Policy & Compliance

  • July 15, 2026

    NC Panel Nixes Nurse Noncompetes For Being 'Too Broad'

    A medical clinic provider couldn't convince a North Carolina state appeals court to overturn a ruling that noncompete agreements for two former nurses were unenforceable, after a split panel ruled Wednesday that the terms were overly broad and voidable under public policy.

  • July 15, 2026

    United Owes $630K In Fight Over Teen's Mental Health Care

    United Healthcare must pay $630,000 to a mother who challenged the insurance company's decision to deny coverage for her son's residential mental health treatment, a Utah federal judge ordered, after rejecting the company's bid to slim her requests for interest and attorney fees.

  • July 15, 2026

    Mass. Says UnitedHealth FCA Case Belongs In State Court

    Massachusetts asked a federal judge to send its $100 million state False Claims Act lawsuit alleging overbilling by UnitedHealthcare back to state court, accusing the insurer of forum shopping with a theoretical defense touching on federal law.

  • July 15, 2026

    DC Circ. Affirms Ratings For Alignment Medicare Plans

    The D.C. Circuit sided with the Centers for Medicare & Medicaid Services regarding its decision not to discard certain unfavorable surveys for Alignment Healthcare's Medicare Advantage plans, saying there is no indication of an administrative error.

  • July 14, 2026

    Albertsons Probed On Pharmacy Compliance Staffing At Trial

    Two former Albertsons pharmacy compliance executives testified in video depositions played Tuesday before a Washington judge considering whether Albertsons failed to prevent the diversion of opioids in the state, acknowledging the nationwide compliance team consisted of just six staffers between 2015 and 2020 despite heightened scrutiny amid the opioid epidemic.

  • July 14, 2026

    3rd Circ. Revives Providers' Underpayment Suit Against Cigna

    The Third Circuit partially revived several New Jersey-based healthcare practices' Employee Retirement Income Security Act suit alleging Cigna improperly underreimbursed them for covered healthcare services provided to Cigna's subscribers, ruling Monday the plaintiffs sufficiently alleged they were underpaid for some out-of-network services when compared to their normal charges for similar services.

  • July 14, 2026

    Patent Eligibility Bill Divides Senators Over Health Costs

    Several U.S. senators expressed strong support at a hearing Tuesday for a bill aimed at expanding which inventions are eligible for patents, while others appeared to have reservations about the potential effect of the proposed changes on healthcare costs.

  • July 14, 2026

    Medical Device Co. Settles FCA Claims

    A company that sells compression devices to reduce swelling in patients with certain medical conditions will pay $551,000 to settle allegations that it obtained Medicare reimbursement with falsified medical records, the U.S. attorney's office in Massachusetts announced Tuesday.

  • July 14, 2026

    FDA Resumes Drug Denial Letters Amid Secrecy Clash

    Drugmakers are examining a new batch of drug application rejection letters released by the U.S. Food and Drug Administration this month — the first disclosure since regulators paused the releases amid industry outcry.

  • July 14, 2026

    CVS Caremark Settles Out Of FTC Suit Over Insulin Pricing

    The Federal Trade Commission reached a settlement on Tuesday with CVS Caremark that includes a number of changes to its business practices, the second deal in a case accusing the country's largest pharmacy benefit managers of inflating insulin prices through unfair rebate schemes.

  • July 14, 2026

    The Latest Medicare Star Lawsuits: What You Need To Know

    Following a win in a Georgia federal court for a health plan challenging a Medicare Advantage Star Ratings calculation, Law360 Healthcare Authority looks at a recent batch of insurer lawsuits seeking to capitalize on the ruling.

  • July 14, 2026

    1st Circ. Backs CDC Ban On Importing Dogs Under 6 Months

    The First Circuit has upheld a rule requiring all dogs imported into the U.S. to be at least six months of age, saying the federal Centers for Disease Control and Prevention had shown it was a reasonable measure to fight rabies.

  • July 14, 2026

    DOJ Asks 9th Circ. Undo Trans Health Ruling Against Premera

    The federal government has backed Premera Blue Cross in its bid at the Ninth Circuit to overturn a Washington federal court's judgment that held the insurance company's coverage policy for gender dysphoria surgery is discriminatory, arguing the decision is out of line with U.S. Supreme Court precedent.

