Policy & Compliance

  • April 08, 2026

    HIV, AIDS Patients End Disability Bias Suit With CVS

    CVS Pharmacy Inc. and a group of HIV and AIDS patients have agreed to wrap up a suit claiming the company made it harder for them to get their medication in violation of disability discrimination law, according to a California federal court filing.

  • April 07, 2026

    Calif. Dialysis Bill Violates 1st Amendment, 9th Circ. Says

    The Ninth Circuit on Tuesday struck down provisions of a California law that aims to restrict dialysis providers' ability to profit from patients receiving health insurance premium assistance from nonprofit charities, ruling in a published opinion that the provisions violated nonprofit American Kidney Fund's and dialysis providers' First Amendment rights.

  • April 07, 2026

    Pa. Hospitals Accuse Aetna Of Underpaying Medicare Claims

    Two Pennsylvania hospital operators have sued Aetna Health Inc. in federal court, alleging the insurer has been improperly denying Medicare Advantage claims for inpatient services, or underpaying, under a new policy.

  • April 07, 2026

    Insurer Premera Accuses Clinic Of Misusing No Surprises Act

    Premera Blue Cross sued a weight loss clinic on Monday in Washington federal court saying it abused a federal law aimed at safeguarding patients from unexpected medical bills in order to shake down the insurer for exorbitant amounts of money — as much as 10 times what Premera pays in-network providers.

  • April 07, 2026

    Acadia Still On Hook For $9M Rehab Death Negligence Verdict

    A California state appeals court on Tuesday affirmed a more than $9 million jury verdict against Acadia Healthcare Co. Inc. in a suit stemming from the death of a patient at one of its addiction treatment centers, saying there was substantial evidence that the Marin County facility was negligently understaffed.

  • April 07, 2026

    HHS Must Face States' Suit Over RFK's 'Dramatic Overhaul'

    A Rhode Island federal judge rejected Tuesday the government's bid to toss a group of states' lawsuit challenging Robert F. Kennedy Jr.'s "dramatic overhaul" of the U.S. Department of Health and Human Services, criticizing the government for rehashing jurisdictional arguments the court already rejected and finding the states' claims are plausible.

  • April 07, 2026

    Minn. Can't Unfreeze $243M In Medicaid Funds, Judge Says

    A Minnesota federal judge on Monday denied the state's preliminary injunction request to release $243 million in Medicaid funds deferred by the federal government during a fraud investigation, holding that the "unprecedented" size and scope of the deferral action doesn't mean the Centers for Medicare & Medicaid Services isn't legally cleared to pursue the action.

  • April 07, 2026

    3 Healthcare Decisions You May Have Missed This Week

    A proposed class of HIV and AIDS patients is dropping their disability bias lawsuit, the Third Circuit on a COVID-era fraudster sentence, and Aetna escapes a testing payment lawsuit. Law360 Healthcare Authority looks at three decisions you may have missed.

  • April 07, 2026

    Judge Questions FTC's Motive In Gender-Care Probe

    A federal judge in Washington said Tuesday he would have to balance any legitimate concerns about parents and children being misled on the issue of gender-affirming care with what appeared to be retaliatory motives behind Federal Trade Commission investigative demands to a pair of nonprofits.

  • April 07, 2026

    HHS Staff Changes Likely To Lead To Uncertain 2026

    Healthcare experts are keeping a close eye on personnel changes at the U.S. Department of Health and Human Services. Law360 Healthcare Authority looks at how they could affect key agency policies.

  • April 07, 2026

    Mich. AG Says PBMs Can't Stall Discovery In Drug-Pricing Suit

    Michigan's attorney general is urging a federal court to reject a renewed bid by pharmacy benefit managers to pause discovery in an antitrust case accusing them of price-fixing reimbursement rates, claiming the companies are relying on exaggerated burden claims and an ordinary motion to dismiss that is unlikely to succeed.

  • April 07, 2026

    DC Circ. Skeptical Ex-Steward CEO Could Skip Senate Hearing

    A D.C. Circuit judge told the attorney for the embattled former CEO of Steward Health Care on Tuesday that she couldn't comprehend how his client could invoke his Fifth Amendment rights without showing up to his scheduled appearance before a Senate committee.

