Policy & Compliance
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October 28, 2025
Off-Label Prescribing Was Common, Novo Nordisk Tells Jury
A whistleblower suing drugmaker Novo Nordisk for allegedly defrauding Washington state's Medicaid system acknowledged from the witness stand Tuesday that she previously prescribed hemophilia drugs for off-label use in her own practice — despite concerns she raised in her lawsuit about other doctors' off-label prescription of Novo Nordisk's drug NovoSeven.
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October 28, 2025
4 Emergency Medical Care Rulings You Don't Want To Miss
Following a Michigan appellate court's recent finding that evidence brought in a wrongful death suit against paramedics was enough to get around immunity protections, Law360 Healthcare Authority looks at significant rulings affecting emergency medical care in 2025.
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October 28, 2025
Home Health Aide Says Cos. Shaved Time Off Pay
Home health care companies failed to pay aides for the hours they worked by failing to properly calculate their overtime, while also having a "problematic clocking system" that led to time-shaving issues, a suit filed in New York federal court on Tuesday claims.
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October 28, 2025
High Court Medicaid Ruling Adds To Safety-Net Hospital Pain
Earlier this year, U.S. Supreme Court Justice Ketanji Brown Jackson raised a warning about the future of the nation's safety-net hospitals in a case focused on "disproportionate share" Medicaid payments. Funding cuts at issue in the case are now hitting hospitals.
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October 28, 2025
Akin Beats Malpractice Claim Over Alleged IP Theft Plot
A Third Circuit panel on Tuesday refused to revive a malpractice claim against Akin Gump Strauss Hauer & Feld LLP lodged in a lawsuit that accused attorneys of manipulating patent litigation to steal a former Cornell University graduate student's DNA sequencing intellectual property.
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October 28, 2025
HHS Can't Yet Yank Sex Ed Grants Over 'Gender Ideology' Info
An Oregon federal judge has halted the U.S. Department of Health and Human Services' plans to revoke federal funding for teen sexual health education programs that included "gender ideology," agreeing with states that this is likely a case of executive overreach.
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October 28, 2025
4th Circ. Overturns Landmark W.Va. Opioid Verdict
The Fourth Circuit on Tuesday overturned a key ruling by a West Virginia judge in the first federal bellwether in multidistrict opioid litigation that went in favor of the country's three biggest drug distributors, finding that the oversupply of opioids can create a public nuisance.
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October 28, 2025
Wash. Hospital System Can't Undo $230M Wage Suit Loss
A hospital system can't undo a $230 million judgment against it because it didn't sufficiently counter evidence that its default rounding system was unlawful and assumed caregivers wouldn't take a second meal break, a Washington state appeals panel ruled.
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October 28, 2025
Tylenol Autism Warning May Face Legal, Free Speech Hurdles
The Trump administration’s plan to add an autism warning to Tylenol's labeling could generate procedural and First Amendment challenges. Legal experts expect federal officials’ own words will be used against them.
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October 28, 2025
Minn. Hospital Noncompetes Face Test In State AG Probe
A Minnesota investigation could help answer key questions for doctors and employers about a 2023 state ban on noncompete provisions: When do changes to employment contracts amount to a new contract?
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October 28, 2025
Texas Accuses Tylenol Makers Of Hiding Autism Danger
The Texas Attorney General's Office on Tuesday sued the makers of Tylenol, alleging they hid the risk that the drug could lead to autism while marketing acetaminophen as the safest pain relief option for pregnant women and young children.
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October 27, 2025
Teva To Pay $35M In Suit Over Delayed Generic Inhalers
Teva Pharmaceuticals will pay $35 million to resolve claims from a coalition of union healthcare funds that say the company schemed to delay generic competition for its QVAR asthma inhalers, according to a motion for preliminary injunction filed in Massachusetts federal court.
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October 27, 2025
CVS Let 401(k) Get Bogged Down With High Fees, Suit Says
CVS costs workers millions in retirement savings and violated federal benefits law by failing to rein in excessive administrative fees in its $27 billion 401(k) plan, a former pharmacist said in a proposed class action filed in New York federal court.
