Policy & Compliance

  • June 02, 2026

    Nonnetwork Insurance Plans Could Spur Legal Challenges

    A new Centers for Medicare & Medicaid Services rule will bring more high-deductible, low-premium plans to the Affordable Care Act marketplace. Some legal experts believe the inclusion of insurers without provider networks may run afoul of the law. .

  • June 01, 2026

    Albertsons Had Duty To Curb Opioid Diversion, Judge Rules

    As providers of controlled substances, pharmacy giants Albertsons and Safeway had legal duties to prevent the diversion of opioid drugs, a Washington state judge ruled on Monday, though whether the companies failed to fulfill those duties will be determined at trial.

  • June 01, 2026

    DC Circ. Says Military Trans Ban Flouts Constitutional Rights

    A divided D.C. Circuit panel Monday said the Trump administration illegally banned transgender individuals from military service, then narrowed a preliminary injunction to prevent the government's exclusion of transgender people presently serving in the military but not those desiring to enlist.

  • June 01, 2026

    DOJ Says Ohio Health System Can't Duck Antitrust Case

    The U.S. Department of Justice defended its antitrust case accusing OhioHealth Corp. of blocking competition through its contracts with insurers, telling an Ohio federal court the health system is depriving consumers of lower-cost health plans.

  • June 01, 2026

    NC Biz Court Bulletin: Referee Tapped, CEO To Be Deposed

    The North Carolina Business Court rounded out May by appointing a discovery referee in a healthcare antitrust class action and ordering the deposition of a top executive in a trade secrets battle, in addition to fielding a new complaint alleging unpaid capital contributions for a captive insurance company.

  • June 01, 2026

    High Court Turns Away Health Workers' Vaccine Mandate Case

    The U.S. Supreme Court declined a bid for review Monday from workers who said a nonprofit healthcare system and Washington state violated their rights by issuing COVID-19 vaccination mandates, leaving in place a Ninth Circuit ruling that said their case didn't pass muster.

  • May 29, 2026

    Illumina Ducks DNA Sequence Rival's Antitrust Suit, For Now

    A DNA sequencing startup will have to rejigger its antitrust lawsuit against Illumina after a California federal judge said it hasn't shown that the industry giant has entered exclusive agreements and hasn't adequately asserted that Illumina priced its offerings below cost, among other failings.

  • May 29, 2026

    Hospital Already Satisfied SEIU Drug Test Award, Judge Says

    An Ohio federal judge tossed a Service Employees International Union affiliate's bid to confirm an arbitration award against a Cleveland hospital Friday, saying the hospital already complied with the award by expunging discipline from a worker's record.

  • May 29, 2026

    Ohio AG Says Cigna Can't Use Sherman Act To Ax State Case

    The Ohio attorney general has urged a federal judge not to dismiss prescription drug price-fixing claims against Express Scripts, its Cigna parent and fellow pharmacy benefit manager Prime Therapeutics, arguing the companies are trying to fight his state law antitrust claims by invoking federal law standards that do not apply.

  • May 29, 2026

    Blood Test Lab Owner Gets 4 Years For $11M Tax Evasion

    The owner of a blood-testing laboratory was sentenced to more than four years in federal prison after evading $11.2 million in taxes by using an accomplice to illegally collect Medicare reimbursements made to the company, California federal prosecutors said.

  • May 29, 2026

    Full 4th Circ. To Rethink W.Va., Md. 340B Drug Discount Laws

    The full Fourth Circuit will revisit two panel decisions that created a circuit split when they temporarily blocked a pair of state laws that barred drugmakers from prohibiting federally funded hospitals from contracting with an unlimited number of pharmacies to dispense discounted drugs in the 340B Drug Pricing Program. 

  • May 29, 2026

    UnitedHealthcare Defrauded Mass. Of $100M, AG Says

    UnitedHealthcare's "growth at all costs strategy" led the insurer's Massachusetts subsidiary to overcharge the state by more than $100 million by exaggerating the medical conditions and needs of seniors, the state's attorney general said in a Friday lawsuit.

  • May 28, 2026

    Wash. Justices Float AI Hypotheticals In Hospital Pixel Case

    As the Washington Supreme Court considered a group of parents' bid to revive their proposed privacy class action over a Seattle hospital's use of the Meta Pixel browser tracking tool on its website, the justices questioned Thursday whether the rise of artificial intelligence-powered chatbots carried implications for the case.

