Policy & Compliance

  • October 05, 2026

    Justices Won't Hear Minn. Indian Child Welfare Act Case

    The U.S. Supreme Court declined Monday to hear two foster parents' challenge to the Indian Child Welfare Act after the Minnesota Supreme Court determined they don't have standing to take on the bedrock law on claims of constitutional equal protection rights.

  • October 02, 2026

    Teva Ruling Creates Medicare Drug 'Chaos,' Full DC Circ. Told

    The federal government asked the full D.C. Circuit on Friday to reconsider a panel ruling allowing Teva to challenge Medicare's rules for deciding which drugs qualify for price negotiations, arguing the decision invites litigation that could create drug-pricing "chaos" and cause drug prices to quickly leap by more than 550%.

  • October 02, 2026

    Pa. Justices Reject Federal Limits On Agency Deference

    Pennsylvania courts do not have to follow federal precedents that limit deference to a state agency's interpretation of unclear regulations, with a majority of the state's highest court finding Thursday that an agency interpretation can be one of multiple factors for analyzing an ambiguous regulation.

  • October 02, 2026

    Judge OKs Provider Not Telling Clients Of Deal End, For Now

    A Colorado state judge granted Friday a home personal care services company's bid to delay notifying clients of a state regulatory agency's decision to terminate its provider agreement amid an upcoming administrative appeal hearing, citing a potential care gap for the providers' clients — all of them insured by Medicaid.

  • October 02, 2026

    NY-Presbyterian Can't Nix Union Funds' Antitrust Suit

    A New York federal judge ruled three union benefit funds can pursue an antitrust suit against New York Presbyterian Hospital without first proving it holds a large market share in the city, rejecting the hospital's motion to toss the suit on Friday.

  • October 02, 2026

    Pa. Hospital Workers Sue Over Biased Time Rounding

    A patient registration worker sued the University of Pittsburgh Medical Center in federal court Friday, alleging the hospital system's timekeeping software rounds time in the company's favor, while requiring patient services staff to work off the clock before and after their shifts and during meal breaks without compensation.

  • October 02, 2026

    DOJ Envisions 'Full-Fledged Law Firm' To Combat Gov't Fraud

    The National Fraud Enforcement Division was created less than six months ago, but it is rapidly reshaping the U.S. Department of Justice and spurring an uptick in internal corporate investigations, white collar experts say.

  • October 02, 2026

    6th Circ. Blocks 100s Of Opioid MDL Cases Targeting PBMs

    The Sixth Circuit on Friday overturned a pivotal decision in multidistrict opioid litigation that had dramatically expanded claims against the nation's largest pharmacy benefit managers, saying the MDL's presiding judge "clearly abused" his authority by belatedly allowing hundreds of new cases in one fell swoop.

  • October 02, 2026

    5 Supreme Court Cases To Watch This Fall

    The U.S. Supreme Court will convene Monday to begin its 2026 October term, which includes several cases that could determine the future of climate change tort litigation, expand religious freedoms and parental rights, and grant states authority to require proof of citizenship when individuals register for presidential elections using state forms. 

  • October 02, 2026

    4 Argument Sessions Benefits Attys Should Watch In October

    Former Intel workers' bid to convince the U.S. Supreme Court to revive their suit alleging shoddy retirement plan investments tops the list of oral arguments slated for October that benefits attorneys may want to keep an eye on. Here's a look at that case and three others teed up for argument this month.

  • October 01, 2026

    Home Health Co. Seeks Pause Of Colo. Agency's Backout

    A Colorado home personal care services company exclusively serving those insured by Medicaid urged a state judge Thursday to pause a Colorado regulatory agency's decision to terminate its provider agreement, contending any transition of clients to other providers should come after an administrative court hearing later this month.

  • October 01, 2026

    AbbVie Gets Humira Antitrust Suit Trimmed, But Not Tossed

    An Illinois federal judge tossed all but one claim in a sheet metal worker health plan's putative class action against AbbVie for allegedly causing artificially inflated prices for the rheumatoid arthritis drug Humira, saying the plan sufficiently alleged AbbVie unlawfully stifled competition in the adalimumab market.

  • October 01, 2026

    NH Families Seek To Block Medicaid Ban On Youth Trans Care

    Transgender adolescents and their parents urged a New Hampshire federal court Thursday to block the Trump administration's plan to cut off Medicaid funding for minors' gender-affirming care, arguing it's unconstitutional, motivated by discriminatory animus and violates the Administrative Procedure Act.

