Policy & Compliance

  • June 04, 2026

    Feds Tout Medicaid Fraud Crackdown In Ohio, Slam Hawaii

    The Trump administration on Thursday praised Ohio's fight against Medicaid fraud and said Hawaii was doing too little, as federal officials pushed states to ramp up anti-fraud prosecutions or risk the loss of federal funding.

  • June 04, 2026

    Cities, Doctors' Group Seek Bar On ACA Marketplace Reforms

    Several cities and groups representing doctors and small businesses urged a Maryland federal court to strike down recently finalized Affordable Care Act marketplace reforms, arguing they will strain community resources by increasing the population of underinsured and uninsured Americans.

  • June 04, 2026

    NC Doctor Seeks Probation In $11M Medicare Fraud Case

    A North Carolina doctor convicted of making false statements as part of an $11 million Medicaid fraud scheme has asked a federal judge in the state to not send her to federal prison and instead give her probation after a jury found her guilty.

  • June 03, 2026

    AbbVie Loses Miss. Discount Drug Law Challenge For Good

    A Mississippi federal judge on Wednesday threw out a suit brought by AbbVie and other pharmaceutical manufacturers that participate in Medicaid challenging a law barring their interference with the distribution of discounted prescriptions to pharmacies serving low-income patients.

  • June 03, 2026

    Judge Questions Terms Of Student Loan Forgiveness Change

    A Massachusetts federal judge considering whether to block a new Trump administration rule that could kick millions of public sector and nonprofit employees out of a student loan forgiveness program repeatedly pressed a government lawyer Wednesday on the precise criteria the U.S. Department of Education would use to decide who is no longer eligible.

  • June 03, 2026

    Treatment Providers Can't DQ Participants' Atty In Wage Suit

    Several Texas-based addiction recovery program operators cannot remove a worker's attorney from a proposed wage class action over his prior involvement with the programs, a federal judge found, saying the operators failed to show the attorney had a conflict of interest or was a necessary witness.

  • June 03, 2026

    Medical Equipment Co. Inks $14.3M Deal In Overbilling Suit

    Pennsylvania-based AdaptHealth Corp. will pay $14.3 million to settle claims that it violated the North Carolina Debt Collection Act by overcharging and trying to collect debts from patients who had returned medical equipment to the company, according to details of a deal released this week.

  • June 03, 2026

    Bankrupt Hospital Can't Exit $3B BCBS Antitrust Deal

    A bankrupt Alabama hospital with "settler's remorse" can't bail on a multibillion-dollar antitrust settlement with Blue Cross Blue Shield, a federal judge ruled Tuesday.

  • June 03, 2026

    Ill. Court Blocks Fla. Suit Targeting Gender Care Policies

    An Illinois federal judge blocked the Florida attorney general's lawsuit targeting medical groups' policies on youth gender-affirming care, saying there's sufficient jurisdiction over Sunshine State officials because of a potential nationwide chilling effect the enforcement action caused.

  • June 03, 2026

    Trans Youth Sue NYU Langone, DOJ To Bar Records Release

    A group of transgender minors and young adults who received gender dysphoria care at NYU Langone urged a New York federal court to bar the U.S. Department of Justice from accessing their sensitive health records through a criminal subpoena.

  • 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.

Expert Analysis

  • 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.

  • 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.