  • May 28, 2026

    Trans Patients Say Stanford Can't Give DOJ Medical Records

    A group of transgender adolescents who received gender-related care at a Stanford Medicine hospital urged a California federal court to order the hospital not to turn over any of their medical records in response to a criminal subpoena issued by a grand jury in Texas.

  • May 28, 2026

    UnitedHealthcare Unit Settles PrEP Coverage Fight

    A UnitedHealthcare subsidiary and two customers who alleged its failure to approve full coverage for PrEP violated the Affordable Care Act have agreed to settle their dispute, parties told a Minnesota federal court.

  • May 28, 2026

    DOJ To Speed Up Review Of Qui Tam Benefits Fraud Claims

    The U.S. Department of Justice announced that it's speeding up the agency's review of whistleblower complaints accusing contractors of defrauding state-administered benefits programs that are funded by the federal government, in violation of the False Claims Act. 

  • May 28, 2026

    9th Circ. Won't Revisit FCA Ruling Over Drug Price Program

    The Ninth Circuit has said it will not disturb its March ruling allowing a hospital chain to pursue a False Claims Act lawsuit against various pharmaceutical companies for allegedly causing the government to overpay for drugs under a discount program.

  • May 27, 2026

    Pharmacies Beat Fla. Hospitals' Opioids Suit

    A Florida state judge has handed Walmart, Walgreens and CVS a win in a fight with hospitals over treatment of opioid-addicted patients, finding the hospitals cannot recover damages under state racketeering law because their injuries are indirect.

  • May 27, 2026

    ProPublica Denied Access To Ranbaxy Antitrust MDL Docs

    A Massachusetts federal court denied ProPublica's bid to unseal court filings in settled multidistrict litigation alleging a subsidiary of Indian drugmaker Sun Pharmaceuticals illegally delayed market entry of generic drugs, ruling the nonprofit news organization's request came too late in the case.

  • May 27, 2026

    Judge Doubts Prison Bureau Claim Trans Care Isn't Banned

    A D.C. federal judge repeatedly challenged a Trump administration attorney's claims that a looming ban on gender-affirming care in federal prisons wouldn't amount to a categorical ban on hormone treatments for inmates as he weighed extending an injunction already stopping the policy from taking effect.

  • May 27, 2026

    NY-Presbyterian Says DOJ's Antitrust Case Is Misguided

    New York-Presbyterian Hospital is pushing back against claims that it blocks cheaper insurance plans through its contracts with insurers, telling a federal court that enforcers are challenging industry-standard contract terms that lower prices and guarantee patient access.

  • May 27, 2026

    US Tells Justices To Hold 'Lightning Rod' Health Ministry Case

    The U.S. Supreme Court should hold out on deciding whether a New Mexico insurance law violates the religious rights of nonprofit healthcare-sharing ministries that provide cheap, Christian-focused health insurance options while the justices decide a similar case, the U.S. solicitor general told the court. 

  • May 26, 2026

    9th Circ. Won't Revive Wash. City Workers' Vax Mandate Suit

    A Ninth Circuit panel Tuesday put an end to city workers' lawsuit challenging Bellingham, Washington's COVID-19 vaccine mandate, ruling that a lower court appropriately dismissed the action and barred the workers from amending their claims.

  • May 26, 2026

    Seattle Hospital Loses Appeal Of Dr.'s $21M Race Bias Verdict

    A Washington Court of Appeals panel Tuesday upheld a $21 million verdict against Seattle Children's Hospital in a Black ex-medical director's lawsuit claiming he faced racism in the workplace and retaliation for complaining about systemic inequities, ruling "substantial evidence" justified the jury's findings and damages award.

  • May 26, 2026

    New Suits Target DOJ Release, Loan Rule And More

    Law360 Healthcare Authority looks at new suits filed over the past week, including a $50 million suit over the U.S. Justice Department's handling of a criminal case against Maryland doctors and another challenge over the U.S. Department of Education's rule altering federal student loan eligibility.

Expert Analysis

  • 7 Steps For Gov't Contractors In Post-IEEPA Tariff Landscape

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    In response to U.S. Supreme Court's recent decision to strike down tariffs issued by the Trump administration under the International Emergency Economic Powers Act, there are several actions federal contractors should take to preserve their place in any refund waterfall, and to manage audit, overpayment and False Claims Act risk, say attorneys at Holland & Knight.