  • April 07, 2026

    High Court Ruling Won't End 'Conversion Therapy' Battles

    The U.S. Supreme Court's rejection of Colorado's ban on what is commonly known as gay conversion therapy may have rendered dozens of similar laws toothless, but don't expect it to be the end of legal challenges in this arena.

  • April 07, 2026

    Jury Awards $39.5M Over Discharged Psych Patient's Victims

    A Philadelphia jury on Tuesday hit a healthcare management company and a Pennsylvania hospital with a $39.5 million verdict, finding them liable for the deaths of four people who were murdered by a family member who was discharged from a psychiatric unit that failed to submit paperwork that would have prevented him from purchasing the gun he used to kill them.

  • April 06, 2026

    RFK Jr. Tweaks HHS Vaccine Policy Panel Membership Criteria

    U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. is making changes to a key federal vaccine advisory panel's charter, according to a renewal notice the agency published Monday, after a Massachusetts federal judge last month declared Kennedy's committee picks "appear distinctly unqualified."

  • April 06, 2026

    Anthem Owes $2.1M For No Surprises Act Awards, Court Told

    Two medical providers said Anthem Blue Cross and Blue Shield owes them a combined $2.1 million for medically necessary services rendered to its insured members, telling a Colorado state court that the carrier is wrongfully withholding payment despite losing multiple federal arbitration proceedings.

  • April 06, 2026

    Biz Groups Urge 4th Circ. To End Allergan Overcharge Suit

    Major pharmaceutical and business associations urged the Fourth Circuit to reconsider a panel decision that revived a whistleblower lawsuit accusing an Allergan Sales LLC predecessor of overcharging Medicaid, warning it threatens to become a road map for False Claims Act abuses.

  • April 06, 2026

    Splenda Loses Bid To End Scientist's Libel Counterclaim

    The maker of Splenda lost its bid for a pretrial win on a scientist's counterclaims for libel after a North Carolina federal judge on Monday ruled they weren't filed too late because the counterclaims are directly linked to the company's defamation suit challenging her statements linking Splenda to cancer-causing chemicals.

  • April 06, 2026

    1st Circ. Suggests It May Resurrect AdTech Wiretap Case

    A panel of the First Circuit appeared receptive Monday to reinstating federal wiretap claims leveled against a Massachusetts healthcare system over its use of online tracking tools, despite arguments that such a ruling could cripple the industry amid an influx of similar cases nationwide.

  • April 06, 2026

    Cleary FCA Task Force Head On Enforcement Trends To Watch

    Former U.S. Attorney for the Eastern District of New York Breon Peace, who now leads a False Claims Act task force at Cleary Gottlieb Steen & Hamilton LLP, is predicting a continued surge in enforcement as the Trump administration wields the law in new ways.

  • April 06, 2026

    Mass. Justices Hint Insurer Owes Defense In Doc's Discipline

    An allegation that a Massachusetts doctor prescribed addictive medications to manipulate a patient into a sexual relationship could be enough to trigger a malpractice insurer's duty to defend him in a disciplinary proceeding launched years later over other alleged misconduct, justices on the state's highest court hinted Monday.

  • April 06, 2026

    WilmerHale Adds Regulatory Atty From Mayer Brown In DC

    WilmerHale announced Monday it has hired a veteran U.S. Food and Drug Administration and life sciences regulatory attorney from Mayer Brown LLP.

  • April 03, 2026

    Case-By-Case Guide As Justices Eye Landmark Pharma Law

    Drugmakers and prominent allies are inundating the U.S. Supreme Court with calls to scrutinize Medicare's new power to slash payments by tens of billions of dollars, and the justices look poised to take up or turn down a fistful of legal challenges in one fell swoop.

  • April 03, 2026

    Wash. DOC Inks Deal Over Trans Treatment In Facilities

    The Washington State Department of Corrections will start improving conditions for transgender, intersex and nonbinary people in its facilities and submit to yearly monitoring, according to a settlement agreement between the agency and a nonprofit in the state.

  • April 03, 2026

    SEC Moves To Set Up $40M Investor Fund In Cassava Case

    The U.S. Securities and Exchange Commission asked a Texas federal court on Friday to establish a $40 million fund to potentially compensate investors harmed by a Texas biopharmaceutical company and two former executives' alleged misstatements about an Alzheimer's drug, following the company's 2024 settlement with the regulator.

