Policy & Compliance
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April 08, 2025
UnitedHealth Puts Anesthesiologists' Antitrust Suit To Sleep
A New York federal judge tossed an antitrust lawsuit accusing a United Healthcare unit of using its market power in the New York metropolitan area to cut reimbursement rates to anesthesia providers by 80% in its public-sector employee health plan, while enlisting MultiPlan to pressure providers into accepting the rates.
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April 08, 2025
Md. Board Enacts Expungement Rule For Physician Records
Maryland doctors who have faced administrative action for failing to pay taxes or attend continuing education classes can have their public records wiped clean under a new rule from the state Board of Physicians.
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April 08, 2025
2nd Circ. Rejects Biden Diary Thief's Appeal Over Medical Info
The Second Circuit denied an appeal on Tuesday from a woman who pled guilty to stealing a diary belonging to former President Joe Biden's daughter, rejecting her arguments that a judge was wrong to allow a probation officer to disclose her presentencing report and prior medical records to mental health providers without first obtaining consent.
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April 07, 2025
CMS' Nursing Home Staffing Requirements Struck Down
A Texas federal judge on Monday struck down new staffing standards for nursing homes participating in Medicare or Medicaid, ruling that federal health officials overstepped their authority by establishing a one-size-fits-all requirement.
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April 07, 2025
Policy Group Tells 4th Circ. Drug Discount Law Needs Reform
The Fourth Circuit on Monday allowed a Boston-based think tank to file an amicus brief supporting a district court's injunction against a West Virginia law that pharmaceutical companies and lobbyists claim unconstitutionally expands a federal drug discount program.
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April 07, 2025
Drug Buyers, Generics Cos. Fight Over Bellwether Litigation
Generic drug buyers vied Friday with the pharmaceutical companies they've accused of price-fixing over how to shape the first rounds of long-gestating Pennsylvania federal court litigation that the plaintiffs want heard in separate consecutive trials and that the drugmakers want combined.
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April 07, 2025
AGs Announce $335M Opioid Deal With Mylan
New York Attorney General Letitia James on Monday said her office and those of other states reached a $335 million deal with Mylan to help combat the opioid crisis.
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April 07, 2025
Ex-Conn. Budget Official Plans To Testify In Corruption Cases
Twice-indicted former Connecticut budget official Konstantinos Diamantis plans to testify in two upcoming federal corruption trials, his attorney revealed Monday during a scheduling call that snapped into focus the timeline for both cases.
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April 07, 2025
Conn. Judge Pauses 'Staggering' Hospital Data Subpoena
A Connecticut judge temporarily paused a subpoena seeking what a health nonprofit called "a staggering amount" of confidential patient data by a proposed class of Constitution State residents accusing Hartford HealthCare Corp. of monopolizing the state's healthcare industry, stating that the court must review the subpoena first.
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April 07, 2025
11 States Tell 6th Circ. To Ax Mich. Conversion Therapy Ban
Eleven U.S. states led by Iowa and South Carolina urged the Sixth Circuit to strike down Michigan's ban on conversion therapy for minors, saying the law censors therapists' speech.
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April 07, 2025
Feds Say Fla. Doctor Fleeced Medicare With Bogus Charges
A doctor and his Florida-based business, Vohra Wound Physicians Management LLC, deliberately overbilled Medicare for years, charging it for wound care procedures that were unnecessary or not performed, according to federal prosecutors.
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April 04, 2025
Split DC Circ. Denies Calif. Subsidies For Border Hospitals
A split D.C. Circuit panel on Friday found it was not unconstitutional for California to exclude hospitals bordering the state from a program distributing supplemental payments to providers that serve Medi-Cal beneficiaries.
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April 04, 2025
HHS Drops 11th Circ. Fight Over ACA Trans Rule Freeze
The U.S. Department of Health and Human Services agreed to drop its bid to overturn an order blocking it from enforcing regulations that extend the Affordable Care Act's anti-discrimination provisions to transgender individuals against Florida organizations, according to filings with the Eleventh Circuit.
