Policy & Compliance
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January 27, 2026
Long Road For Kaiser Whistleblowers Ends In Historic Payout
The whistleblowers behind a massive Medicare Advantage "upcoding" case spent years in isolation before a historic settlement was finally reached.
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January 27, 2026
Clinic Workers' Vax Bias Suit Needs 2nd Look, 3rd Circ. Says
A split Third Circuit panel reinstated a religious bias suit claiming Geisinger Medical Center illegally required workers who opposed its COVID-19 vaccine mandate to undergo nasal testing, saying the employees should have been allowed to explore whether a chemical in the nasal swabs made that accommodation unreasonable.
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January 27, 2026
Divisions Emerge At 2nd Circ. Over Reproductive Rights Law
A Second Circuit panel appeared split Tuesday on whether an anti-abortion group challenging a New York state law that bars employers from penalizing workers based on their reproductive health decisions has standing to challenge the law as unconstitutional.
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January 26, 2026
Generics Makers Fight Cert. In Cholesterol Drug Pricing MDL
Generic-drug makers sought to defeat a bid to certify proposed classes comprising thousands of pharmacies that indirectly purchased and resold generics at the center of sprawling price-fixing litigation, telling a Pennsylvania federal court Monday that certification would result in an "unmanageable trial."
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January 27, 2026
Record FCA Haul Sends 'Loud' Message On Federal Priorities
Aggressive enforcement by President Donald Trump's administration and the qui tam bar's success prosecuting fraud even without government intervention helped fuel the explosion in recoveries under the False Claims Act last year, experts say.
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January 26, 2026
Anthem Seeks Dismissal Of 'Ghost Network' Class Action
A proposed class action's allegations that Anthem Health Plans maintains inaccurate mental health directories known as ghost provider networks aren't true and are "legally deficient," the insurer and its parent company, Elevance Health Inc., argued while urging a Connecticut federal court to toss the suit.
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January 26, 2026
3rd Circ. Finds NJ Officials Shielded From COVID Deaths Suit
A proposed class action on behalf of the families of roughly 10,000 nursing home residents who died early in the COVID-19 pandemic cannot proceed against New Jersey officials over their response, the Third Circuit has ruled, finding the officials are protected through qualified immunity.
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January 26, 2026
Novo Nordisk Faces Class Claims Over GLP-1 Patent Tactics
A South Carolina drug company has launched a proposed class action against major pharmaceutical company Novo Nordisk, alleging it engaged in anticompetitive behavior to prolong its monopoly against generic competition for the GLP-1 drug Victoza.
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January 23, 2026
Providers Oppose Credit Bureaus' Medical Debt Appeal
A proposed class of medical providers and collection agencies accusing Equifax, Experian and TransUnion of colluding to exclude medical debt under $500 from consumer credit reports is opposing a bid by the credit bureaus to expedite an appeal of a ruling that denied dismissal of the claims.
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January 23, 2026
High Court's Med Mal Ruling Won't Spark Rise In Suits
The U.S. Supreme Court's recent ruling that a Delaware medical malpractice statute can't be enforced in federal court won't cause a noticeable rise in cases, experts said, but it could lay the groundwork for other cases involving conflicting procedural state laws.
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January 23, 2026
$200M Sun, Taro Generics Deal Gets Final OK
A Pennsylvania federal judge granted final approval Friday for a $200 million deal resolving employee benefits plans' claims against Sun Pharmaceutical and Taro Pharmaceuticals in the sprawling price-fixing litigation against generic-drug makers, while again ensuring the claims from dozens of state attorneys general remain untouched by the settlement.
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January 22, 2026
DC Circ. Presses Feds To Justify Military Trans Ban
A D.C. Circuit judge pressed the government on Thursday to justify a policy that effectively bars transgender people from serving in the military, questioning why Secretary of Defense Pete Hegseth imposed a more stringent policy than the first Trump administration did.