  • July 14, 2026

    Clinics Want Medicaid Abortion Stay Lifted After Pa. Court Win

    Allegheny Reproductive Health Center and other healthcare providers on Tuesday asked a Commonwealth Court judge to unfreeze money for Medicaid-funded abortions in Pennsylvania following the court's landmark ruling that the state's coverage exclusions for such abortions were unconstitutional.

  • July 14, 2026

    Kroger Says Flimsy Claims Doom Tobacco Fee Suit

    Grocery giant Kroger urged an Ohio federal judge to toss a suit challenging the legality of an extra health plan fee it charged tobacco users, stating it complied with federal benefits law by giving workers a 90-day window each year to dodge the fee by enrolling in a wellness program.

  • July 14, 2026

    HHS Wields Checkbook To Pressure State Fraud Units

    Cutting off federal funding to Medicaid fraud units in New York and Hawaii could reshape the enforcement priorities of similar units across the country. The HHS watchdog has made clear the agency wants states to lean in on criminal Medicaid fraud cases.

  • July 14, 2026

    Amgen Colo. Win May Chill States' Push To Cap Drug Prices

    A Colorado injunction blocking a prescription drug pricing statute may have thrown a wrench into efforts in other states to limit drug costs for consumers through a new crop of state oversight boards.

  • July 13, 2026

    Albertsons, Safeway Face Trial Over Wash.'s Opioid Epidemic

    Albertsons and Safeway ignored signs of problematic opioid prescriptions in Washington for years, an attorney for the state told a Seattle judge Monday during opening statements in a bench trial over allegations that the pharmacy chains failed to prevent the diversion of opioids that fueled the state's long-running overdose crisis.

  • July 13, 2026

    2nd Circ. Says Tylenol Maker Must Face Autism, ADHD Suits

    The Second Circuit said Monday that a lower court had wrongly excluded plaintiffs experts from testifying about an alleged relationship between using Tylenol during pregnancy and autism spectrum disorder and attention-deficit/hyperactivity disorder, although the panel cautioned that the decision was not political or scientific.

  • July 13, 2026

    J&J Asks 3rd Circ. To Block Return Of Ex-Worker's Fee Claims

    Johnson & Johnson has asked the Third Circuit to keep dismissed excessive fee claims out of a proposed class action alleging the company charged employees too much for a prescription drug benefits program, arguing that the lower court correctly tossed that portion of the suit for lack of standing.

  • July 13, 2026

    Northwell Escapes Suit Over Pension Plan Conversion

    Northwell Health defeated a proposed class action alleging it hid cuts to workers' pension plans when converting to a cash-balance plan in the late 1990s, with a New York federal judge finding the hospital system adequately disclosed how the change could impact participants' benefits.

  • July 13, 2026

    Health Org. Can't Halt FTC Texas Suit Over Trans Youth Care

    A D.C. federal court declined to bar the Federal Trade Commission from pursuing a consumer protection suit in Texas against the World Professional Association for Transgender Health, finding WPATH failed to show those proceedings threatened the court's injunction of a related investigation by the FTC.

  • July 13, 2026

    Utah Health System Beats 401(k) Suit Over Stable Value Fund

    A Utah federal judge tossed a suit by workers who claimed a western U.S. health system kept an underperforming stable value fund in a retirement plan and greenlighted excessive management fees, ruling their case lacks evidence that the plan could have secured better funds and fees.

  • July 10, 2026

    JPMorgan Workers Defend ERISA Suit Over High Drug Costs

    JPMorgan employees urged a New York federal judge on Friday not to end their Employee Retirement Income Security Act suit alleging they paid too much for prescription drugs, arguing JPMorgan still has not shown that its contract with its pharmacy benefit manager was reasonable.

  • July 10, 2026

    States' Stopgap Suit Aims To Shield K-12 Mental Health Grants

    Washington and 14 other states launched a preemptive lawsuit Friday to stop the Trump administration from ending federal grants for mental health programming in public schools, seeking to preserve the funding if the U.S. Department of Education succeeds in asserting new grounds for canceling the grants in a related case.

