Policy & Compliance

  • March 24, 2026

    $5.7M Cigna Ghost Network Deal Receives Final Go-Ahead

    An Illinois federal judge gave his final sign-off Tuesday to a $5.7 million settlement in what he called an "interesting" case accusing Cigna of improperly advertising out-of-network providers as though they're in-network for certain benefit plans it administered.

  • March 24, 2026

    Health Co. Escapes Workers' 401(k) Forfeiture Suit In La.

    A Louisiana federal judge agreed to toss a federal benefits lawsuit against a health company from workers who alleged the company misspent forfeitures from their employee 401(k) plan, rejecting the workers' argument that funds should have gone toward defraying expenses instead of lowering employer-side contribution obligations.

  • March 24, 2026

    Utah Hospitals To Track Violence As States Step Up Reporting

    Under a new law, Utah hospitals will join a national effort to better understand the risks facing healthcare workers.

  • March 24, 2026

    Ohio Justices Likely Split On Trans Care Restrictions

    The Ohio Supreme Court appeared split Tuesday as to whether a new state law banning gender-affirming care for minors trumps a decade-old healthcare freedom provision passed by voters that says state laws can't block a patient from obtaining healthcare. 

  • March 24, 2026

    Fraud Task Force May Boost White Collar Defense Work

    A new federal anti-fraud task force involving at least a dozen federal agencies could soon expose more state and local governments, contractors, companies and others to compliance risks, particularly in healthcare fraud and False Claims Act cases, experts say.

  • March 24, 2026

    Justices Won't Review Class Cert. In Diabetes Drug Risk Case

    The U.S. Supreme Court has declined to review whether a federal court can certify a class of third-party payors who claim drugmakers hid the cancer risks of an anti-diabetes drug.

  • March 24, 2026

    Mass General Accused Of Shaving Time From Workers' Pay

    Boston-based healthcare system Mass General Brigham shaved as much as 14 minutes a day from employees' pay by rounding their clock-in and clock-out times, according to a proposed class and collective action filed in federal court.

  • March 23, 2026

    J&J Amici Seek Clarity On Goldman Precedent For Class Cert.

    Four groups of amici have urged the U.S. Supreme Court to take up Johnson & Johnson's challenge to a Third Circuit decision allowing a securities class action over its talc products to proceed, warning the ruling could reshape how shareholder suits are litigated nationwide.

  • March 23, 2026

    FTC Stays Focused On Healthcare, Launches Task Force

    The Federal Trade Commission announced it is launching a new task force with staff from across the agency to coordinate healthcare policy approaches and initiate investigations meant to help protect patients, healthcare workers and American taxpayers.

  • March 23, 2026

    Progressive Escapes Workers' Tobacco, Vaccine Fee Suit

    Allegations that Progressive Corp. wrongly charged higher health premiums from workers who used tobacco or refused the COVID-19 vaccination failed to state a claim for violating federal benefits law, an Ohio federal judge ruled as he tossed a proposed class action against the insurance giant.

  • March 23, 2026

    Feds Approve Minnesota's Plan To Combat Medicaid Fraud

    Minnesota may soon receive the release of $243 million in deferred Medicaid funds after the Centers for Medicare & Medicaid Services approved the state's updated plan to combat Medicaid fraud, Minnesota state health officials told a federal court last week.

  • March 23, 2026

    Health Insurers Can't Force Conn. ERISA Row Into Arbitration

    Elevance Inc. can't compel arbitration of a union health plan's allegations the insurer caused it to pay excessive administrative fees and medical costs, a Connecticut federal judge ruled, finding the insurer and its subsidiaries waived that right by seeking to dismiss the proposed class action.

  • March 23, 2026

    High Court Won't Hear Mich. Newborn Blood Testing Case

    The U.S. Supreme Court on Monday declined to hear a petition from parents seeking to revive claims that the way newborn blood samples are collected and stored in a Michigan health screening program violates their rights to make medical decisions for their children.

  • March 23, 2026

    Justices Won't Review Lab Owner's Kickback Conviction

    The U.S. Supreme Court on Monday declined to review the conviction of a former California biotech president sentenced to eight years in prison for lying about the efficacy of his company's COVID-19 and allergy testing and conducting a $70 million Medicare fraud scheme. 

  • March 23, 2026

    High Court Won't Hear Calif. Border Hospital Medicaid Fight

    The U.S. Supreme Court said Monday it would not consider a case challenging California's exclusions of hospitals in neighboring states from supplemental federal payments going to providers that serve Medi-Cal beneficiaries.

  • March 20, 2026

    Feds Rip Ex-NFL Player's New Trial Bid Over Medicare Scheme

    The federal government opposed a new trial bid by Keith Gray, a former NFL player and Texas laboratory owner convicted in a $328 million scheme involving billing for unnecessary cardiovascular genetic testing for Medicare beneficiaries, arguing Thursday he lacks any valid basis to "disturb the jury's sound verdict."

  • March 20, 2026

    EPA's Ethylene Oxide Plan May Hinder Other Air Toxics Regs

    A new proposal from the U.S. Environmental Protection Agency to weaken emission standards for a medical sterilizer could have broader implications for the agency's power to tighten air pollution limits when new science becomes available.

  • March 20, 2026

    Pa. Hospital Must Pay $109M For Brain Injury During Birth

    Jefferson Health and its subsidiary Einstein Healthcare Network have been hit with a nearly $109 million verdict by a Philadelphia jury in a lawsuit accusing them of negligence leading to debilitating brain injuries sustained by a child delivered at one of their hospitals.

