Policy & Compliance

  • February 25, 2026

    White House Cites Fraud, Freezes $259M In Minn. Medicaid

    The Trump administration on Wednesday said it would hold back $259.9 million in Medicaid funding for Minnesota as part of what it called an unprecedented effort to combat fraud in programs that support low-income families.

  • February 25, 2026

    Fla. Court Blocks Doctor Dispensing Rules For Worker Claims

    A Florida panel on Wednesday set aside a state agency's proposed rules that would include doctors in a workers' compensation law that gives patients an "absolute choice" over which pharmacist can fill their prescriptions, saying the proposals go beyond what lawmakers intended.

  • February 25, 2026

    Centene Says Filed Rate Doctrine Dooms RICO, Fraud Claims

    Centene Corp. urged an Illinois federal judge Tuesday to grant it partial judgment in a proposed class action by patients alleging the company violated racketeering laws and cheated them out of billions with bogus policies, arguing the filed rate doctrine bars the refunds they seek for alleged overcharges.

  • February 25, 2026

    Pakistan Native Pleads Not Guilty To $10M Healthcare Fraud

    A native of Pakistan who is living in Texas pled not guilty Wednesday to a Chicago indictment claiming he participated in an alleged $10 million healthcare fraud and money laundering scheme involving fake medical companies that filed claims for items and services they never provided.

  • February 25, 2026

    9th Circ. Rules K-12 Mental Health Grants Must Continue

    The U.S. Department of Education must fund K-12 mental health grants given to public schools to help students cope with school shootings, the Ninth Circuit ruled, denying the agency's emergency request to pause a lower court's permanent injunction pending an appeal. 

  • February 24, 2026

    Ariz., Calif. Lead Suit Over 'Senseless' HHS Vaccine Overhaul

    Arizona and California are leading a coalition of states challenging the U.S. Department of Health and Human Services' decision to cut vaccine recommendations for American children, alleging in a lawsuit Tuesday that the "unprecedented attack" stems from HHS Secretary Robert F. Kennedy Jr.'s "unscientific hostility to vaccines."

  • February 24, 2026

    6th Circ. Affirms Dismissal Of Sotera Toxic Gas Investor Suit

    The Sixth Circuit on Tuesday affirmed a lower court's dismissal of an investor lawsuit accusing Sotera Health Co. of concealing the carcinogenic nature of a gas used at its sterilization plants, finding Sotera did not make any actionable false or misleading statements to investors.

  • February 24, 2026

    Texas Panel Skeptical That Doctor's Hands Are Property

    A Texas appellate court appeared dubious at a claim that a doctor's hands count as personal property in a case accusing a state-owned hospital of healthcare negligence, asking Tuesday what to do with the state Supreme Court's instruction to narrowly construe waivers of sovereign immunity.

  • February 24, 2026

    Abortion Pill Access, Tariff Questions And More In Court

    Law360 Healthcare Authority looks at drugmakers' intervention in federal litigation concerning mail-order abortion medication, questions left open by the U.S. Supreme Court's decision striking down tariffs and other significant litigation developments this week.

  • February 24, 2026

    How To Read FDA's Flip-Flop On Moderna Flu Vaccine

    An unusual FDA reversal on a new flu vaccine is raising alarm bells for health experts and attorneys.

  • February 24, 2026

    Ariz. Bill To Limit 'No Surprises' Arbitration Offers Put On Hold

    A powerful Arizona state lawmaker this week agreed to pause his proposal to establish limits on how much medical providers can seek under the No Surprises Act arbitration system, saying the legislation needs more work and he'll bring it back next year.

  • February 24, 2026

    FDA Expert Panels May Exploit A Legal 'Loophole,' Atty Says

    Law360 Healthcare Authority talks to attorney Joseph Daval about the rise of FDA expert panels, federal law, and blurring the lines between expert and stakeholder.

  • February 24, 2026

    Mallinckrodt's Ch. 11 Blocks Antitrust Payouts, Judge Rules

    A Connecticut federal judge has ruled that drugmaker Mallinckrodt PLC shrugged off monetary claims brought by states in a sprawling generic drug antitrust enforcement action when the company emerged from bankruptcy in 2022.