Expert Analysis

  • How To Engage With Gov't's Direct-To-Consumer Drug Policy

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    The U.S. Department of Health and Human Services' recent request for industry input on manufacturers' direct-to-consumer drug sales reflects the government's caution in this arena, and allows stakeholders a rare opportunity to help shape policy, says Mary Kohler at Kohler Health Law.

  • When Fraud Involvement Disqualifies FCA Whistleblowers

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    A Massachusetts federal court's recent dismissal of a False Claims Act relator in U.S. ex rel. Perry v. First Psychiatric Planners provides instructive insight into when whistleblowers may be denied their share of settlement proceeds, even if their involvement in the underlying fraud is a step removed, say attorneys at Holland & Knight.

  • Lessons From Justices' Split On Major Questions Doctrine

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    The justices' varied opinions in Learning Resources v. Trump, which held the International Emergency Economy Powers Act did not confer the power to impose tariffs, offer a meaningful window into the U.S. Supreme Court's perspective on the major questions doctrine that will likely shape lower courts' approach to executive action challenges, say attorneys at Venable.

  • Drug Wholesaler's DPA Shows Imperfect Efforts Still Count

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    Atlantic Biologicals’ recent deferred prosecution agreement with federal prosecutors for allegedly distributing controlled substances to pill mill pharmacies demonstrates that even subpar cooperation, when combined with genuine remediation and strategic advocacy, can yield outcomes that protect a company's long-term interests, says Jonathan Porter at Husch Blackwell.

  • Key Takeaways As HRSA Aims To Revive 340B Rebate Pilot

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    The U.S. Department of Health and Human Services' recent request for feedback on the 340B Rebate Model Pilot Program demonstrates that it intends to correct the model's procedural defects, which is positive news for participating manufacturers, but a setback for covered entities, say attorneys at Manatt.

  • Unique Issues Facing Brand-Compounder Patent Litigation

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    Recent litigation and potential enforcement action against Hims & Hers Health raise questions about how compounders and branded pharmaceuticals companies would be positioned in patent litigation as compared to generics companies, which would require strategies different from those that would be used in traditional Hatch-Waxman Act litigation, say attorneys at Morgan Lewis.

  • Pros And Cons Of FDA's Push For Nonprescription Drugs

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    The U.S. Food and Drug Administration's recent moves to shift more prescription drugs to over-the-counter status could increase access to important medications, but also bring potential safety risks and other trade-offs for drug companies, say attorneys at Hogan Lovells.

  • Prepping For The Future Of No Surprises Act Enforcement

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    This year is expected to be a transition point for the No Surprises Act framework from regulatory delay to operational enforcement, so stakeholders should use this time to stress-test systems, clean up processes and prepare for enforcement, say attorneys at Akerman.

  • High Court's 'Skinny Label' Case May Tackle Wider Questions

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    The U.S. Supreme Court's upcoming decision in Hikma v. Amarin will have important ramifications for broader debates over what defines a generic version of a drug, and the pending case is already altering patent practice, say attorneys at Taft.

  • Unpacking Key Themes From NY's New Healthcare Strategy

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    New York Gov. Kathy Hochul's 2026 State of the State agenda, read together with the state's fiscal year 2027 executive budget, reflect a clear framework to utilize Medicaid as the state's operating platform for healthcare reform, say attorneys at Sheppard.

  • Trans Care Enforcement Landscape Is Evolving Quickly

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    The recent coordinated federal effort to reshape pediatric gender-affirming care through enforcement and funding pressure has created a rapidly evolving regulatory environment marked by shifting risk assessments and potential downstream market effects for healthcare institutions and life sciences companies, say attorneys at Arnall Golden.

  • 11th Circ. May Bring Tectonic Shift To FCA Qui Tam Actions

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    The Eleventh Circuit's upcoming decision in Zafirov v. Florida Medical Associates, assessing whether the False Claims Act permits ordinary citizens to stand as officers of the federal government, could significantly limit private relators' ability to bring FCA actions, say attorneys at Saul Ewing.

  • 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.