Policy & Compliance

  • June 02, 2025

    Nursing Exec Says DOJ Misapplied Justices' Fraud Ruling

    A Nevada nursing home executive convicted of wage-fixing and wire fraud has told a Nevada federal judge that a recent U.S. Supreme Court ruling in a fraud case doesn't preclude his motion for a new trial, contrary to what the U.S. Department of Justice has argued.

  • May 30, 2025

    $5.2M Generic Drug Price-Fixing MDL Deal Gets Final OK

    Apotex Corp. will be paying $5.2 million to settle claims from a class of indirect purchasers alleging the drugmaker was working with other pharmaceutical companies to hike up the price of certain generic medications.

  • May 30, 2025

    5th Circ. To Rehear No Surprises Act Ruling En Banc

    The full Fifth Circuit agreed Friday to reconsider a dispute over provisions for calculating qualifying payments under the 2020 No Surprises Act.

  • May 30, 2025

    DLA Piper Adds Healthcare Regulatory Atty In DC Office

    DLA Piper strengthened its healthcare regulatory resources in Washington, D.C., with the recent addition of an attorney who previously served as acting general counsel for the U.S. Department of Health and Human Services.

  • May 29, 2025

    AstraZeneca Inks $51.4M Settlement In Pay-For-Delay Case

    AstraZeneca Pharmaceuticals LP and Handa Pharmaceuticals LLC have agreed to shell out a combined $51.4 million to put to rest allegations AstraZeneca paid off generic-drug makers, including Handa, to protect its brand antipsychotic drug Seroquel XR, according to a filing Thursday in Delaware federal court.

  • May 29, 2025

    CMS Seeks Hospital Responses On Gender Dysphoria Care

    The Centers for Medicare & Medicaid Services is asking hospitals to produce information on gender dysphoria care provided to children and adolescents, noting in an oversight letter that the U.S. government has "serious concerns" surrounding hormone therapy and other gender-affirming medical interventions.

  • May 29, 2025

    Ga. BCBS Says Providers Are Gaming Billing Dispute System

    Blue Cross Blue Shield of Georgia has accused a healthcare consulting firm and a handful of Peach State providers of systematic abuse of a federal dispute resolution process for surprise medical bills, accusing them of "flooding" the system with bogus dispute claims.

  • May 29, 2025

    Express Scripts Says Arkansas Can't Ban PBM Pharmacies

    Pharmacy benefits manager Express Scripts sued the state of Arkansas in federal court Thursday, alleging that the state's recently enacted law banning PBMs from owning pharmacies in the state violated the U.S. Constitution and ran afoul of federal law governing military employee benefits.

  • May 29, 2025

    Split 9th Circ. Says Spa's Rule On Certain Trans Women Biased

    A divided Ninth Circuit refused to reinstate a Korean spa's constitutional challenge against the Washington State Human Rights Commission and ordered it to rescind its policy denying admission to trans women without gender-affirming surgery, noting Thursday the policy violated state law prohibiting discrimination based on sexual orientation and gender identity.

  • May 28, 2025

    Elon Musk Is Leaving White House Role, Trump Admin Says

    Billionaire Elon Musk is ending his work with President Donald Trump and the federal Department of Government Efficiency, a White House official confirmed Wednesday evening.

  • May 28, 2025

    Justices Told Del. Expert Law Doesn't Apply In Federal Court

    A retired attorney who claims he was negligently injured by healthcare providers urged the U.S. Supreme Court on Tuesday to hold that a Delaware federal court need not apply a state statute requiring an expert affidavit for all medical malpractice suits.

  • May 28, 2025

    Judge Rejects Johns Hopkins Unit's Claim FCA Suit Is Untimely

    A Maine federal judge on Wednesday denied Johns Hopkins Medical Services Corp.'s bid to dismiss a False Claims Act suit as untimely, ruling it must face allegations it failed to report being overpaid for healthcare services for military personnel, retirees and their families.

