Policy & Compliance

  • March 03, 2026

    Inova Defeats Nurses' COVID Vax Bias Suits At 4th Circ.

    The Fourth Circuit refused Tuesday to revive suits from nurse anesthetists who said they faced religious and disability discrimination when they were fired for refusing to get vaccinated against COVID-19, ruling that nonprofit healthcare provider Inova wasn't their employer.

  • March 03, 2026

    Death From Stem Cell Treatment For ALS Draws $24M Verdict

    A Washington state jury awarded $24 million to the family of a patient who died just two days after what his family members described as a "worthless" spinal cord procedure to treat his ALS at a Seattle stem cell clinic.

  • March 03, 2026

    Ex-FDA Leaders Rebut Contraception Rollbacks At 3rd Circ.

    Former FDA commissioners argued that Trump-era religious exemptions for birth control coverage jeopardize public health and distort medical science, in an animus brief filed Monday with the Third Circuit.

  • March 03, 2026

    NC Doctor's Bid For New Trial Is Too Late, Judge Says

    A North Carolina federal judge has refused to order a new trial for a doctor convicted of participating in an $11 million Medicare fraud scheme, finding that because the motion did not contain new evidence, the deadline to request another trial has passed.

  • March 03, 2026

    Elevance Sanction Adds To Medicare Advantage Troubles

    Amid slowing enrollment rates and rising enforcement interest in private Medicare plans, insurer Elevance Health is being barred from signing up new patients to some prescription drug plans. It's not the only bad news for Elevance or the MA market.

  • March 03, 2026

    Florida Man Pleads Guilty In $24M HIV Drugs Fraud Scheme

    The owner of a marketing company in Florida has pled guilty to receiving kickbacks as part of a $24 million scheme to sign up Medicare and Medicaid beneficiaries for HIV prophylactic medications they did not need.

  • March 03, 2026

    Wells Fargo Escapes Ex-Workers' Prescription Cost Suit

    Former Wells Fargo workers on the employer healthcare plan failed to show that the company violated federal benefits law by allowing them to overpay for prescription drugs, a Minnesota federal judge found Tuesday, tossing the proposed class action.

  • March 03, 2026

    Pharma In Uphill Fight With Contract Pharmacy Laws

    Silence in the federal law governing the 340B discount drug program on the issue of contract pharmacies is working against drugmakers in their effort to stop states from protecting provider agreements with pharmacies.

  • March 03, 2026

    3 Argument Sessions For Healthcare Attys To Watch In March

    Ohio defends a gender transition ban and Janssen seeks to shed a $1.64 billion False Claims Act judgment. Law360 looks at the healthcare oral arguments to watch for in March.

  • March 03, 2026

    States Can't Duck Regeneron Counterclaims In FCA Case

    Eleven states pursuing a False Claims Act case against Regeneron Pharmaceuticals over what they say were inflated reimbursements for an eye drug can't block counterclaims by the drugmaker on sovereign immunity grounds, a Massachusetts federal judge has ruled.

  • March 03, 2026

    Judge Won't Rely On DOJ 'Decency' In Trans Records Case

    A Pennsylvania federal judge blocked the U.S. Department of Justice from getting patient-specific records of gender-affirming care at the University of Pittsburgh Medical Center Children's Hospital, excoriating the government's request and its reasoning for demanding the data.

  • March 03, 2026

    1st Circ. Won't Revive Boston's Opioid Claims Against PBMs

    Boston lost its bid to revive opioid crisis-related claims against two pharmacy benefit managers, as a First Circuit panel affirmed that the suit came years too late.

  • March 03, 2026

    Fla. Billing Co. To Settle With Feds Over $15M Medicare Fraud

    The U.S. government has settled its False Claims Act lawsuit with a medical coding and billing business it accused of aiding a Miami-based laboratory in fraudulently billing Medicare for more than $15 million in genetic tests.

  • March 02, 2026

    High Court Blocks California's Gender Privacy Rule

    The U.S. Supreme Court on Monday reinstated a lower court order that barred California public schools from allowing transgender and gender-nonconforming students to use different names and pronouns at school without their parents' knowledge or consent while the order is appealed.

