Policy & Compliance
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March 19, 2026
11th Circ. Partially Reopens Aetna Twin Birth Coverage Fight
The Eleventh Circuit on Thursday undid Aetna's escape from a worker's coverage dispute over an extended hospital stay for her newborn twins, agreeing with the lower court that allegations failed to state a claim for violating federal benefits law but holding that an amended complaint should have been allowed.
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March 19, 2026
Calif. Families Sue Rady Health Over Move To End Trans Care
Four families have asked a state judge to prevent California's largest pediatric health system from cutting off gender-affirming care for minors, alleging the move would violate state antidiscrimination laws and leave them scrambling to find new providers, some more than 100 miles away.
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March 19, 2026
CVS, Caremark Pocket Money Meant For Rebates, Suit Claims
CVS charges drug manufacturers "exorbitant" fees in exchange for pushing their products, then pockets the money instead of funneling it toward customer rebates as it promises, a federal lawsuit alleges, accusing the company of collecting billions of dollars at customers' expense and violating the anti-racketeering statute.
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March 18, 2026
Key Details As 3rd Circ. Ponders FCA's Fate, $1.6B J&J Fine
Third Circuit judges Wednesday explored divergent views of the False Claims Act's constitutionality and a record fraud verdict against Johnson & Johnson, expressing little eagerness to gut the FCA's whistleblower mechanism, and voicing uncertainty about evidence and jury instructions underpinning the drug promotion punishment.
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March 18, 2026
SelectQuote Looks To Escape Investors' Kickback Probe Suit
SelectQuote has asked a New York federal judge to dismiss a proposed class action accusing it of harming investors by concealing a kickback scheme, which is currently the subject of a suit by the U.S. Department of Justice, arguing the existence of the government's suit is not enough to show the shareholders were damaged.
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March 18, 2026
UnitedHealth Customers Denied Class Cert. In PrEP Suit
Two UnitedHealthcare customers can't turn their Affordable Care Act lawsuit against a company subsidiary into a class action, a Minnesota federal judge ruled Wednesday, denying the pair's bid to represent thousands of customers in litigation accusing the subsidiary of failing to approve full coverage for PrEP.
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March 18, 2026
Ed. Dept. Flouting Mental Health Funding Order, States Claim
The U.S. Department of Education is flouting orders that it fund K-12 mental health grants given to public schools by only partially funding the grants and threatening to withhold remaining funds, a group of state attorneys general told a Washington federal court.
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March 18, 2026
Doctor Gets 6½ Years For Healthcare Fraud, Tax Evasion
An Anchorage, Alaska, physician was sentenced to six and a half years in prison for committing over $16 million in healthcare fraud and tax evasion as part of a scheme that injected sick patients with the wrong medications or dosages, the federal government said Wednesday.
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March 18, 2026
ADA Challenge to Oregon Psilocybin Law Can Proceed
An Oregon federal judge Tuesday rejected the state's health regulator's bid for a favorable judgment in a suit brought under federal antidiscrimination law, seeking to broaden access for homebound patients to the state's regulated psilocybin program.
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March 18, 2026
Health Litigator Rejoins Holland & Knight From In-House Role
A former Holland & Knight LLP attorney has returned to the firm in Jacksonville, Florida, after a 10-year stint in-house at Florida Blue, a subsidiary of GuideWell Mutual Holding Corp.
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March 18, 2026
FDA Can't 'Refuse To File' Tobacco Applications, Suit Says
The maker and a seller of Zone nicotine pouches are suing the U.S. Food and Drug Administration in Texas federal court, alleging the agency stalled and eventually refused to file their marketing application, despite federal law requiring the FDA to either approve or deny such applications.
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March 17, 2026
The Legal Reasoning That Put RFK's Vax Panel On Ice
The legal reasoning behind a Massachusetts court's decision to freeze major changes to national vaccine policy is simpler than you might expect.
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March 17, 2026
9th Circ. Backs Rare FCA Theory In Huge Drug Prices Program
In a novel and potentially far-reaching decision, the Ninth Circuit on Tuesday revived a major hospital chain's False Claims Act suit accusing large pharmaceutical companies of massive overcharges in a prominent drug discount program where pricing disputes are common.
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March 17, 2026
Dr. Oz Claims Florida Also Has Healthcare Fraud Problem
Dr. Mehmet Oz, the administrator for the Centers for Medicare & Medicaid Services, announced Tuesday that he is taking his efforts to combat healthcare-related fraud to Florida, where he says millions of dollars have been wasted on schemes involving durable medical equipment.
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March 17, 2026
Chaperones Alone Not Enough To Prevent Abuse, Sidley Says
A BigLaw team interviewed more than 120 witnesses as part of an investigation into failures that allowed an OB-GYN to sexually assault patients for 25 years. The report contains broader lessons on how to better protect patients.
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March 17, 2026
Ex-Database Administrator Settles OT Claim
A former database administrator who accused Express Scripts and two other companies of misclassifying him as an independent contractor reached a $30,000 deal with the entities to settle his federal law claim, the parties told a New York federal court.