  • March 20, 2026

    Mich. BCBS Unit Gets Health Plans' Claims Fight Transferred

    A federal judge granted Blue Cross Blue Shield of Michigan's request to transfer a proposed class action alleging the insurance company violated federal benefits law by mismanaging claims in self-funded employee healthcare plans it administered, given that a similar, earlier-filed action was proceeding in an adjacent district.

  • March 20, 2026

    Eye On ERISA: A Chat With King & Spalding's Darren Shuler

    Increased scrutiny of health plans and the high costs of care are fueling a litigation uptick that's coming not just from plan participants but also from employers frustrated with their third-party administrators, said Darren Shuler, a partner at King & Spalding LLP. Here, Shuler speaks with Law360 about litigation trends involving the Employee Retirement Income Security Act.

  • March 19, 2026

    HHS Can't Block Trans Care Under Kennedy Edict, Court Says

    A coalition of 21 states and the District of Columbia prevailed on Thursday in their challenge to a Trump administration move to cut access to gender-affirming care for minors when an Oregon federal judge agreed to void a policy statement from Health and Human Services Secretary Robert F. Kennedy Jr.

  • March 19, 2026

    Pharma Group Can't Halt Colo. Law Over Drug Discount Rules

    A Colorado federal judge denied a bid by the Pharmaceutical Research and Manufacturers of America seeking to halt enforcement of a state law guarding providers' ability to contract with pharmacies to distribute discounted drugs under the federal 340B program.

  • March 19, 2026

    Legislative Update: Cannabis And Psychedelics Bill Roundup

    Virginia lawmakers last week gave final approval to legislation that would tax and regulate the sale of adult-use cannabis, Georgia legislators passed a dramatic expansion of the state's medical cannabis program, and Iowa lawmakers approved a bill to designate kratom as a Schedule I substance. Here are the major moves in cannabis and psychedelics legislation from the past week.

  • March 19, 2026

    11th Circ. Partially Reopens Aetna Twin Birth Coverage Fight

    The Eleventh Circuit on Thursday undid Aetna's escape from a worker's coverage dispute over an extended hospital stay for her newborn twins, agreeing with the lower court that allegations failed to state a claim for violating federal benefits law but holding that an amended complaint should have been allowed.

  • March 19, 2026

    Calif. Families Sue Rady Health Over Move To End Trans Care

    Four families have asked a state judge to prevent California's largest pediatric health system from cutting off gender-affirming care for minors, alleging the move would violate state antidiscrimination laws and leave them scrambling to find new providers, some more than 100 miles away.

Expert Analysis

  • 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.

  • How Healthcare Practices Can Prepare For ICE Visits

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    Healthcare providers that may face encounters with immigration enforcement should familiarize themselves with compliance obligations beyond ensuring employment authorization, and mitigate risk by establishing clear policies and specific procedures that safeguard patient rights and manage staff interactions with agents, say attorneys at Roetzel & Andress.

  • Adapting To Calif.'s Enhanced Regulation Of PE In Healthcare

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    New California legislation enhances oversight on the role of private equity groups and hedge funds in healthcare transactions, featuring both a highly targeted nature and vague language that will require organizations to carefully evaluate existing practices, says Andrew Demetriou at Husch Blackwell.

  • Lessons From 7th Circ. Decision Affirming $183M FCA Verdict

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    The Seventh Circuit's decision to uphold a $183 million False Claims Act award against Eli Lilly engages substantively with recurring materiality and scienter questions and provides insights into appellate review of complex trial court judgments, say Ellen London at London & Naor, Li Yu at Bernstein Litowitz and Kimberly Friday at Osborn Maledon.

  • Calif. Justices Continued Anti-Arbitration Trend This Term

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    In the 2024-2025 term, the California Supreme Court justices continued to narrow arbitration's reach under state law, despite state courts' extreme caseload backlog and even as they embraced contractual autonomy in other contexts, says Josephine Petrick at The Norton Law Firm.

  • Steps For Healthcare Providers After Cigna ERISA Settlement

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    Following the Cigna class action's settlement, where Employee Retirement Income Security Act violations arose from Cigna's online provider directory advertising providers as in-network who were actually out-of-network, providers should routinely audit their contract status and directory listings, and proactively coordinate with plans and payor partners, say attorneys at ArentFox Schiff.

  • What's New In FDA's Latest Cell And Gene Therapy Guidance

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    New draft guidance from the U.S. Food and Drug Administration, along with other recent initiatives, come together to promote cell and gene therapy product development by streamlining development and review pathways, say attorneys at Holland & Knight.

  • Adapting To Enforcement Focus On Wound Care Fraud

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    As federal agencies target wound care industry fraud as a top enforcement priority, attorneys advising industry stakeholders should evaluate business relationships for Anti-Kickback Statute violations, emphasize appropriate product use and documentation, and use internal data analytics to monitor billing patterns, say David Tarras at Tarras Defense and Jay McCormack at Verrill Dana.

  • AG Watch: Illinois A Key Player In State-Level Enforcement

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    Illinois Attorney General Kwame Raoul has systematically strengthened his office to fill federal enforcement gaps, oppose Trump administration mandates and advance state policy objectives, particularly by aggressively pursuing labor-related issues, say attorneys at Troutman.