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January 22, 2026
6th Circ. Revives Law Firm Worker's Anthem Coverage Fight
Anthem Blue Cross Blue Shield's decision denying coverage for a law firm employee's son to continue receiving residential mental health treatment was arbitrary and capricious, the Sixth Circuit ruled Thursday, saying the insurer needs to carry out a "full and fair review of the requested coverage."
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January 22, 2026
Yale Hospital Wants Infant Death Verdict Reduced By $30M
Yale University and Yale New Haven Hospital on Thursday asked a Connecticut judge to reduce a $32 million infant death verdict to just $2 million, saying damages for the loss of enjoyment of life cannot be awarded in addition to damages for the infant's death itself.
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January 22, 2026
Docs Ask NJ Justices To Send Allstate RICO Case To Arbitration
Medical providers facing a racketeering suit from Allstate units pressed the New Jersey Supreme Court on Thursday to compel the insurers to arbitrate even large-scale fraud and racketeering claims tied to personal injury protection benefits under the state's no-fault statute, as the justices questioned whether that was feasible.
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January 22, 2026
FDA Action Shouldn't Halt Amazon Labeling Suit, Plaintiffs Say
Shoppers accusing Amazon of failing to make required disclosures on dietary supplement product pages told a Washington federal judge there's no need to pause their proposed class action amid possible rulemaking by the U.S. Food and Drug Administration, arguing that the supposed rule change wouldn't negate the suit's claims under California law.
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January 22, 2026
As Lawmakers Scrutinize Costs, Insurers Point To Hospitals
Facing a barrage of questions from lawmakers on Capitol Hill about rising costs, the heads of the biggest health insurance companies in the U.S. sought to blame providers and other parts of a complex industry.
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January 22, 2026
Arnall Golden Starts Gender-Affirming Care Defense Team
Arnall Golden Gregory LLP has started a team to defend healthcare providers and others who are facing federal investigations and enforcement actions over gender-affirming care.
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January 22, 2026
Ex-Surgeon Prevails Over Insurers In Lifetime Disability Fight
A Michigan federal judge handed a disabled surgeon a win against two insurance companies Thursday in his suit seeking total disability benefits for life, siding with the ex-worker's argument that the insurers erred in determining that his condition was caused by sickness instead of injury and cutting off benefits.
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January 22, 2026
Investors Drop LA Law Firm From Bioscience Fraud Suit
A group of investors including a "Toy Story" screenwriter pursuing an $87 million fraud suit against a bioscience company in California state court has agreed to drop claims against a California law firm and its name partner, with the firm in turn withdrawing an anti-SLAPP motion it filed in the suit.
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January 21, 2026
CVS, UnitedHealth, Express Scripts Duck PBM Antitrust Suit
A Missouri federal judge has thrown out a proposed class action accusing the country's three largest pharmacy benefit managers — owned by CVS, UnitedHealth Group and Cigna Group — of inflating prescription costs through their rebating practices.
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January 21, 2026
Midwives Challenge Miss. Practice Limits In Antitrust Suit
The American College of Nurse-Midwives launched a suit seeking to permanently block Mississippi rules requiring certified nurse-midwives to obtain collaboration agreements with physicians, arguing the rules unlawfully restrict competition and exacerbate public health challenges in the state.
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January 21, 2026
BCBS Says Bankrupt Hospital Can't Leave $3B Antitrust Deal
Blue Cross Blue Shield is opposing a bankrupt Alabama hospital's bid to opt out of a $2.8 billion antitrust class action settlement to pursue its own claims in bankruptcy court, arguing the hospital has no excuse for missing the deadline.
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January 21, 2026
Feds Say Medicare Steering Case Meets FCA Legal Bar
The government said Wednesday that its False Claims Act complaint accusing insurers and brokers of participating in a kickback scheme to steer customers to Medicare Advantage plans doesn't conflict with a First Circuit decision last year setting out the standard for such cases.