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March 17, 2026
State Lawmakers Take On Practice Limits: 3 Bills To Know
Law360 Healthcare Authority looks at some of the latest moves by state lawmakers to relax practice restrictions in Florida, New York and Minnesota.
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March 17, 2026
Bipartisan Bill To Waive $100K H-1B Fee Gets AMA Backing
Medical organizations and a bipartisan group of lawmakers are backing federal legislation introduced Tuesday that would exempt physicians and other healthcare workers from the Trump administration's $100,000 fee on H-1B visas.
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March 16, 2026
1st Circ. Affirms Block Of Trump's 'Unprecedented' Aid Freeze
The First Circuit on Monday mostly upheld a lower court's order blocking the Trump administration from enacting a "sweeping and unprecedented categorical 'freeze' of federal financial assistance," ruling that the states involved in the suit will likely successfully show that the federal government acted arbitrarily and capriciously.
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March 16, 2026
Judge Tosses Kaiser Whistleblowers' Claims After $556M Deal
A California federal court on Monday officially dismissed False Claims Act lawsuits from the federal government and three people alleging that Kaiser Permanente affiliates engaged in Medicare fraud, on the heels of Kaiser's $556 million settlement reached in January.
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March 16, 2026
Mich. Jury Awards $10M To Med Resident Fired During Leave
A Michigan state jury has awarded more than $10 million to a former medical student who said she was fired from a hospital's OB-GYN residency program after being forced to take a required licensing exam while on maternity leave.
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March 16, 2026
HHS' Childhood Vaccine Policy Changes Put On Ice
A Massachusetts federal judge on Monday blocked the Trump administration's modified childhood vaccine schedule and put all decisions made by Health Secretary Robert F. Kennedy Jr.'s federal vaccine policy committee on hold, finding they veered sharply from normal procedure and likely violated the law.
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March 16, 2026
Mass. City Accused Of Bias In Mental Health 911 Response
The city of Worcester, Massachusetts, was hit with a suit Monday claiming that its 911 response is inadequate and discriminatory towards people with mental disabilities because the armed police who usually show up are ill-equipped to deal with those calls and often make matters worse.
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March 13, 2026
'Swinging Dicks' Dissent Stirs Uproar Across 9th Circ. Bench
A raunchy dissent in litigation over transgender spa patrons prompted dozens of Ninth Circuit judges to denounce the "vulgar barroom talk" of a colleague, who returned fire by ridiculing his peers for adopting the "fastidious sensibilities of a Victorian nun."
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March 13, 2026
4th Circ. Brings Back Allergan Medicaid Overcharging Suit
A split Fourth Circuit panel on Friday revived a whistleblower suit accusing an Allergan Sales LLC predecessor of overcharging Medicaid by more than $680 million, saying the whistleblower plausibly alleged the company knowingly improperly aggregated discounts into "best prices" for drugs.
Expert Analysis
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Regulatory Uncertainty Ahead For Organ Transplant System
Pending court cases against a Centers for Medicare and Medicaid Services final rule that introduced a competition-centric model for assessing organ procurement organizations' performance will significantly influence the path forward for such organizations and transplant hospitals, say attorneys at Crowell & Moring.
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Key False Claims Act Trends From The Last Year
The False Claims Act remains a powerful enforcement tool after some record verdicts and settlements in 2025, and while traditional fraud areas remain a priority, new initiatives are raising questions about its expanding application, says Veronica Nannis at Joseph Greenwald.
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It's Too Soon To Remove Suicide Warnings From GLP-1 Drugs
The U.S. Food and Drug Administration's decision this month to order removal of warnings about the risk of suicidal thoughts from GLP-1 weight-loss drugs is premature — and from a safety and legal standpoint, the downside of acting too soon could be profound, says Sean Domnick at Rafferty Domnick.
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What To Know About DOL's New FLSA, FMLA Opinion Letters
The U.S. Department of Labor kicked off 2026 by releasing several opinion letters addressing employee classification, incentive bonuses and intermittent leave, reminding employers that common practices can create significant risk if they are handled inconsistently or without careful documentation, say attorneys at Woods Rogers.
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What Changed For Healthcare Transaction Law In 2025
Though much of the legislation introduced last year to expand state scrutiny of healthcare transactions did not pass, investors should pay close attention to the overarching trends, which are likely to continue in this year's legislative sessions, say attorneys at Ropes & Gray.
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Expect State Noncompete Reforms, FTC Scrutiny In 2026
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.
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CMS 2027 Proposal Is Mixed Bag For Medicare Advantage
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.
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3 Key Takeaways From Planned Rescheduling Of Cannabis
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.
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6 Issues That May Follow The 340B Rebate Pilot Challenge
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.
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2026 State AI Bills That Could Expand Liability, Insurance Risk
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.
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How 11th Circ.'s Zafirov Decision Could Upend Qui Tam Cases
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.
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Key Trends For Life Sciences Cos. To Watch In 2026
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.
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The Next Pressure Point In Digital Health: Informed Consent
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.