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October 27, 2025
AbbVie Defends Challenge Of Colorado's Discount Drug Law
AbbVie defended its lawsuit challenging a Colorado law it says conflicts with federal law by forcing manufacturers to sell drugs at steep discounts to Walgreens, CVS and other pharmacy chains, telling a federal judge that the state compels the biotech company to sell more discounted drugs than federal law requires.
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October 27, 2025
Temp Agency Placed Unqualified Nursing Aides, Charges Say
A Massachusetts temporary staffing agency sent unqualified nursing aides into at least four healthcare facilities by misrepresenting their credentials, and it allowed one of them to use the identity of a former employee, the state's attorney general alleged in an indictment announced Monday.
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October 27, 2025
Judge Tosses Eli Lilly Suit Over Telehealth Weight Loss Drugs
A California federal court has dismissed a lawsuit from Eli Lilly against a telehealth company and related entities over the compounding of its popular weight loss drugs Mounjaro and Zepbound, saying the pharmaceutical giant's complaint failed to plausibly allege claims under the Lanham Act and the state's false advertising and consumer protection laws.
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October 27, 2025
Ex-Magellan CEO Avoids Prison Over Faulty Lead Tests
The former CEO of Magellan Diagnostics was sentenced in Massachusetts federal court Monday to a year of home confinement for failing to alert regulators to a problem in the company's lead-testing devices that resulted in inaccurately low lead levels being detected in blood samples.
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October 24, 2025
USAA Defends Medical Reimbursement Cuts In Coverage Row
Two USAA units sought to toss two insureds' proposed class action accusing the companies of under-reimbursing their medical providers via claim handling software, telling a Washington federal court "there is no admissible evidence that plaintiffs' treatments were medically necessary and related to their auto accidents."
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October 24, 2025
Generic-Drug Makers Want Conn. Price Cap Blocked During Suit
A trade group for generic and biosimilar drugmakers is asking a Connecticut federal judge to block the state's new drug price cap during the pendency of its challenge, saying it illegally controls prices on sales made outside the state.
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October 24, 2025
Paramedics Can't Use Mich. Law To Escape Negligence Suit
Evidence suggesting paramedics may have forged a patient's signature declining hospital transport for COVID-19 care and purported statements that responders didn't bring him in because hospitals were full are enough to overcome a state law that gives immunity to emergency responders, a Michigan appellate panel has determined.
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October 23, 2025
Wash. Justices Skeptical Of Debtor's Collection Notice Stance
Washington Supreme Court justices appeared wary Thursday of second-guessing a Seattle federal judge who asked them to decide whether a hospital billing disclosure law applies to debt collectors, as the plaintiff in the underlying proposed class action pressed the court to "reformulate" the certified question.
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October 23, 2025
6th Circ. Panel Torn On Mich. 'Conversion Therapy' Ban
A Sixth Circuit panel appeared divided Thursday about whether to block enforcement of Michigan's ban on conversion therapy for minors as the U.S. Supreme Court grapples with a nearly identical Colorado law.
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October 23, 2025
Ex-Exec Accused Of Stealing IVF Co.'s Trade Secrets
The co-founder of a Garden State genetic testing company abruptly quit, deleted all the data on his company laptop — including the only copy of some materials — then took the trade secrets to help a competitor, according to a lawsuit filed in New Jersey federal court.
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October 23, 2025
Telehealth Ketamine Provider Hit With Wrongful Death Suit
Online ketamine therapy provider Mindbloom was hit with a wrongful death suit in North Carolina state court by the father of a 27-year-old man who says his medical history should have disqualified him from receiving the allegedly dangerous anesthetic.
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October 23, 2025
2nd Circ. Says NY Health System Must Face Race Bias Claims
The Second Circuit reinstated a suit Thursday from a Black registered dietitian who said her boss berated her and fired her out of prejudice, ruling the former employee put forward enough detail to keep some of her race bias claims afloat.
Expert Analysis
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What US Medicine Onshoring Means For Indian Life Sciences
Despite the Trump administration's latest moves to onshore essential medicine manufacturing, India will likely remain an indispensable component of the U.S. drug supply chain, but Indian manufacturers should prepare for stricter compliance checks, says Jashaswi Ghosh at Holon Law Partners.
