Policy & Compliance

  • June 12, 2026

    Aetna Can't Nix Unfair Practices Claims In Medical Billing Row

    A Washington acupuncture clinic and doctor accused of submitting fraudulent bills for medical services may proceed with their counterclaims against Aetna for unfair trade practices under the state's Consumer Protection Act, a federal court ruled.

  • June 12, 2026

    $1.9M Deal In Health System Retirement Suit Gets 1st OK

    A Michigan federal judge granted initial approval to a $1.9 million deal between a health system and a proposed class of employee retirement plan participants who alleged underperforming investment options violated federal benefits law, greenlighting a deal that was first submitted to the court for approval in late April.

  • June 11, 2026

    Ed. Dept. Tries New Tack To Scrap K-12 Mental Health Grants

    The U.S. Department of Education pressed ahead with its plan to end up to a billion dollars in school mental health grants, arguing Wednesday that a Seattle federal judge's December 2025 injunction barring the discontinuation of the grants shouldn't block the government from canceling the contracts outright.

  • June 11, 2026

    AbbVie Loses Colorado 340B Drug Pricing Law Challenge

    A Colorado federal judge on Wednesday dismissed all of AbbVie Inc.'s claims against the state over its federal 340B drug pricing law, finding that the Colorado law isn't federally preempted and courts across the country have settled the issue.

  • June 11, 2026

    Stop & Shop Parent Pays $40M On Inflated Drug Price Claims

    Stop & Shop's parent company will pay $40 million to resolve allegations it violated the False Claims Act by failing to report discounted prescription drug prices as "usual and customary" in claims submitted to federal Medicare, Medicaid and TRICARE programs, which resulted in overcharges, the U.S. Department of Justice announced Wednesday.

  • June 11, 2026

    HHS OIG Reports 'Concerning' Medicare Advantage Denials

    A pair of reports released by the inspector general for the U.S. Department of Health and Human Services on Thursday found that UnitedHealth Group, Humana and CVS Health logged some of the highest prior authorization denial rates among their Medicare Advantage peers for post-acute care.

  • June 11, 2026

    Braidwood Files New Challenge To ACA Birth Control Mandate

    For-profit healthcare company Braidwood Management and several individuals sued the government in Texas federal court to challenge no-cost contraception coverage requirements under the Affordable Care Act, arguing that the court should enjoin enforcement of the policy because it burdened their faith in violation of federal religious freedom law.

  • June 10, 2026

    Morgan & Morgan Atty Again Blocked From Harvard Suit

    A Massachusetts judge rebuffed a Morgan & Morgan PA attorney's second attempt to appear in a lawsuit over the theft of body parts from a Harvard Medical School morgue, saying he would not reconsider his earlier decision to bar the attorney over an incident in a separate court involving fake AI-generated case citations.

  • June 10, 2026

    Judge Won't Certify Class Of Health Workers In No-Poach Suit

    An Illinois federal judge on Wednesday refused to certify a class of former healthcare employees claiming that their wages were suppressed by alleged no-poach agreements among DaVita, UnitedHealth Group's Surgical Care Affiliates and Tenet Healthcare Corp. unit United Surgical Partners International, ruling that the proposed class is too diverse.

  • June 10, 2026

    Abbott Offered Faulty Health Plan Option, Ex-Worker Says

    Abbott Laboratories violated federal benefits law by offering a health plan option with higher premiums and lower deductibles without disclosing that participants would always pay less if they chose a high-deductible plan, according to a proposed class action filed Wednesday in Illinois federal court.

  • June 10, 2026

    NJ High Court Says Nonprofit Hospital Gets Limited Immunity

    The New Jersey Supreme Court unanimously concluded Wednesday that a nonprofit federally qualified health center isn't immune from a patient's negligence suit under a statute shielding nonprofits organized "exclusively" for charitable or educational purposes, reversing a lower court's finding to the contrary.

  • June 10, 2026

    Insurance Cos. Score Dismissal Of Zepbound Coverage Case

    A D.C. federal judge Wednesday agreed to toss a proposed class action against CVS Caremark and CareFirst BlueCross BlueShield from a worker who challenged coverage denials for Zepbound to treat sleep apnea, holding an exclusion in his employee health plan that the companies administered complied with federal benefits law.

  • June 10, 2026

    Lab To Pay $4.9M To Settle AGs' COVID Test Pricing Suit

    Eighteen states' attorneys general have entered into a $4.87 million settlement with GS Labs to resolve claims that the defunct testing company overcharged consumers for COVID-19 tests, according to statements issued Wednesday.

  • June 10, 2026

    Houston Hospital System Settles Retirement Fee, Fund Fight

    A Texas hospital system agreed to settle a proposed class action from ex-workers alleging the healthcare nonprofit failed to curb excessive recordkeeping fees and remove underperforming funds from its $2.8 billion employee retirement plan, after a magistrate judge recommended denying its motion to dismiss an amended complaint in May.

  • June 09, 2026

    Novartis, AbbVie Lose Bid To Halt Wash. 340B Pharmacy Law

    A Washington federal judge declined Tuesday to block a state law passed to protect prescription drug access for low-income and uninsured patients, rejecting arguments from AbbVie and Novartis that the new measure illegally adds to pharmaceutical manufacturers' obligations under the federal 340B Drug Pricing Program.