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April 04, 2025
Ohio AG Takes Trans Care Limits Bid To State Justices
Ohio Attorney General Dave Yost has taken his bid to reinstate limits on gender-affirming care for transgender youths to the state's highest court and wants the law's enforcement to continue throughout his appeal.
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April 04, 2025
Seattle Children's Faces Class Action Over Nurse Meal Breaks
A Washington nurse has filed a proposed class action alleging Seattle Children's Hospital broke state law by failing to schedule or provide mandatory rest and meal breaks, in a state court complaint that said the problem was made worse by understaffing during the COVID-19 pandemic.
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April 04, 2025
AGs Sue To Halt Disruptions To NIH Grant Funding
A coalition of 16 states on Friday sued the National Institutes of Health over delays and cancellations of grant programs linked to vaccines, transgender issues and other areas they say are currently "disfavored" by the Trump administration.
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April 03, 2025
Optum, Express Scripts Want Judge Ousted From Opioid MDL
Pharmacy benefit managers Optum and Express Scripts say the Ohio federal judge overseeing multidistrict opioid litigation should recuse himself because he "regularly communicates" with plaintiffs' attorneys in the litigation and is biased in favor of plaintiffs, according to a motion filed Wednesday.
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April 03, 2025
TV Star Dr. Oz Confirmed As New Medicare, Medicaid Leader
The U.S. Senate on Thursday voted 53 to 43, along party lines, to confirm former talk show host and surgeon Dr. Mehmet Oz to be the next administrator of the Centers for Medicare & Medicaid Services.
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April 03, 2025
Swedish Health Services Found Liable For Wage Violations
A Washington state judge has put Seattle-area hospital system Swedish Health Services on the hook for state wage law violations in an employee class action, finding workers were shortchanged by its timekeeping practices and failure to provide a second meal break on longer shifts.
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April 03, 2025
Senate Panel Advances Bills Tackling Drug Patents, Pricing
A U.S. Senate panel on Thursday approved a group of bills tackling pharmaceutical patents and drug pricing, including measures that claim to address so-called patent thickets and an industry practice called "product hopping."
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April 03, 2025
2nd Circ. Judge Thinks Drug Price Fight Sounds Like Antitrust
A Second Circuit judge on Thursday suggested that the federal government may be insulated from claims over its demand for lower prices for Medicare and Medicaid recipients, musing that Boehringer Ingelheim Pharmaceuticals Inc.'s constitutional challenge to an Inflation Reduction Act provision sounds more like an antitrust allegation.
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April 03, 2025
RI Judge Hits Pause On Billions In Health Grant Funding Cuts
A Rhode Island federal judge on Thursday barred the Trump administration from moving forward, for now, with the termination of billions of dollars in grants supporting state public health programs.
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April 03, 2025
Baker Donelson Elevates Health Law And Public Policy Heads
Three Baker Donelson Bearman Caldwell & Berkowitz PC shareholders have been tapped for leadership roles within the firm's national health law and public policy department.
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April 02, 2025
NIH Sued By Researchers Over 'Ideological Purge' On Grants
The American Public Health Association and others sued the federal government in Massachusetts federal court on Wednesday over the cancellations of billions of dollars worth of National Institutes of Health research grants on such issues as gender identity, diversity, vaccine hesitancy and climate change, claiming the "ideological purge" is illegal.
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April 02, 2025
GoodRx, PBM Price-Fixing MDL Set In Rhode Island
The Judicial Panel on Multidistrict Litigation on Wednesday consolidated in Rhode Island litigation alleging that GoodRx conspired with pharmacy benefit managers, including CVS Caremark and Express Scripts, to suppress reimbursements to independent pharmacies for dispensing generic prescription medications.
Expert Analysis
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Key Takeaways From FDA's Latest Social Media Warnings
The U.S. Food and Drug Administration's latest untitled letter concerning a drug company's social media promotion provides lessons for how companies should navigate risk presentation, FDA labeling requirements and superiority claims, say attorneys at Sheppard Mullin.