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January 21, 2026
Whole Foods Can't Escape Workers' Tobacco Fee Suit
A Texas federal judge refused to toss a proposed class action against Whole Foods from employee health plan participants who challenged a surcharge on workers who used tobacco, ruling allegations should proceed to discovery that the fees violated multiple provisions of federal benefits law.
Expert Analysis
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A Shifting Trend In FDA Form 483 Disclosure Obligations
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.
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The Future Of Lab-Test Regs After FDA Rescinds Rule
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.
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Unpacking Ore. Law's Limits On PE Healthcare Investment
A recent Oregon law imposes significant restrictions on nonphysicians owning or controlling medical practices, but newly enacted amendments provide some additional flexibility in certain ownership arrangements without scuttling the law's intent of addressing concerns about the rise of private equity investment in healthcare, say attorneys at Debevoise.
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Criminal Healthcare Fraud Takeaways From 4th Circ. Reversal
After the Fourth Circuit reversed a doctor’s postconviction acquittal in U.S. v. Elfenbein last month, defense attorneys should consider three strategies when handling complex criminal healthcare matters, says Jonathan Porter at Husch Blackwell.
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AG Watch: Texas Embraces The MAHA Movement
Attorneys at Kelley Drye examine Texas Attorney General Ken Paxton's actions related to the federal Make America Healthy Again movement, and how these actions hinge on representations or omissions by the target companies as opposed to specific analyses of the potential health risks.
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How States Are Regulating Health Insurers' AI Usage
The absence of a federal artificial intelligence framework positions states as key regulators of health insurers’ AI use, making it important for payors and service providers to understand the range of state AI legislation being passed in California and elsewhere, and consider implementing an AI-focused compliance infrastructure, say attorneys at Ropes & Gray.
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HHS Plan To Cut Immigrant Benefits Spurs Provider Questions
A recent notice from the U.S. Department of Health and Human Services identifying new federal public benefit programs for which nonqualified aliens are not eligible may have a major impact on entities that participate in these programs — but many questions remain unanswered, say attorneys at Foley.
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Noncompete Forecast Shows Tough Weather For Employers
Several new state noncompete laws signal rough conditions for employers, particularly in the healthcare sector, so employers must account for employees' geographic circumstances as they cannot rely solely on choice-of-law clauses, say lawyers at McDermott.
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Previewing State Efforts To Regulate Mental Health Chatbots
New York, Nevada and Utah have all recently enacted laws regulating the use of artificial intelligence to deliver mental health services, offering early insights into how other states may regulate this area, say attorneys at Goodwin.
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How DOJ's New Data Security Rules Leave HIPAA In The Dust
The U.S. Department of Justice's recently effective data security requirements carry profound implications for how healthcare providers collect, store, share and use data — and approach vendor oversight — that go far beyond the Health Insurance Portability and Accountability Act, say attorneys at Nelson Mullins.
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Texas Med Spas Must Prepare For 2 New State Laws
Two new laws in Texas — regulating elective intravenous therapy and reforming healthcare noncompetes — mark a pivotal shift in the regulatory framework for medical spas in the state, which must proactively adapt their operations and contractual practices, says Brad Cook at Munsch Hardt.
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DOJ-HHS Collab Crystallizes Focus On Health Enforcement
The recently announced partnership between the U.S. Department of Justice and U.S. Department of Health and Human Services to combat False Claims Act violations, following a multiyear trend of high-dollar DOJ recoveries, signals a long-term enforcement horizon with major implications for healthcare entities and whistleblowers, say attorneys at RJO.
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How The Healthline Privacy Settlement Redefines Ad Tech Use
The Healthline settlement is the first time California has drawn a clear line in the sand around how website tracking must function in practice, so if your site uses tracking technologies, especially around sensitive content like health or finance, regulators are inspecting your website's back end, not just its banner, say attorneys at Baker Donelson.