Policy & Compliance

  • February 12, 2026

    Trump Admin. Blocked From Cutting $600M In Health Funding

    An Illinois federal judge on Thursday temporarily blocked the Trump administration from terminating more than $600 million in public health funding to four Democratic-led states, saying the states will likely succeed in showing they are unconstitutionally being targeted due to political or policy objectives.

  • February 12, 2026

    Feds Charge 2 Foreign Nationals Over $10M Healthcare Fraud

    Federal officials in Chicago announced healthcare fraud charges Thursday against two natives of Pakistan who allegedly made $10 million by using fake medical companies to submit Medicare and other health benefit claims for items and services they never provided.

  • February 12, 2026

    DC Circ. Judge Rips Into Insurer In CMS Rating Case

    A Louisiana insurer found a tough critic in one D.C. Circuit judge Thursday as it argued that the Centers for Medicare & Medicaid Services used an unfair method to assess its "star ratings" for insurance plans, with the jurist saying the company seemed like it "just wanted whatever interpretation will give you a higher score."

  • February 12, 2026

    Ex-Pharma Exec Fights AGs' Quick Win Bid In Antitrust Case

    A former pharmaceutical marketing executive urged a Connecticut federal court to reject summary judgment sought against him by state attorneys general pursuing wider price-fixing litigation against most of the generic drug industry, arguing key cooperating witnesses' questionable credibility makes a trial necessary.

  • February 12, 2026

    Goodwin Expands Healthcare Team With Ex-Reed Smith Atty

    A healthcare attorney specializing in guiding clients through regulatory and transactional matters has moved her practice to Goodwin Procter LLP's Philadelphia office after more than 11 years with Reed Smith LLP.

  • February 11, 2026

    AbbVie Sues Medicaid, HHS Over Botox Fair Price Controls

    AbbVie Inc. on Wednesday asked a D.C. federal court to block the Centers for Medicare and Medicaid Services from controlling the price of Botox under the Inflation Reduction Act, arguing the cosmetic drug and migraine treatment should be excluded from the controls because it's a "plasma-derived" product.

  • February 11, 2026

    Ex-Lt. Col. Sues Hegseth Over Son's Benefits Denial

    A former U.S. Army lieutenant colonel sued Defense Secretary Pete Hegseth and the Defense Health Agency on Wednesday, alleging his son was wrongfully denied health care coverage for continued inpatient mental health treatment, leaving in limbo more than $270,000 in costs. 

  • February 11, 2026

    Anesthesia Group Looks To End FTC Rollup Suit

    U.S. Anesthesia Partners has urged a Texas federal court to end the Federal Trade Commission's case accusing the group of buying competing practices through a so-called rollup strategy, asserting that enforcers have no evidence of any harm to competition.

  • February 11, 2026

    Judge Won't Review Tossed ERISA Claim In Benefits Dispute

    An Ohio federal court refused Wednesday to reconsider a recent decision dismissing a woman's Employee Retirement Income Security Act claims against her husband's employer and several UnitedHealth Group Inc. companies that administered the couple's employee health benefits.

  • February 11, 2026

    HHS Says RFK Jr. Trans Care Policy View Not Legally Binding

    Health and Human Services Secretary Robert F. Kennedy Jr.'s declaration supporting the Trump administration's move to cut funding to hospitals that provide gender-affirming care is a nonbinding policy view, his agency told an Oregon federal court, and doesn't trigger provider exclusions from federal health programs.

  • February 11, 2026

    Organ Donor Network Must Face Veteran's Waitlist Bias Suit

    A Black veteran who alleges his kidney transplant timeline was delayed because the United Network for Organ Sharing artificially inflated his kidney function scores can proceed with his Title VI lawsuit, a Georgia federal judge ruled, denying the network's bid to have the suit tossed.

  • February 11, 2026

    Trans Health And Pediatric Groups Challenge FTC Subpoenas

    A major transgender medical group and a pediatric healthcare organization are seeking to end what they call "unlawful" consumer protection investigations from the Federal Trade Commission that want information pertaining to the medical groups' claims made in their marketing and advertising for gender-affirming care for minors. 