  • March 02, 2026

    Texas AG Says Gender Care Ban Includes Mental Health

    Mental-health professionals in Texas risk losing their licenses and public funding if they "facilitate" the gender-affirming care banned under state law, said an opinion issued Friday by Attorney General Ken Paxton, which calls them the "gatekeepers."

  • March 02, 2026

    Anthem Avoids Patients' Ghost Network Suit In NY

    A New York federal judge on Monday granted Anthem escape from a proposed class action from patients who alleged inaccuracies in the insurer's mental health provider directory violated New York state laws, holding their claims were preempted by federal employee health benefits law.

  • March 02, 2026

    J&J Unit Wins Bid To Revive Talc Libel Suit With New Basis

    A New Jersey federal judge has revived a bankrupt Johnson & Johnson talc subsidiary's trade libel claim over a 2020 scientific article linking asbestos in talc to mesothelioma, finding that new evidence and allegations concerning the authenticity of the author's data are enough to survive a motion to dismiss.

  • March 02, 2026

    Drugmakers Warn Justices Oregon Pricing Law Risks Secrets

    Pharmaceutical manufacturers have asked the U.S. Supreme Court to overturn Oregon's drug‑pricing transparency law, arguing it forces companies to publicly justify their pricing decisions and give up valuable trade secrets in violation of the First Amendment and the Constitution's takings clause.

  • February 27, 2026

    Recovery Provider Asks For Halt To Anthem's Claims Practices

    A Colorado mental health and substance use treatment facilities operator and its patients asked a Colorado federal judge to stop Anthem Blue Cross and Blue Shield's claims practices, alleging its process violates federal benefits and mental health parity laws and disrupts access to lifesaving care.

  • February 27, 2026

    3rd Circ. Preview: Janssen, Penn State Prof. Seek Relief

    A packed March argument calendar will put several high‑stakes disputes before the Third Circuit, including a billion‑dollar False Claims Act judgment and challenges at the intersection of academic freedom, DEI programming, cannabis‑sector finance and campus Title IX procedures.

  • February 27, 2026

    Credit Bureaus Fight Bid To Add Plaintiffs, Claims To Suit

    Medical providers and a collection agency in a proposed class action accusing Equifax, Experian and TransUnion of conspiring to exclude less than $500 in medical debt from consumer credit reports lack good cause to again amend their complaint, the credit reporting agencies told a federal court. 

  • February 27, 2026

    Judge Says RFK Jr.-Tied Group Can't Join Childhood Vax Suit

    A Massachusetts judge said an anti-vaccine advocacy group with ties to U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. cannot join a lawsuit over the federal government's new childhood vaccine schedule, a day after the government said it opposed the group intervening in the case.

  • February 27, 2026

    Minn. State Sens. Introduce Medical Psilocybin Bill

    A pair of Minnesota state senators have introduced a bill to create and regulate a medical psilocybin use program, which would allow residents over 21 with qualifying medical conditions to cultivate and use the drug to treat their conditions.

  • February 27, 2026

    121-Year-Old Ruling Still A Shot In The Arm For Vax Mandates

    Having already withstood five global pandemics, 21 presidencies and more than a century of developments in both the law and public health policy, the U.S. Supreme Court's most durable precedent blessing mandatory vaccination is well positioned to survive a new wave of challenges, experts say.

  • February 27, 2026

    NYC Health Center Sues HHS Over $31M Medicare Repayment

    The U.S. Department of Health and Human Services is unlawfully attempting to recoup more than $31 million in Medicare overpayments made during the COVID-19 pandemic, a New York City skilled nursing center told a federal court, saying it shouldn't have to repay the money.

Expert Analysis

  • Federal Grantees May Soon Face More Limitations On Speech

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    If courts accept the administration’s new interpretation of preexisting case law, which attempts to graft onto grant recipients the existing limitations on government contractors' free speech, a more deferential standard may soon apply in determining whether an agency’s refusal or termination of a grant was in violation of the First Amendment, say attorneys at Venable.