  • October 01, 2026

    Judge Bars HHS Medicaid Cuts For Wash. Noncitizens On SSI

    A federal judge has temporarily halted the U.S. Department of Health and Human Services' attempts to cancel Medicaid benefits to noncitizens in Washington state receiving supplemental security income, finding the loss of benefits could lead to permanent disability or death.

  • October 01, 2026

    Fla. Doc Says He Opposed Cruise Co.'s Billing, Got Fired

    A doctor has brought a federal whistleblower lawsuit against Norwegian Cruise Lines Holdings Ltd. in Florida federal court, alleging he lost his job after speaking out against what he believed were fraudulent practices to overcharge passengers for medical services that weren't necessary. 

  • October 01, 2026

    Fla. AG Says Pfizer Hid COVID Vax Risks From Consumers

    Florida's attorney general sued Pfizer and its CEO on Thursday, claiming they deceptively marketed the pharmaceutical company's COVID-19 vaccines as safe despite knowing of reports of adverse events.

  • October 01, 2026

    Calif. Co. Will Pay $20M To Settle COVID Payment Claims

    Los Angeles-based medical lab Signal Diagnostics LLC agreed to pay $20.5 million to settle allegations that it unlawfully retained overpayments for COVID tests for people who had health insurance, according to federal prosecutors.

  • September 30, 2026

    Aetna Escapes Zelis Repricing Tool Antitrust Case

    A Massachusetts federal judge granted Aetna's bid Wednesday to dismiss claims against it in consolidated antitrust litigation accusing insurance companies of using Zelis Healthcare's repricing tools to reduce reimbursements paid to healthcare providers, finding an amended complaint failed to plausibly allege that Aetna used the tools.

  • September 30, 2026

    Ex-NFL Players Object To Proposed Race-Norming Settlement

    More than 100 former NFL players spoke against a proposed class action settlement over allegedly discriminatory cognitive disability assessments, telling a federal judge it threatens to release the league's benefit plans from claims raised in other litigation and deliver largely empty rescoring promises.

  • September 30, 2026

    Pharma Co. Says Mass. Plant Hid FDA Sterility Concerns

    A North Carolina pharmaceutical company says in a complaint filed Wednesday in Massachusetts state court that the company it hired to package a drug for clinical trials involving young children intentionally downplayed a U.S. Food and Drug Administration inspection that flagged multiple contamination issues.

  • September 30, 2026

    Relator Must Seek Part Of $4.7B Opioid Deal In State Courts

    A whistleblower must turn to state courts to pursue his bid for a portion of a $4.7 billion settlement between Walgreens Boots Alliance Inc. and a group of states resolving opioid-related claims against the retail pharmacy chain, an Illinois federal judge ruled.

  • September 30, 2026

    Judge Backs CMS' Contested Organ Procurement Metrics

    Federal health officials didn't violate federal law when they implemented a competitive rule that will alter how organ procurers are rated by decertifying low performers, a Florida federal judge ruled, a holding that could bring wide changes to the organ donor network. 

  • September 30, 2026

    Health Co. Wins Initial Toss Of Retirement Forfeiture Suit

    An Oregon federal judge agreed Wednesday to toss a proposed class action alleging a health company misspent forfeitures from two employee retirement plans by putting assets toward employer-side contribution obligations instead of lowering administrative costs, holding that allegations failed to state a claim for violating federal benefits law.

  • September 30, 2026

    Independence Blue Cross Will Pay $22.5M To End FCA Case

    Pennsylvania health insurer Independence Blue Cross has agreed to pay $22.5 million to resolve allegations from the federal government that the company violated the False Claims Act by submitting inaccurate and untruthful diagnosis codes for its Medicare Advantage Plan enrollees, the U.S. attorney's office in Philadelphia said Wednesday.

  • September 29, 2026

    Courts Rule On Bayer Vax IP Row, Lilly Drug Collab And More

    Law360 Healthcare Authority looks at an order allowing Bayer CropScience to pursue patent infringement suits against COVID-19 vaccine makers, a $90 million verdict for Eli Lilly in litigation with a clinical-stage biotech company, and other legal news from the past week.