  • February 24, 2026

    United Wants Partial Fraud Suit Win Against Billing Co.

    TeamHealth has been submitting fraudulent claims to get UnitedHealthcare to overpay it by more than $100 million, the insurer argued as it asked a Tennessee federal judge to grant it a partial early win in its suit against the emergency room staffing and billing company.

  • February 24, 2026

    Philips Unit Escapes CPAP Machine Whistleblower Case

    Philips Respironics, a unit of Koninklijke Philips NV, fended off a whistleblower suit alleging it provided kickbacks to CPAP suppliers that bought its products, with a Pennsylvania federal judge ruling that a former Philips manager failed to show that the company willfully engaged in illegal conduct.

  • February 24, 2026

    PE-Owned Doc Staffing Raises ER Fraud Risk

    As private equity firms scoop up physician staffing companies, healthcare litigators say emergency rooms and referrals are fertile ground for fraud and False Claims Act enforcement.

  • February 24, 2026

    AbbVie Tests Exclusion Strategy In Drug Price Fight

    Following a series of drugmaker losses in suits challenging Medicare drug price negotiations, AbbVie Inc. is trying something new in a challenge focused on Botox and a legal exclusion for drugs made from human plasma.

  • February 24, 2026

    AstraZeneca Drug Price Challenge Falls Short In Hawaii

    A federal judge in Hawaii temporarily upheld the state's law that prevents drug manufacturers from blocking safety-net hospitals from contracting with an unlimited number of outside pharmacies to dispense discounted prescription drugs under the 340B Drug Discount Program. 

  • February 24, 2026

    Mintz Lands IP Pro From Wilson Sonsini In San Francisco

    Mintz Levin Cohn Ferris Glovsky and Popeo PC. announced Tuesday that it has added a patent litigation attorney who was at Wilson Sonsini Goodrich & Rosati PC for more than two decades to bolster its intellectual property division.

  • February 23, 2026

    DC Circ. Talks Sharks, Moats In Vertex HHS Kickback Appeal

    Sharks and moats were top of mind Monday morning for one judge on the D.C. Circuit, as gene therapy drugmaker Vertex Pharmaceuticals attempted to convince the court that its fertility preservation program does not violate the Anti-Kickback Statute.

  • February 23, 2026

    Zynex Faces Securities Suit Following Arrest Of Former Execs

    After being arrested last month on charges of securities fraud and conspiracy, the former CEO and ex-chief compliance officer of bankrupt medical device maker Zynex have been hit with a securities class action that alleges they and others caused the company to engage in fraudulent billing practices that inflated its stock price and led to investor losses once the truth came to light.

  • February 23, 2026

    Ferguson Braswell Adds Healthcare Practice With 2 In Texas

    Ferguson Braswell Fraser Kubasta PC announced Monday that it has opened a healthcare practice with a pair of new shareholders in Houston, expanding the firm's corporate platform.

  • February 20, 2026

    DOJ Says Ohio Health System's Contracts Violate Antitrust

    The U.S. Department of Justice and Ohio's attorney general's office sued OhioHealth Corp. Friday in federal court, accusing the healthcare system of using contractual restrictions to block insurers from offering plans that include lower-cost rivals.

  • February 20, 2026

    Court OKs $376K Arb. Victory For Accountant In PWFA Suit

    A Texas federal court approved a $376,000 arbitration award for a former community center accounting employee who alleged she was belittled by a supervisor and denied telework as a temporary accommodation following childbirth.

  • February 20, 2026

    Kaiser Sues Insurers To Tap $95M D&O Policy For Fraud Deal

    Kaiser Foundation Health Plan sued Chubb and other insurers in California federal court Friday seeking to tap $95 million in directors and officers liability coverage for a recently settled whistleblower action that accused Kaiser of submitting false diagnoses for Medicare Advantage Plan enrollees. 

Expert Analysis

  • Unique Aspects Of Texas' Approach To AI Regulation

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    The Texas Responsible AI Governance Act — which will soon be the sole comprehensive artificial intelligence law in the U.S. — pulls threads from EU and Colorado laws but introduces more targeted rules with fewer obligations on commercial entities, say attorneys at MVA Law.