  • HHS Wound Care Report Highlights Need For Payment Reform

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    The U.S. Department of Health and Human Services' recent report on potential abuse in Medicare Part B payments for skin substitutes highlights specific fraud schemes, but more importantly emphasizes that broader changes are needed for the wound care sector's fundamentally flawed payment system, say attorneys at Paul Hastings.

  • Assessing The Future Of The HIPAA Reproductive Health Rule

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    In light of a Texas federal court's recent decision to strike down a U.S. Department of Health and Human Services rule aimed to protect the privacy of patients seeking abortions and gender-affirming care, entities are at least temporarily relieved from compliance obligations, but tensions are likely to continue for the foreseeable future, says Liz Heddleston at Woods Rogers.

  • DOJ's Tracing Rule For Pandemic Loan Fraud Is Untenable

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    In conducting investigations related to COVID-19 relief fraud, the government's assertion that loan proceeds are nonfungible and had to have been segregated from other funds is unsupported by underlying legislation, precedent or the language establishing similar federal relief programs, say Sharon McCarthy, Jay Nanavati and Lasya Ravulapati at Kostelanetz.

  • New Health AI Guidance Features A Provider-Centric Approach

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    New guidance from the Joint Commission and Coalition for Health AI regarding the responsible use of artificial intelligence in healthcare deviates from preexisting guidance by recommending a comprehensive framework for using AI tools, focusing on healthcare provider organizations rather than on AI developers, say attorneys at Ropes & Gray.

  • Mass. Ruling May Pave New Avenue To Target Subpoenas

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    A Massachusetts federal court’s recent decision to quash a subpoena seeking information on gender-affirming care at Boston Children’s Hospital is a significant departure from courts' deferential approach to subpoena enforcement, and may open a new pathway for practitioners challenging investigative tools in the future, say attorneys at Gibson Dunn.

  • What To Expect After FDA Warnings To GLP-1 Compounders

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    The U.S. Food and Drug Administration's recent warning letters to companies advertising compounded versions of GLP-1 medications raise questions not just about the enforcement outlook for marketing such products, but also about the future of drug compounding as a whole, say attorneys at Spencer Fane.

  • How Financial Cos. Can Prep As NYDFS Cyber Changes Loom

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    Financial institutions supervised by the New York State Department of Financial Services can prepare for two critical cybersecurity requirements relating to multifactor authentication and asset inventories, effective Nov. 1, by conducting gap analyses and allocating resources to high-risk assets, among other steps, say attorneys at Pillsbury.

  • How Courts May Interpret Data-Driven Healthcare Fraud Suits

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    As the U.S. Department of Justice and other agencies increasingly turn to data mining as an enforcement tool, courts will have to determine how far data alone can take a fraud case, and sound theory, clinical expertise and institutional context will play an important role, say Jaime Jones at Sidley and Andrée-Anne Fournier and Atang Gilika at Analysis Group.

  • How Gov't Shutdown Will Affect Federal Health Agencies

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    Federal health agencies' contingency plans indicate that many major programs will remain insulated from disruption during the ongoing government shutdown, but significant policy proposals will likely be delayed and the Trump administration's emphasis on reduction-in-force plans distinguishes this shutdown from past lapses, says Miranda Franco at Holland & Knight.

  • Assessing Legal, Regulatory Hurdles Of Healthcare Offshoring

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    The offshoring of administrative, nonclinical functions has emerged as an increasingly attractive option for healthcare companies seeking to reduce costs, but this presents challenges in navigating the web of state restrictions on the access or storage of patient data outside the U.S., say attorneys at McDermott.

  • 5 Years In, COVID-19 Fraud Enforcement Landscape Is Shifting

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    As the government moves pandemic fraud enforcement from small-dollar individual prosecutions to high-value corporate cases, and billions of dollars remain unaccounted for, companies and defense attorneys must take steps now to prepare for the next five years of scrutiny, says attorney David Tarras.

  • 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.