Expert Analysis

  • FTC's Clinical Trial Requirement Threatens Food Claim Rules

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    The Federal Trade Commission's general requirement for randomized controlled trials for most health-benefit claims, recently embraced by the National Advertising Review Board, lacks legal basis and endangers the existing statutory framework Congress created for marketing food and dietary supplements versus drugs, say attorneys at Keller & Heckman.

  • HHS Enforcement Restructuring Signals Compliance Risks

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    The U.S. Department of Health and Human Services' recent restructuring of its Office for Civil Rights suggests that, while Health Insurance Portability and Accountability Act enforcement remains central, its priorities have expanded to encompass civil rights, conscience and religious freedom, and data and cybersecurity issues, say attorneys at King & Spalding.

  • AG Watch: Oregon's Strategic Civil Enforcement Approach

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    Oregon Attorney General Dan Rayfield’s recent antitrust litigation activity and proposed staffing increase are the latest in a series of structural and policy changes that signal that the state Department of Justice is taking a more aggressive approach to civil enforcement, says Keturah Taylor at Cozen O'Connor.

  • A Decade Later, Escobar Is Still Shaping FCA Cases

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    The U.S. Supreme Court's decision 10 years ago in Universal Health Services v. U.S. ex rel. Escobar changed the way in which lower courts evaluate False Claims Act cases — and the ruling remains vital in nearly every FCA case filed today, say attorneys at Bradley Arant.

  • How FCA, FCPA Risks Are Shifting As Feds Pull Back

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    As the federal government continues its retreat from white collar enforcement, companies should expect False Claims Act risk to grow through private whistleblower suits and Foreign Corrupt Practices Act scrutiny to shift toward foreign prosecutors, requiring more adaptability as accountability becomes less centralized, says Temidayo Aganga-Williams at Selendy Gay.

  • Trump Admin's Agency Records Purge Tests Judicial Notice

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    While courts commonly take judicial notice of data in government websites and reports, the Trump administration's recent modification or wholesale deletion of these sources means that litigants must look elsewhere to support trial admission of this information, says Jon Gryskiewicz at Lewis Baach.

  • West Coast Health Cos. Must Brace For Federal Enforcement

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    In light of the U.S. Department of Justice's newly established West Coast strike force targeting healthcare fraud across Northern California, Arizona and Nevada, health organizations will need to prioritize knowledge, vigilance and operational discipline to reduce exposure from potentially parallel criminal and civil investigations, says Michael Beckwith at Dickinson Wright.

  • High Court's Hikma Decision Reshapes 'Skinny Label' Suits

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    The U.S. Supreme Court's decision in Hikma v. Amarin marks a significant victory for generic drug manufacturers, but rather than putting an end to so-called skinny label inducement claims, it narrows and refocuses them, say attorneys at Sterne Kessler.

  • Turning To The Courts When PBM Reform Falls Short

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    The effectiveness of state laws intended to regulate pharmacy benefit managers remains uncertain, but litigation — utilizing tried-and-true theories like breach of contract and fair dealing — offers another mechanism through which stakeholders may seek relief from PBMs, say attorneys at Reed Smith.

  • High Court's Abortion Pill Stay Reinforces Appellate Principles

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    The U.S. Supreme Court's recent order in Danco Laboratories v. Louisiana, staying a Fifth Circuit ruling that reinstated an in-person requirement for dispensing the abortion medicine mifepristone, should be seen not as a definitive ruling on reproductive rights, but as an affirmation of a more disciplined jurisdictional reality, says Daniel Nardo at Nardo & Associates.

  • Bracing For Enforcers' Growing Focus On Behavioral Health

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    While recent law enforcement scrutiny of the behavioral health industry has resulted in several settlements, indicating that more enforcement activity is on the way, organizations now have an opportunity to take proactive compliance measures, says Jeffrey Fitzgerald at Polsinelli.

  • DOJ Activity Indicates Rising Antitrust Risk For Hospitals

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    Two civil actions filed by the U.S. Department of Justice against New York-Presbyterian Hospital and OhioHealth, both alleging that the hospital systems used their market power to stifle competition, highlight the government's growing scrutiny of barriers to lower-cost insurance options, say attorneys at Freshfields.

  • Engaging With FDA's New Complete Response Letter Policy

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    A citizen petition filed with the U.S. Food and Drug Administration last month puts renewed focus on the agency's practice of releasing complete response letters in near real time, materially altering the context in which life sciences companies communicate with investors regarding regulatory developments, say attorneys at Debevoise.