  • May 28, 2025

    Feds Urge Supreme Court To Let 10th Circ. PBM Ruling Stand

    The federal government urged the U.S. Supreme Court not to take up the state of Oklahoma's challenge to a Tenth Circuit decision that found parts of a law regulating pharmacy benefit managers were preempted by federal benefits and healthcare laws, arguing the case doesn't warrant further review from the justices.

  • May 28, 2025

    Colorado, Feds Clash Over $6.7M From Collapsed Insurer

    A Colorado federal judge pressed the state Wednesday on how its bid to pay out $6.7 million from a defunct health insurer to a Denver Health plan doesn't conflict with the federal government's interests, noting the disbursement would result in less money to a federal risk program.

  • May 28, 2025

    DOJ Says Justices' Ruling Backs Nursing Exec's Conviction

    The U.S. Department of Justice is pointing to a recent U.S. Supreme Court ruling to bolster its fight against a new trial being sought by a convicted Nevada nursing home executive, saying that the new high court decision establishes that economic loss isn't needed to prove wire fraud.

  • May 28, 2025

    Cooley Adds Ex-FDA Attorney To DC Life Sciences Group

    Cooley LLP has hired a former U.S. Food and Drug Administration attorney, who for the majority of her public service career worked as an associate chief counsel, trying civil actions and criminal prosecutions against those accused of violating regulations for a range of products.

  • May 27, 2025

    Musk, DOGE Fail To Nix States' Suit Against 'Limitless' Power

    Fourteen states can proceed in their lawsuit challenging Elon Musk and the Department of Government Efficiency's influence in the federal government after a D.C. federal judge Tuesday refused to toss their suit, rejecting the government's contention that Musk wasn't subject to the U.S. Constitution's appointments clause.

  • May 27, 2025

    CMS Heightens Medicaid Oversight For Immigrant Care

    The Centers for Medicare & Medicaid Services on Tuesday said it is ramping up its financial oversight of states to detect misuse of federal Medicaid dollars, telling states it will seek to recoup federal funds spent on nonemergent care for "illegal aliens."

  • May 27, 2025

    Healthcare Hires: Wilson Sonsini, BCLP, Proskauer And More

    Wilson Sonsini Goodrich & Rosati PC has bolstered its regulatory practice with the addition of a U.S. Department of Health and Human Services attorney who most recently led Crowell & Moring LLP's digital health group.

  • May 27, 2025

    What The MAHA Report Tells Us About Its Future Agenda

    A long-awaited report from a commission tasked with addressing childhood chronic disease in the United States signals key parts of the healthcare system that may soon see policy changes as part of the larger Make America Healthy Again agenda.

  • May 27, 2025

    The Surgical Pay Gap: How Bias May Hurt Women's Health

    Medical and legal professionals warn that systemic sex discrimination in U.S. surgical valuations — in the form of lower pay for procedures on female anatomy — discourages specialization in women's health, leads to delayed care and increased suffering for female patients, and could expose insurers to legal liability.

  • May 27, 2025

    Feds No Longer Advise COVID Shot For Kids, Pregnant Adults

    The nation's public health agency on Tuesday pulled the COVID-19 vaccine from the list of recommended shots for healthy children and pregnant adults, a move that experts say could reduce demand for the vaccine and make it more expensive for some families.

  • May 27, 2025

    Fla. Judge Pauses Suit Over Baseball Player's Death

    A Florida state court judge on Tuesday ordered a temporary halt to a lawsuit alleging medical malpractive against a Minnesota Twins physician over the death of a minor league baseball player, pausing the case while an order denying immunity for the doctor is appealed.

  • May 27, 2025

    Wilson Sonsini Adds Ex-HHS, Crowell & Moring Leader In DC

    A former policy director at the U.S. Department of Health and Human Services who later helped Crowell & Moring LLP launch its healthcare consulting group has joined Wilson Sonsini Goodrich & Rosati PC's Washington, D.C., team, the firm announced Tuesday.

  • May 23, 2025

    Minn. Patient Sues Over Colorado Limits On Aid-In-Dying Care

    A new suit by two Colorado doctors and an out-of-state patient challenges a state restriction barring nonresidents from accessing a form of healthcare legalized in Colorado allowing patients to receive a doctor's help in ending their life.