  • February 11, 2026

    Mass. AG Charges Medical Transport Co. With Billing Fraud

    A nonemergency medical transportation provider and its former owner are facing criminal charges for allegedly billing Massachusetts' Medicaid program for tens of thousands of fake rides and laundering the proceeds to accounts in Uganda, according to a Wednesday announcement.

  • February 11, 2026

    Kaiser Will Pay $30M To End DOL Mental Health Investigations

    Kaiser Permanente has agreed to fork over at least $30 million and change its practices to end multiple U.S. Department of Labor investigations into the adequacy of the healthcare organization's mental health and substance use disorder treatment networks in California, the DOL said.

  • February 10, 2026

    US Says Abbott Lied, Must Repay Funds Spent On Formula

    Abbott Laboratories must face the federal government's lawsuit over the 2022 infant formula crisis caused by the discovery of potentially deadly bacteria in a facility that made baby formula, prosecutors told a Michigan federal court, saying the company "repeatedly lied" about the cleanliness of its plant.

  • February 10, 2026

    Ex-DOJ Fraud Prosecutors Launch DC White Collar Boutique

    Two former U.S. Department of Justice fraud prosecutors are opening their own Washington, D.C., boutique firm to represent clients in complex fraud and white collar cases, they said Tuesday.

  • February 10, 2026

    PBMs Enter New Era Of Legal Scrutiny

    The recent government funding bill includes extensive reforms for the embattled pharmacy benefit manager industry. It may presage a new wave of agency scrutiny, regulatory action and lawsuits, including from PBMs.

  • February 10, 2026

    Abortion Rules, Vaccine Recommendations And More In Court

    Abortion restrictions in Arizona are facing a new legal challenge, and an interstate clash over abortion pills is heating up. Here, Law360 Healthcare Authority takes a look at the week's top healthcare news.

  • February 10, 2026

    Wash. Panel Says Healthcare Cost-Share Group Is An Insurer

    A Utah-based healthcare cost-sharing nonprofit operates as and must register as an insurer under Washington state law, a state appeals panel ruled, upholding a $50,000 fine from the state's insurance commissioner that found the nonprofit ran afoul of Washington insurance law. 

  • February 10, 2026

    Pa. Emerges As Battleground Over State False Claims Laws

    Momentum is growing to pass a False Claims Act law in Pennsylvania, the most populous U.S. jurisdiction without one already on the books. It's also reigniting debate over the value of anti-fraud statutes around the country.

  • February 10, 2026

    Hospitals Face 'Perfect Storm' Of Fed. Cuts, Revenue Strains

    Facing federal budget cuts, soaring labor costs and a rising tide of uninsured patients, U.S. hospitals are approaching a financial cliff that could trigger a wave of closures nationwide.

  • February 10, 2026

    Fresenius Can't Knock Out 401(k) Forfeiture Suit

    A Massachusetts federal judge narrowed but declined to dismiss a suit claiming dialysis company Fresenius violated federal benefits law by using forfeited 401(k) funds to pay for match contributions instead of plan fees, ruling the workers behind the suit adequately explained that the move may have flouted their interests.

  • February 09, 2026

    Anti-Abortion Groups Say Mich. Law Impedes 1st Amendment

    Two Michigan-based anti-abortion organizations are suing several officials, alleging recent amendments to Michigan's civil rights law will force them to hire employees and volunteers who do not share or may openly oppose their religious beliefs and stance on abortion.

  • February 09, 2026

    Medical Equipment Co. Nets Tentative Deal In Overbilling Suit

    Medical supply giant AdaptHealth Corp. has tentatively settled an overbilling suit brought by a proposed class of patients who claim they were overcharged for home healthcare equipment, according to a North Carolina court order pausing upcoming deadlines in the case.

  • February 06, 2026

    Ga. Panel Backs Sperm Bank Win In 'Wrongful Birth' Case

    A Georgia appeals court backed a win for sperm bank Xytex Corp. in consolidated litigation alleging the company sold sperm under false pretenses about the medical, psychological and social history of the donors.

Expert Analysis

  • Courts Keep Upping Standing Ante In ERISA Healthcare Suits

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    As Article III standing becomes increasingly important in litigation brought by employer-sponsored health plan members under the Employee Retirement Income Security Act, several recent cases suggest that courts are taking a more scrutinizing approach to the standing inquiry in both class actions and individual matters, say attorneys at Crowell & Moring.