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Rank-And-File DOJ Attorneys Will Keep Calm And Carry On
Career prosecutors at the U.S. Department of Justice often pride themselves on their ability to remain apolitical in order to ensure consistency and keep the department’s mission afloat, and the incoming Trump administration is unlikely to upend this tradition, says Michael Landman at Bird Marella.
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Unpacking Arguments From High Court's Rural Hospital Case
During oral arguments in Advocate v. Becerra, the U.S. Supreme Court justices focused questions on the meaning of being "entitled to" supplementary security income assistance, and there's reason for optimism that the likely split decision will break in favor of hospitals, say attorneys at King & Spalding.
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Health Policy Predictions For Trump's Second Administration
As President-elect Donald Trump's nominations for health policy and enforcement heads work their way through the confirmation process, healthcare organizations can look at nominee backgrounds, campaign statements and actions from Trump's previous presidency to predict incoming priorities, say attorneys at McDermott.
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What Trump's Next Term May Mean For Biz Immigration
Leonard D'Arrigo at Harris Beach discusses the employment-based immigration policies businesses can potentially expect during President-elect Donald Trump’s second term, based on policies enacted during his first administration, statements made during his campaign and proposals in Project 2025.
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Weak Reasoning Underlies Fla. Judge's Bold Qui Tam Ruling
U.S. District Judge Kathryn Mizelle's groundbreaking decision in U.S. ex rel. Zafirov v. Florida Medical Associates LLC, holding that qui tam provisions of the False Claims Act are unconstitutional, relies on weak logic to reach a conclusion that differs from every other court that has ruled on the issue, says Ethan Greenberg at Anderson Kill.
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Medicare Overpayment Rules Are A Mixed Bag For Providers
The Centers for Medicare & Medicaid Services' updated rules for handling agency overpayments adopt a more reasonable definition of what it means to have "identified" an overpayment, which is a win for providers, but their new time frame for investigating related overpayments is unrealistic, says Susan Banks at Holland & Knight.
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Expect More State-Level Scrutiny Of Noncompetes Ahead
Despite the nationwide injunction against the Federal Trade Commission’s noncompete ban, and the incoming Republican administration, employers should anticipate that state legislatures will continue to focus on laws that limit or ban noncompetes, including those that target certain salary thresholds or industries, says Benjamin Fryer at FordHarrison.
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Cos. Should Inventory Issues To Prep For New Congress
As the legislative and oversight agendas of the 119th Congress come into sharper focus, corporate counsel should assess and plan for areas of potential oversight risk — from tax policy changes to supply chain integrity — even as much uncertainty remains, say attorneys at WilmerHale.
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Incoming Admin May Shake Up Life Sciences Regulation
Though President-elect Donald Trump has not yet articulated policy priorities regarding the life sciences industry, the sector is positioned to see significant changes that could affect everything from drug exclusivity and generic drug approvals, to the availability of over-the-counter drugs, to laboratory-developed tests and digital health, say attorneys at Morgan Lewis.
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Navigating DOJ's Patchwork Whistleblower Regime
In the past few months, the U.S. Department of Justice and several individual U.S. attorney’s offices have issued different pilot programs aimed at incentivizing individuals to blow the whistle on misconduct, but this piecemeal approach may create confusion and suboptimal outcomes, say attorneys at BakerHostetler.
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What To Expect Next From Federal Health Tech Regulation
Healthcare organizations should pay close attention to federal health information technology regulators' recent guidance concerning barriers to accessing electronic health information, which signals that more enforcement in this area is likely forthcoming, say attorneys at Ropes & Gray.
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5 Areas Congress May Investigate After GOP Election Wins
With Republicans poised to take control of Congress in addition to the executive branch next year, private companies can expect an unprecedented uptick in congressional investigations focused on five key areas, including cryptocurrency and healthcare, say attorneys at Cahill Gordon.