  • CMS Healthcare Enforcement Initiatives May Cause Disruption

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    The Centers for Medicare & Medicaid Services' recently announced enforcement actions against healthcare fraud mark a significant escalation, and CMS' prior approach in the hospice sector suggests that even compliant providers and suppliers should brace for impact, say attorneys at Morgan Lewis.

  • What We Know About DOJ's New FCA Enforcement Priorities

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    Recent remarks from the leader of the Justice Department’s commercial litigation branch provide key insights on how False Claims Act cases — especially healthcare fraud, trade fraud, antidiscrimination and cybersecurity claims — will be evaluated, prioritized and pursued as heightened enforcement becomes the new normal, say attorneys at Latham.

  • How PBMs Can Adapt To Plan Sponsors' Disclosure Demands

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    As federal reforms, growing state regulation and litigation threats push plan sponsors to expect visibility into revenue streams, pharmacy benefit managers should leverage transparency strategically, including by simplifying how they get paid, offering clients audit-ready data and co-designing contracts that are easy for fiduciaries to explain and defend, says Kristie Blase at Frazer + Blase.

  • How To Engage With Gov't's Direct-To-Consumer Drug Policy

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    The U.S. Department of Health and Human Services' recent request for industry input on manufacturers' direct-to-consumer drug sales reflects the government's caution in this arena, and allows stakeholders a rare opportunity to help shape policy, says Mary Kohler at Kohler Health Law.

  • When Fraud Involvement Disqualifies FCA Whistleblowers

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    A Massachusetts federal court's recent dismissal of a False Claims Act relator in U.S. ex rel. Perry v. First Psychiatric Planners provides instructive insight into when whistleblowers may be denied their share of settlement proceeds, even if their involvement in the underlying fraud is a step removed, say attorneys at Holland & Knight.

  • Lessons From Justices' Split On Major Questions Doctrine

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    The justices' varied opinions in Learning Resources v. Trump, which held the International Emergency Economy Powers Act did not confer the power to impose tariffs, offer a meaningful window into the U.S. Supreme Court's perspective on the major questions doctrine that will likely shape lower courts' approach to executive action challenges, say attorneys at Venable.

  • Drug Wholesaler's DPA Shows Imperfect Efforts Still Count

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    Atlantic Biologicals’ recent deferred prosecution agreement with federal prosecutors for allegedly distributing controlled substances to pill mill pharmacies demonstrates that even subpar cooperation, when combined with genuine remediation and strategic advocacy, can yield outcomes that protect a company's long-term interests, says Jonathan Porter at Husch Blackwell.

  • Key Takeaways As HRSA Aims To Revive 340B Rebate Pilot

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    The U.S. Department of Health and Human Services' recent request for feedback on the 340B Rebate Model Pilot Program demonstrates that it intends to correct the model's procedural defects, which is positive news for participating manufacturers, but a setback for covered entities, say attorneys at Manatt.

  • Unique Issues Facing Brand-Compounder Patent Litigation

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    Recent litigation and potential enforcement action against Hims & Hers Health raise questions about how compounders and branded pharmaceuticals companies would be positioned in patent litigation as compared to generics companies, which would require strategies different from those that would be used in traditional Hatch-Waxman Act litigation, say attorneys at Morgan Lewis.

  • Pros And Cons Of FDA's Push For Nonprescription Drugs

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    The U.S. Food and Drug Administration's recent moves to shift more prescription drugs to over-the-counter status could increase access to important medications, but also bring potential safety risks and other trade-offs for drug companies, say attorneys at Hogan Lovells.

  • Prepping For The Future Of No Surprises Act Enforcement

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    This year is expected to be a transition point for the No Surprises Act framework from regulatory delay to operational enforcement, so stakeholders should use this time to stress-test systems, clean up processes and prepare for enforcement, say attorneys at Akerman.

  • High Court's 'Skinny Label' Case May Tackle Wider Questions

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    The U.S. Supreme Court's upcoming decision in Hikma v. Amarin will have important ramifications for broader debates over what defines a generic version of a drug, and the pending case is already altering patent practice, say attorneys at Taft.