Expert Analysis

  • 2025 State AI Laws Expand Liability, Raise Insurance Risks

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    As 2025 nears its end, claims professionals should be aware of trends in state legislation addressing artificial intelligence use, as insurance claims based on some of these liability-expanding statutes are a certainty, say attorneys at Wiley.

  • Learning From 2025 FCA Trends Targeting PE In Healthcare

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    False Claims Act enforcement trends and legislative developments from this year signal intensifying state and federal scrutiny of private equity's growing footprint in healthcare, and the urgency of compliance, says Lisa Re at Arnold & Porter.

  • How 11th Circ.'s Qui Tam Review Could Affect FCA Litigation

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    On Dec. 12, the Eleventh Circuit will hear arguments in U.S. ex rel. Zafirov v. Florida Medical Associates, setting the stage for a decision that could drastically reduce enforcement under the False Claims Act, and presenting an opportunity to seek U.S. Supreme Court review of the act's whistleblower provisions, say attorneys at Epstein Becker.

  • How MAHA Is Taking Shape At The State Level

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    The national spotlight on the federal government's Make America Healthy Again movement is bolstering state-level actions regarding potential health impacts of certain food ingredients, increasing the difficulty and importance of maintaining effective compliance programs, say attorneys at Cooley.

  • A Look At Middlemen Fees In 340B Drug Discount Program

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    A U.S. Senate committee's recent hearing on the Section 340B drug discount program, along with statistical analysis of payment amounts, contribute to a growing consensus that middlemen fees are too high, say William Sarraille at the University of Maryland, and Shanyue Zeng and Rory Martin at IQVIA.

  • Nursing Home Abuse Cases Face 3 Barriers That Need Reform

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    Recent headlines reveal persistent gaps in oversight and protection for vulnerable residents in long-term care, but prosecution of these cases is often stymied by numerous challenges that will require a comprehensive overhaul of regulatory, legal and financial structures to address, says Veronica Finkelstein at Wilmington University.

  • Mulling Differing Circuit Rulings On Gender-Affirming Care

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    Despite the Eleventh Circuit's recent holding in Lange v. Houston County that a health plan's exclusion for gender-affirming surgery did not violate Title VII, employers should be mindful of other court decisions suggesting that different legal challenges may still apply to blanket exclusions for such care, say attorneys at Smith Gambrell.

  • State AGs May Extend Their Reach To Nat'l Security Concerns

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    Companies with foreign supply-chain risk exposure need a comprehensive risk-management strategy to address a growing trend in which state attorneys general use broadly written state laws to target conduct that may not violate federal regulations, but arguably constitutes a national security threat, say attorneys at Wiley.

  • Unique Aspects Of Texas' Approach To AI Regulation

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    The Texas Responsible AI Governance Act — which will soon be the sole comprehensive artificial intelligence law in the U.S. — pulls threads from EU and Colorado laws but introduces more targeted rules with fewer obligations on commercial entities, say attorneys at MVA Law.

  • Surveying The Healthcare Policy Landscape Post-Shutdown

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    With last week's agreement to reopen the federal government, at least through the end of January, key healthcare legislation that has been in limbo since a December 2024 spending bill fell apart may recapture the attention of Congress, say attorneys at Faegre Drinker.

  • FDA Biosimilar Guidance Should Ease Biologics Development

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    New draft guidance from the U.S. Food and Drug Administration, indicating that the agency may no longer routinely require comparative efficacy studies when other evidence provides sufficient assurance of biosimilarity, underscores the FDA's trust in analytical technology as a driver of biologics access, say attorneys at Hogan Lovells.

  • Prison Body Cams Raise Health Privacy Compliance Issues

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    The increasing use of prison staff body cameras to enhance transparency and safety presents correctional healthcare partners with new risk management questions where they must carefully reconcile the benefits of surveillance with the imperative to protect patient privacy, say attorneys at Gordon Rees.

  • Employer Considerations After 11th Circ. Gender Care Ruling

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    The Eleventh Circuit's en banc decision in Lange v. Houston County, Georgia, finding that a health plan did not violate Title VII by excluding coverage for gender-affirming care, shows that plans must be increasingly cognizant of federal and state liability as states pass varying mandates, say attorneys at Miller & Chevalier.