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FCA Working Group Reboot Signals EHR Compliance Risk
The revival of the False Claims Act working group is an aggressive expansion of enforcement efforts by the Justice Department and the U.S. Department of Health and Human Services targeted toward technology-enabled fraud involving electronic health records and other data, say attorneys at ArentFox Schiff.
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FDA's Hasty Policymaking Approach Faces APA Challenges
Though the U.S. Food and Drug Administration has abandoned its usual notice-and-comment process for implementing new regulatory initiatives, two recent district court decisions make clear that these programs are still susceptible to Administrative Procedure Act challenges, says Rachel Turow at Skadden.
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The Metamorphosis Of The Major Questions Doctrine
The so-called major questions doctrine arose as a counterweight to Chevron deference over the past few decades, but invocations of the doctrine have persisted in the year since Chevron was overturned, suggesting it still has a role to play in reining in agency overreach, say attorneys at Crowell & Moring.
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A Rapidly Evolving Landscape For Noncompetes In Healthcare
A wave of new state laws regulating noncompete agreements in the healthcare sector, varying in scope, approach and enforceability, are shaped by several factors unique to the industry and are likely to distort the market, say attorneys at Seyfarth.
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Arguing The 8th Amendment For Reduction In FCA Penalties
While False Claims Act decisions lack consistency in how high the judgment-to-damages ratio in such cases can be before it becomes unconstitutional, defense counsel should cite the Eighth Amendment's excessive fines clause in pre-trial settlement negotiations, and seek penalty decreases in post-judgment motions and on appeal, says Scott Grubman at Chilivis Grubman.
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$95M Caremark Verdict Should Put PBMs On Notice
A Pennsylvania federal judge’s recent ruling that pharmacy benefits manager CVS Caremark owes the government $95 million for overbilling Medicare Part D-sponsored drugs highlights the effectiveness of the False Claims Act, as scrutiny of PBMs’ outsized role in setting drug prices continues to increase, say attorneys at Duane Morris.
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DOJ Actions Signal Rising Enforcement Risk For Health Cos.
The U.S. Department of Justice's announcement of a new False Claims Act working group, together with the largest healthcare fraud takedown in history, underscore the importance of sophisticated compliance programs that align with the DOJ's data-driven approach, say attorneys at Debevoise.
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Spotlight On Medicare Marketing Practices Enforcement Trend
Recent U.S. Department of Justice actions, including its recent Medicare kickback allegations in Shea v. eHealth, demonstrate increasing enforcement scrutiny on Medicare Advantage marketing practices, say Ellen London at London & Naor, Li Yu at Bernstein Litowitz and Erica Hitchings at the Whistleblower Law Collaborative.
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Federal Regs Order May Spell Harsher FDCA Enforcement
A recent executive order aimed at reducing criminal prosecutions of those who unknowingly violate complex federal regulations may actually lead to more aggressive felony indictments under the Federal Food, Drug and Cosmetic Act, but companies and executives can mitigate risks by following several key principals, say attorneys at McGuireWoods.
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What High Court's Tenn. Trans Care Ruling Means Nationally
The U.S. Supreme Court's decision in U.S. v. Skrmetti, upholding a Tennessee ban on gender-affirming medical care for minors, is fairly limited in scope and closely tailored to the specific language of Tennessee's law, but it may have implications for challenges to similar laws in other states, say attorneys at Hall Render.
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High Court ACA Ruling May Harm Preventative Care
The U.S. Supreme Court's decision in Kennedy v. Braidwood last week, ruling that the U.S. Department of Health and Human Services secretary has authority over an Affordable Care Act preventive care task force, risks harming the credibility of the task force and could open the door to politicians dictating clinical recommendations, says Michael Kolber at Manatt.
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Rising Enforcement Stakes For Pharma Telehealth Platforms
Two pieces of legislation recently introduced in Congress could transform the structure and promotion of telehealth arrangements as legislators increasingly scrutinize direct-to-consumer advertising platforms, potentially paving the way for a new U.S. Food and Drug Administration policy with bipartisan support, say attorneys at Sheppard Mullin.