  • Surveying The Healthcare Policy Landscape Post-Shutdown

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    With last week's agreement to reopen the federal government, at least through the end of January, key healthcare legislation that has been in limbo since a December 2024 spending bill fell apart may recapture the attention of Congress, say attorneys at Faegre Drinker.

  • FDA Biosimilar Guidance Should Ease Biologics Development

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    New draft guidance from the U.S. Food and Drug Administration, indicating that the agency may no longer routinely require comparative efficacy studies when other evidence provides sufficient assurance of biosimilarity, underscores the FDA's trust in analytical technology as a driver of biologics access, say attorneys at Hogan Lovells.

  • Prison Body Cams Raise Health Privacy Compliance Issues

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    The increasing use of prison staff body cameras to enhance transparency and safety presents correctional healthcare partners with new risk management questions where they must carefully reconcile the benefits of surveillance with the imperative to protect patient privacy, say attorneys at Gordon Rees.

  • Employer Considerations After 11th Circ. Gender Care Ruling

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    The Eleventh Circuit's en banc decision in Lange v. Houston County, Georgia, finding that a health plan did not violate Title VII by excluding coverage for gender-affirming care, shows that plans must be increasingly cognizant of federal and state liability as states pass varying mandates, say attorneys at Miller & Chevalier.

  • How Healthcare Practices Can Prepare For ICE Visits

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    Healthcare providers that may face encounters with immigration enforcement should familiarize themselves with compliance obligations beyond ensuring employment authorization, and mitigate risk by establishing clear policies and specific procedures that safeguard patient rights and manage staff interactions with agents, say attorneys at Roetzel & Andress.

  • Adapting To Calif.'s Enhanced Regulation Of PE In Healthcare

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    New California legislation enhances oversight on the role of private equity groups and hedge funds in healthcare transactions, featuring both a highly targeted nature and vague language that will require organizations to carefully evaluate existing practices, says Andrew Demetriou at Husch Blackwell.

  • Lessons From 7th Circ. Decision Affirming $183M FCA Verdict

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    The Seventh Circuit's decision to uphold a $183 million False Claims Act award against Eli Lilly engages substantively with recurring materiality and scienter questions and provides insights into appellate review of complex trial court judgments, say Ellen London at London & Naor, Li Yu at Bernstein Litowitz and Kimberly Friday at Osborn Maledon.

  • Calif. Justices Continued Anti-Arbitration Trend This Term

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    In the 2024-2025 term, the California Supreme Court justices continued to narrow arbitration's reach under state law, despite state courts' extreme caseload backlog and even as they embraced contractual autonomy in other contexts, says Josephine Petrick at The Norton Law Firm.

  • Steps For Healthcare Providers After Cigna ERISA Settlement

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    Following the Cigna class action's settlement, where Employee Retirement Income Security Act violations arose from Cigna's online provider directory advertising providers as in-network who were actually out-of-network, providers should routinely audit their contract status and directory listings, and proactively coordinate with plans and payor partners, say attorneys at ArentFox Schiff.

  • What's New In FDA's Latest Cell And Gene Therapy Guidance

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    New draft guidance from the U.S. Food and Drug Administration, along with other recent initiatives, come together to promote cell and gene therapy product development by streamlining development and review pathways, say attorneys at Holland & Knight.

  • Adapting To Enforcement Focus On Wound Care Fraud

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    As federal agencies target wound care industry fraud as a top enforcement priority, attorneys advising industry stakeholders should evaluate business relationships for Anti-Kickback Statute violations, emphasize appropriate product use and documentation, and use internal data analytics to monitor billing patterns, say David Tarras at Tarras Defense and Jay McCormack at Verrill Dana.

  • AG Watch: Illinois A Key Player In State-Level Enforcement

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    Illinois Attorney General Kwame Raoul has systematically strengthened his office to fill federal enforcement gaps, oppose Trump administration mandates and advance state policy objectives, particularly by aggressively pursuing labor-related issues, say attorneys at Troutman.