Medicaid Services announced after issuing a final rule set to take effect this year. 

  • August 11, 2026

    CMS Fraud Concerns Drive Call For Autism Therapy Audits

    Healthcare providers who work with autistic people are facing greater scrutiny from the federal government over fraud concerns. Experts say the drivers of ballooning costs are complex.

  • August 11, 2026

    Fed. Circ. Revives Man's Vax Injury Case, Citing Mail Delay

    The Federal Circuit reversed a U.S. Court of Federal Claims decision that rejected a man's case seeking vaccine injury compensation, concluding that the court wrongly faulted him for the late arrival of his petition.

  • August 11, 2026

    Judge Probes 7th Circ. Fallout Of Ending Gender Care Fight

    An Illinois federal judge questioned Tuesday what would become of a pending appeal before the full Seventh Circuit if he allows the American Academy of Pediatrics to voluntarily dismiss, without prejudice, its challenge to a Florida racketeering probe over the medical group's gender-affirming care guidelines, an issue one attorney predicted would be "hotly contested."

  • August 11, 2026

    What To Know About Hartford HealthCare Privilege Row

    Hartford HealthCare, a Teamsters health insurance plan and a transit district are heading to court to argue over whether Hartford must produce documents in an antitrust lawsuit accusing the hospital group of exercising monopoly power.

  • August 11, 2026

    DOJ Drops 3rd Circ. Bid For Pa. Hospital Trans Patient Info

    The U.S. Department of Justice has dropped its request for the Third Circuit to review a district court's order quashing its demand for records on patients who received gender-affirming care at a University of Pittsburgh Medical Center children's hospital, effectively ending its subpoena fight in the district.

  • August 11, 2026

    Ga. Justices Call For Balancing Privacy Rights In Herpes Suit

    Georgia's top court ruled Tuesday that the privacy rights of a man accused of giving his ex-girlfriend genital herpes must be balanced against her interest in obtaining medical records to support her claims, resolving what the justices called a novel question.

Expert Analysis

  • High Court's Hikma Decision Reshapes 'Skinny Label' Suits

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    The U.S. Supreme Court's decision in Hikma v. Amarin marks a significant victory for generic drug manufacturers, but rather than putting an end to so-called skinny label inducement claims, it narrows and refocuses them, say attorneys at Sterne Kessler.

  • Turning To The Courts When PBM Reform Falls Short

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    The effectiveness of state laws intended to regulate pharmacy benefit managers remains uncertain, but litigation — utilizing tried-and-true theories like breach of contract and fair dealing — offers another mechanism through which stakeholders may seek relief from PBMs, say attorneys at Reed Smith.

  • High Court's Abortion Pill Stay Reinforces Appellate Principles

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    The U.S. Supreme Court's recent order in Danco Laboratories v. Louisiana, staying a Fifth Circuit ruling that reinstated an in-person requirement for dispensing the abortion medicine mifepristone, should be seen not as a definitive ruling on reproductive rights, but as an affirmation of a more disciplined jurisdictional reality, says Daniel Nardo at Nardo & Associates.

  • Bracing For Enforcers' Growing Focus On Behavioral Health

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    While recent law enforcement scrutiny of the behavioral health industry has resulted in several settlements, indicating that more enforcement activity is on the way, organizations now have an opportunity to take proactive compliance measures, says Jeffrey Fitzgerald at Polsinelli.

  • DOJ Activity Indicates Rising Antitrust Risk For Hospitals

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    Two civil actions filed by the U.S. Department of Justice against New York-Presbyterian Hospital and OhioHealth, both alleging that the hospital systems used their market power to stifle competition, highlight the government's growing scrutiny of barriers to lower-cost insurance options, say attorneys at Freshfields.

  • Engaging With FDA's New Complete Response Letter Policy

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    A citizen petition filed with the U.S. Food and Drug Administration last month puts renewed focus on the agency's practice of releasing complete response letters in near real time, materially altering the context in which life sciences companies communicate with investors regarding regulatory developments, say attorneys at Debevoise.

  • Trump's Psychedelics EO Creates A Regulatory Collision

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    Sponsors pursuing U.S. Food and Drug Administration approval for psychedelic drug access must tackle how to generate regulatory-grade safety and efficacy data in controlled trials when President Donald Trump's recent executive order on psychedelics mandates uncontrolled access through Right to Try, say Kimberly Chew at Husch Blackwell and Odette Hauke at Odette Alina.

  • AI Regulatory Gaps May Fuel FCA Enforcement Action

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    The intersection of artificial intelligence and False Claims Act enforcement presents legal risk for government contractors across several industries, particularly in the absence of a federal regulatory framework explicitly governing its development and use, say attorneys at O’Melveny.

  • 5th Circ.'s Abortion Pill Order Is Shaky On Multiple Grounds

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    The Fifth Circuit's recent order in Louisiana v. U.S. Food and Drug Administration, reinstating an in-person dispensing requirement for the abortion medication mifepristone, seems to turn federalism upside-down, and is also questionable for several other reasons, says Gregory Curtner at Curtner Law.

  • 5 Takeaways From Justices' Subpoena Fight Ruling

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    The U.S. Supreme Court's recent decision in First Choice v. Davenport fortifies a line of First Amendment associational privacy cases stretching back nearly 70 years, and ensures that organizations subject to government demands for donor information have a meaningful federal forum in which to defend their constitutional rights, say attorneys at DLA Piper.

  • Accelerated Psychedelic Therapy Pathways Require Caution

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    President Donald Trump's new executive order aiming to accelerate the approval of psychedelic drugs for the treatment of mental health disorders will likely bolster investigational psychedelic therapies, but parties within the psychedelic product supply chain will still need to prepare for potentially burdensome compliance requirements, say attorneys at Morgan Lewis.

  • Health Cos. Must Act Quickly To Secure Digital Front Doors

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    A fast-approaching deadline will require health providers to implement digital accessibility standards to their websites, necessitating important compliance steps that will help to ensure equal access to online health services, say attorneys at Holland & Knight.

  • How Oregon Ruling Affects Federal Gender Care Crackdown

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    In a favorable development for healthcare providers, an Oregon federal court recently vacated certain U.S. Department of Health and Human Services restrictions on gender-affirming care for minors, but the government's broader campaign against this care, including proposed rulemaking and agency investigations, leaves significant uncertainty, say attorneys at Arnold & Porter.