  • June 09, 2026

    Trans Care In Court: 7th Circ. Appeal, Atty Discipline And More

    Law360 Healthcare Authority looks at an emergency request related to the American Academy of Pediatrics, a Rhode Island judge's referral of Justice Department attorneys to a disciplinary committee, and other top news of the past week.

  • June 09, 2026

    Calif. Judge Blocks DOJ's Bid For Trans Patients' Medical Info

    A California federal judge ordered Stanford Medicine hospital not to disclose medical information belonging to trans adolescents who received gender-related care in response to a Texas grand jury subpoena, and blocked the U.S. Department of Justice from taking further steps to obtain their patient records.

  • June 09, 2026

    Eli Lilly Wins Order Halting Alleged Trulicity Fraud

    A Florida federal judge signed off Tuesday on a preliminary injunction pausing a prescription cost share program purportedly for Church of God in Christ members that pharmaceutical giant Eli Lilly and Co. says is actually a fraud scheme to resell GLP-1 drug Trulicity on the secondary market.

  • June 09, 2026

    Loper Battle Looms For Medicaid Frailty Work Exemption

    New federal work requirements for people on Medicaid take a strict view of who's too sick to work. They're almost certain to face legal challenges contending that the Trump administration went too far.

  • June 09, 2026

    4th Circ. Lets Hartford Unit Off The Hook For Drug Test Fight

    A Hartford unit doesn't owe coverage to a drug testing company accused of reporting false positive drug tests due to substandard quality control, the Fourth Circuit ruled Tuesday, saying the suit is related to an earlier claim that was covered by another insurer.

  • June 09, 2026

    The Law360 400: A Look At The Top 100 Firms

    The race to build the legal industry's largest law firm accelerated in 2025, with major firms leaning on mergers, lateral hiring and strategic expansion to climb the ranks of the Law360 400.

  • June 09, 2026

    Georgia County, Trans Deputy OK End To Surgery Bias Fight

    A Georgia county and a transgender sheriff's deputy who sued over her employee health plan's coverage exclusions for gender-affirming surgery have struck a deal to resolve her case, nine months after the en banc Eleventh Circuit issued a ruling that sided with the county. 

  • June 08, 2026

    Kaiser Member Seeks Class Cert. In Microsoft Site Tracker Suit

    A Kaiser Permanente member has called on a federal judge in Seattle to greenlight a series of national classes and California subclasses in her privacy lawsuit accusing Microsoft and Qualtrics of secretly intercepting millions of patients' private health information through tracking technologies embedded in the healthcare system's website.

  • June 08, 2026

    NC Doctor Avoids Prison For Role In $11M Medicaid Fraud

    A North Carolina doctor received five years of probation with eight months of house arrest for making false statements in an $11 million Medicaid fraud scheme, after a federal judge said he was struggling to balance the need to deter others with unwarranted sentencing disparities.

  • June 08, 2026

    Cleveland Clinic Deal With DOJ Bars Trans Care For Minors

    The Cleveland Clinic Foundation will pay over $2.3 million under agreements with the U.S. Department of Justice and the Ohio attorney general to prohibit the provision of puberty blockers and other forms of medical care for minors going through gender transition.

Expert Analysis

  • Trans Care Enforcement Landscape Is Evolving Quickly

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    The recent coordinated federal effort to reshape pediatric gender-affirming care through enforcement and funding pressure has created a rapidly evolving regulatory environment marked by shifting risk assessments and potential downstream market effects for healthcare institutions and life sciences companies, say attorneys at Arnall Golden.

  • 11th Circ. May Bring Tectonic Shift To FCA Qui Tam Actions

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    The Eleventh Circuit's upcoming decision in Zafirov v. Florida Medical Associates, assessing whether the False Claims Act permits ordinary citizens to stand as officers of the federal government, could significantly limit private relators' ability to bring FCA actions, say attorneys at Saul Ewing.

  • To Survive FCA Actions, Small Cos. Must Take Offensive Steps

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    A fumbled response to False Claims Act allegations can doom lower-middle-market businesses, and with FCA enforcement hitting record levels for two years, smaller companies must have offensive strategies ready that focus their limited resources on defeating civil qui tam and federal criminal actions, says Derrelle Janey at Olshan Frome.

  • Record FCA Recoveries Signal Intensified Healthcare Focus

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    In its recently released False Claims Act statistics, the U.S. government's emphasis on record healthcare recoveries and government-initiated healthcare matters last year indicates robust enforcement ahead, though the administration's focus on current policy objectives also extends beyond the healthcare sector, say attorneys at Epstein Becker.

  • A Potential Shift In FDA's Approach To Drug Trial Design

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    Recent guidance released by the U.S. Food and Drug Administration clarifying how Bayesian approaches — which combine prior knowledge with new data — may be used in clinical trials reflects the agency's continued interest in innovative trial designs that may accelerate drug approvals, say attorneys at Alston & Bird.

  • What FDA Guidance Means For Future Of Health Software

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    Two significant final guidance documents released by the U.S. Food and Drug Administration last month reflect a targeted effort to ease innovation friction around specific areas, including singular clinical decision support recommendations and sensor-based wearables, while maintaining established regulatory boundaries, say attorneys at Covington.

  • 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.