Policy & Compliance

  • June 03, 2026

    HHS Says Bronx Facility $31M Payback Suit Filed Prematurely

    The U.S. Department of Health and Human Services says a nursing center in New York City should have pursued administrative remedies before fighting the collection of $31 million in Medicare overpayments with a lawsuit.

  • June 03, 2026

    EEOC Sues Health System Over Female Van Driver's Firing

    A Maryland healthcare system discriminated against a female driver by firing her after a wheelchair-bound nursing home resident fell from her transport van, whereas a male van driver was not disciplined after a similar episode, the U.S. Equal Employment Opportunity Commission said in a new suit.

  • June 02, 2026

    NJ Sues GEO Group Over Denial Of Detention Center Access

    New Jersey sued the owner and operator of immigration detention center Delaney Hall in state court on Tuesday, accusing the contractor of violating state law by blocking health officials from inspecting the center.

  • June 02, 2026

    NC Doctor Says 'Acquitted' Conduct Skews Sentencing

    A doctor convicted of making false statements in connection with an $11 million Medicare fraud scheme is urging a North Carolina federal court to exclude conduct she says she was acquitted of from her sentencing calculation, while the government argues she's mischaracterizing the outcome of the case. 

  • June 02, 2026

    No Surprises Act's New Rule Hands Win To Providers

    A long-awaited update to the No Surprises Act includes technical changes to dispute resolutions that attorneys say add up to a win for providers seeking to navigate a complex process.

  • June 02, 2026

    John Oliver Dodges Defamation Suit Over Medicaid Segment

    A physician highlighted in a "Last Week Tonight" segment on Medicaid who sued host John Oliver for defamation lost his case Tuesday, after a New York federal judge found the challenged statements were protected speech.

  • June 02, 2026

    3 State Drug Pricing Bills Attys Should Know

    State lawmakers continue to debate bills aimed at controlling the prices of prescription drugs. In recent weeks, high-profile bills in Illinois, Virginia and Minnesota all saw movement. Here, Law360 breaks down what attorneys need to know about these three bills. 

  • June 02, 2026

    4 Things To Know Before Feds Fight Rhode Island's 340B Law

    With the federal government's support, drug companies will try to persuade the First Circuit on Wednesday to strike down a Rhode Island law blocking them from constraining federally funded hospitals and contract pharmacies that use the 340B program. Here what you need to know about the legal battles surrounding the program ahead of the hearing.

  • June 02, 2026

    Generics Makers Tell 3rd Circ. Buyers Too Few For Class

    Two pharmaceutical companies embroiled in decadelong litigation over the alleged price-fixing of generic drugs told a Third Circuit panel on Tuesday that groups of drug buyers either didn't have the numbers necessary to support class certification or were not clearly identifiable.

  • 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. 

Expert Analysis

  • How State FCA Activity May Affect Civil Fraud Enforcement

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    A growing trend of state attorneys general enforcing their False Claims Act analogues independently of the U.S. Department of Justice carries potential repercussions for civil fraud enforcement and qui tam litigation considerations, say Li Yu at Bernstein Litowitz, Ellen London at London & Naor and Gwen Stamper at Vogel Slade.

  • Wage-Based H-1B Rule Amplifies Lottery Risks For Law Firms

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    Under the wage-based H-1B lottery rule taking effect Feb. 27, law firms planning to hire noncitizen law graduates awaiting bar admission should consider their options, as the work performed by such candidates may sit at the intersection of multiple occupational classifications with differing chances of success, says Jun Li at Reid & Wise.

  • Assessing Compliance Risks Around TrumpRx Participation

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    As there are novel compliance obligations and potential political opposition related to the new TrumpRx online drug platform, companies intending to participate on the site should consider the pressure points that are likely to draw enforcement scrutiny, say attorneys at Sheppard.

  • Predicting Actual Impact From CDC's New Vaccine Guidance

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    Recent federal changes to the childhood immunization schedule, reducing the number of vaccine recommendations from 18 to 11, do not automatically create enforceable obligations for parents, schools or healthcare providers, but may spur litigation and other downstream effects on school policies and state guidelines, says Mehdi Sinaki at Michelman & Robinson.

  • What Rescheduling Means For Cannabis Labels, Marketing

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    The proposed reclassification of cannabis is expected to bring heightened scrutiny of labeling, advertising and marketing from the U.S. Food and Drug Administration and the Federal Trade Commission, but the brands that tighten evidence, standardize operations and professionalize marketing controls now will see fewer surprises and better outcomes, say attorneys at Wilson Elser.

  • What's At Stake In Possible Circuit Split On Medicaid Rule

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    A recent Eleventh Circuit decision, reviving Florida's lawsuit against a federal rule that reduces Medicaid funding based on agreements between hospitals, sets up a potential circuit split with the Fifth Circuit, with important ramifications for states looking to private administrators to run provider tax programs, say Liz Goodman, Karuna Seshasai and Rebecca Pitt at FTI Consulting.

  • Courts' Rare Quash Of DOJ Subpoenas Has Lessons For Cos.

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    In a rare move, three federal courts recently quashed or partially quashed expansive U.S. Department of Justice administrative subpoenas issued to providers of gender-affirming care, demonstrating that courts will scrutinize purpose, cabin statutory authority and acknowledge the profound privacy burdens of overbroad government demands for sensitive records, say attorneys at ArentFox Schiff.

  • Remote Patient Monitoring Is At Regulatory Inflection Point

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    With remote patient monitoring at the center of new federal pilot programs and a recent report from the U.S. Department of Health and Human Services' Office of Inspector General examining Medicare billing for those services, it is clear that balancing innovation and risk will be a central challenge ahead for digital health stakeholders, say attorneys at Morgan Lewis.

  • Utah's AI Prescription Renewal Pilot Could Inform Policy

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    Utah recently became the first state to approve an artificial intelligence system for autonomously renewing certain prescription medicines, providing a test case for how regulators may be able to draw boundaries between administrative automation and medical judgment, say Jashaswi Ghosh at Holon Law Partners and Bryant Godfrey at Foley Hoag.

  • Ramped Up Psychedelic Production Carries Opportunity, Risk

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    Kimberly Chew at Husch Blackwell discusses the key legal implications of the U.S. Drug Enforcement Administration's recent dramatic increases in the production quotas for a range of psychedelic substances, offering guidance on compliance, risk management and strategic opportunities for practitioners navigating this rapidly evolving landscape.

  • New Biotech Nat'l Security Controls May Have Blunted Impact

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    While the newly enacted federal prohibition against contracting with certain biotechnology providers associated with countries of concern may have consequences on U.S. companies' ability to develop drugs, the restrictions may prove to be less problematic for the industry than the significant publicity around their passage would suggest, say attorneys at Wilson Sonsini.

  • Takeaways From The DOJ Fraud Section's 2025 Year In Review

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    Former acting Principal Deputy Chief Sean Tonolli of the U.S. Department of Justice's Fraud Section, now at Cahill Gordon, analyzes key findings from the section’s annual report — including the changes implemented to adapt to the new administration’s priorities — and lays out what to watch for this year.

  • Traditional FCA Enforcement Surges Amid Shifting Priorities

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    The U.S. Department of Justice’s January report on False Claims Act enforcement in fiscal year 2025 reveals that while the administration signaled its intent to expand FCA enforcement into new areas such as tariffs, for now the greatest exposure remains in traditional areas like healthcare — in which the risk is growing, say attorneys at Debevoise.