Expert Analysis

  • IVF Suits Highlight Need For Better Legal Frameworks

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    The high number of in vitro fertilization embryo losses underscores the need for more cohesive legal and regulatory guidance related to human errors, property versus personhood, and liability, says Jeff Korek at Gersowitz Libo.

  • Takeaways From FDA's Updated Confirmatory Trial Guidance

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    The U.S. Food and Drug Administration's latest draft guidance about accelerated drug approval indicates the FDA's intent to address the significant lag time between accelerated approval and full approval of drugs and may help motivate the industry to complete confirmatory trials, say attorneys at Sheppard Mullin.

  • A Look At FDA's Plans To Establish New OTC Drug Category

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    The U.S. Food and Drug Administration's recently finalized rule, creating a new over-the-counter pathway for drugs when patients satisfy certain conditions, may be useful for off-patent drugs with established safety records, though switching to OTC comes with additional costs and considerations, say attorneys at Skadden.

  • 2024 Was A Significant Year For HIPAA Compliance

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    The Office of Civil Rights' high level of Health Insurance Portability and Accountability Act activity in 2024 and press releases about its specific focus on certain cybersecurity issues make it abundantly clear that the OCR is not going to tolerate widespread compliance complacency, says Nathan Kottkamp at Williams Mullen.

  • How 2025 NDAA May Affect DOD Procurement Protests

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    A bid protest pilot program included in the 2025 National Defense Authorization Act shifts litigation costs onto unsuccessful bid protesters and raises claim-filing thresholds, which could increase risks to U.S. Department of Defense contractors who file protests, and reduce oversight of DOD procurement awards, say attorneys at Venable.

  • Top 10 Noncompete Developments Of 2024

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    Following an eventful year in noncompete law at both state and federal levels, employers can no longer rely on a court's willingness to blue-pencil overbroad agreements and are proceeding at their own peril if they do not thoughtfully review and carefully enforce such agreements, say attorneys at Faegre Drinker.

  • What 2024 Tells Us About Calif. Health Transaction Reviews

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    Looking back at the California Office of Health Care Affordability's first year accepting notices for material healthcare transactions reveals critical lessons on what the OHCA's review process may mean for the future of covered transactions in the state, say attorneys at Ropes & Gray.

  • Updated HIPAA Rule Is A Necessary Step For Data Protection

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    The U.S. Department of Health and Human Services' updated rules addressing cybersecurity threats in healthcare will necessitate significant investment in technology, training and compliance infrastructure, but are an essential evolution in safeguarding data in an increasingly digital world, say attorneys at Clark Hill.

  • Courts Must Curb The Drug Price Negotiation Program

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    The Inflation Reduction Act's drug price negotiation program upends incentive structures that drive medical innovation, and courts must act appropriately to avoid devastating consequences for American healthcare and the pharmaceutical industry, says Jeff Stier at the Consumer Choice Center.

  • The OIG Report: Preparing For Oversight In 2025

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    Across sectors, Office of Inspector General work plans and challenge reports for 2025 provide a trove of information on the issues and industries that will likely be the focus of government oversight in the year to come, says Diana Shaw at Wiley.

  • 5 Drug And Device Developments That Shaped 2024

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    The last year saw significant legal developments affecting drug and device manufacturers, with landmark decisions and regulatory changes that require vigilance and agility from the industry, say attorneys at Faegre Drinker.

  • How New Fraud Enforcement Tool Affects Gov't Contractors

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    Government contractors will likely face greater scrutiny under the recently enacted Administrative False Claims Act, which broadens federal agencies' authority to pursue low-dollar fraud claims, but contractors may also find the act makes settlement of such claims easier to negotiate, say attorneys at Wiley.

  • Consultants Should Be Aware Of DOJ's Potential New Reach

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    The U.S. Department of Justice's recent first-of-its-kind settlement with McKinsey & Co. indicates not only the DOJ's more aggressive stance toward businesses' potential criminal wrongdoings, but also the benefits of self-disclosure and cooperation when wrongdoing becomes apparent, says Dom Caamano at Kibler Fowler.