  • Calif. Bill May Shake Up Healthcare Investment Landscape

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    If signed by the governor, newly passed California legislation would significantly expand the Office of Health Care Affordability's oversight of private equity and hedge fund investments in healthcare companies and management services organizations, and raise several questions about companies' data confidentiality and filing burdens, say attorneys at Ropes & Gray.

  • Pharma Copay Programs Raise Complex Economic Questions

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    The growing prevalence of copay accumulator and maximizer programs in the pharmaceutical industry is drawing increased scrutiny from patients, advocacy groups, lawmakers and courts, bringing complex questions about how financial responsibility for prescription drug purchases is determined and complicating damages assessments in litigation, say analysts at Analysis Group.

  • When AI Denies, Insurance Bad Faith Claims May Follow

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    Two recent rulings from Minnesota and Kentucky federal courts signal that past statements about claims-handling practices may leave insurers using artificial intelligence programs in claims administration vulnerable to suits alleging bad faith and unfair trade practices, say attorneys at Cozen O'Connor.

  • Health Insurance Kickback Cases Signal Greater Gov't Focus

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    A series of recent indictments by federal prosecutors in California suggests that the Eliminating Kickbacks in Recovery Act is gaining momentum as an enforcement tool against illegal inducement of patient referrals in the realm of commercial health insurance, say attorneys at BakerHostetler.

  • FDA Transparency Plans Raise Investor Disclosure Red Flags

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    The U.S. Food and Drug Administration’s recently announced intent to publish complete response letters for unapproved drugs and devices implicates certain investor disclosure requirements under securities laws, making it necessary for life sciences and biotech companies to adopt robust controls going forward, say attorneys at Arnold & Porter.

  • With Obligor Ruling, Ohio Justices Calm Lending Waters

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    A recent decision by the Ohio Supreme Court, affirming a fundamental principle that lenders have no duty to disclose material risks to obligors, provides clarity for commercial lending practices in Ohio and beyond, and offers a reminder of the risks presented by guarantee arrangements, says Carrie Brosius at Vorys.

  • Federal AI Action Plan Marks A Shift For Health And Bio Fields

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    The Trump administration's recent artificial intelligence action plan significantly expands federal commitments across biomedical agencies, defining a pivotal moment for attorneys and others involved in research collaborations, managing regulatory compliance and AI-related intellectual property, says Mehrin Masud-Elias at Arnold & Porter.

  • Preparing For DEA Rescheduling Of 2 Research Chemicals

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    A recent decision to allow the U.S. Drug Enforcement Administration to reclassify two research psychedelics in Schedule I under the Controlled Substances Act may pose significant barriers to scientific study, including stringent registration requirements, heightened security protocols and burdensome reporting obligations, say Kimberly Chew at Husch Blackwell and Jackie von Salm at Psilera.

  • 9th Circ.'s Kickback Ruling Strengthens A Prosecutorial Tool

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    The Ninth Circuit's decision last month in U.S. v. Schena, interpreting the Eliminating Kickbacks in Recovery Act to prohibit kickback conduct between the principal and individuals who do not directly interact with patients, serves as a wake-up call to the booming clinical laboratory testing industry, say attorneys at Kendall Brill.

  • Fla. Misses Opportunity To Rectify Wrongful Death Damages

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    Florida Gov. Ron DeSantis' recent veto of a bill that would have removed certain arbitrary and unfair prohibitions on noneconomic wrongful death damages in medical negligence cases highlights the urgent need for reforms to current state law, say attorneys at Farah & Farah.

  • A Shifting Trend In FDA Form 483 Disclosure Obligations

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    A New York federal court's Checkpoint Therapeutics decision extends a recent streak of dismissals of securities class actions alleging that pharmaceutical companies failed to disclose U.S. Food and Drug Administration Form 483 inspection reports, providing critical guidance for companies during the FDA approval process, say attorneys at Alston & Bird.

  • The Future Of Lab-Test Regs After FDA Rescinds Rule

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    The U.S. Food and Drug Administration recently rescinded its laboratory-developed tests rule in response to a Texas federal court decision this spring, reinforcing a separation of authority between the FDA and the Centers for Medicare & Medicaid Services, and calling into question the FDA's role in overseeing such tests without congressional action, say attorneys at Venable.