Policy & Compliance

  • September 24, 2025

    Trans Youth Care Ban Discriminatory, Mo. High Court Hears

    The Missouri Supreme Court heard arguments Wednesday on a law that bans gender-affirming care for minors and restricts Medicaid coverage for transgender care at any age, but the justices gave little indication of how they might rule.

  • September 24, 2025

    4th Circ. Kicks Trans Care Exclusion Suits Back To Trial Court

    A pair of suits challenging health plan coverage exclusions on gender-affirming care for minors are headed to district court after the Fourth Circuit vacated decisions finding those policies discriminatory, in line with a U.S. Supreme Court directive to revisit the cases in light of new precedent.

  • September 24, 2025

    Hall Booth Smith Grows In NJ With Aging Services Expert

    Hall Booth Smith PC built out its aging services practice this week with the hire of a Paramus, New Jersey-based of counsel attorney specializing in litigation and risk management for clients in the acute care and post-acute care fields.

  • September 24, 2025

    States Say Ed Dept. Must Face Suit Over Mental Health Cuts

    A group of 16 states led by Washington has asked a federal judge not to let the U.S. Department of Education escape the states' claims that the agency violated federal law by discontinuing mental health grants given to public schools to help students cope with school shootings.

  • September 24, 2025

    Amtrak Beats Retired Worker's Suit Over Benefits Reversal

    A Rhode Island federal judge dismissed an ex-Amtrak employee's suit claiming the company illegally rolled back medical care reimbursement benefits that the rail service said it mistakenly granted him in retirement, finding he wasn't entitled to the extra credits under the plan's terms.

  • September 23, 2025

    Fed. Vaccine Panel Prompts Legal, Health Confusion

    It's been days since a Centers for Disease Control and Prevention committee updated recommendations for a common childhood vaccine and the COVID-19 booster. But healthcare and legal experts are still trying to understand the implications of the meeting and the votes that came out of it.

  • September 23, 2025

    Kansas Abortion Mandates On Trial: What You Need to Know

    The largest provider of reproductive healthcare in Kansas will face off with state officials this week at a long-awaited trial focused on a 24-hour abortion waiting period, among other state requirements.

  • September 23, 2025

    Tylenol MDL In Spotlight After Trump Blasts Use In Pregnancy

    The Trump administration's attack on the use of acetaminophen during pregnancy drew on the work of a Harvard expert whose analysis is central to a legal clash now before a federal appeals court. The president's broadside promises to energize plaintiffs.

  • September 23, 2025

    State Medicaid Cuts Mean 'Financial Squeeze' For Providers

    Law360 Healthcare Authority talks with Gayland Hethcoat of ArentFox Schiff LLP about the rationale behind major cuts coming to Medicaid state-directed payments and what they will mean for providers and patients.

  • September 23, 2025

    NC Sens. Vote To Cut Planned Parenthood's Medicaid Funds

    Republican state senators in North Carolina have greenlit a bill that would revoke Medicaid funding for Planned Parenthood, aligning the Tar Heel state with the president's "One Big Beautiful Bill," which prohibits Medicaid funding for nonprofit groups that provide abortion services.

  • September 23, 2025

    Long Time Limits In Trans Care Laws Expand Doctors' Liability

    State lawmakers are including lengthy statutes of limitations — some of them decades-long — in new bans on transgender care for minors. Advocates say long time frames for prosecutions or civil suits make sense when a child is involved. Others see a "chilling" effect for providers.

  • September 23, 2025

    EX-CTA Worker's $425K Vaccine Bias Award Capped At $300K

    An Illinois federal judge lowered a former Chicago Transit Authority employee's $425,000 jury award to $300,000 Tuesday for the ex-worker's claim that he was wrongly fired for refusing the COVID-19 vaccine, entering a judgment the judge said he'll later amend with awards that include back and front pay.

  • September 23, 2025

    Two Longtime HHS Attys Depart Posts For Crowell & Moring

    Two prominent U.S. Department of Health and Human Services attorneys have left their posts for Crowell & Moring LLP after more than two decades in the federal government.

  • September 23, 2025

    Burns White Launches Correctional Healthcare Practice Group

    Pittsburgh-based Mid-Law firm Burns White LLC has launched a practice group focused on helping clients navigate liability risk from providing healthcare in prisons and other correctional settings.

  • September 23, 2025

    Pa. Health Network To Pay $1.15M In 401(k) Forfeiture Suit

    A Pennsylvania health system agreed to pay workers $1.15 million to resolve a federal suit alleging it unlawfully used forfeited retirement plan funds to satisfy its contribution obligations and allowed workers to be overcharged for plan administrative fees.

  • September 22, 2025

    2nd Circ. Undoes $25M Restitution In Horse-Doping Case

    A veterinarian convicted of conspiracy in a sprawling horse-doping scheme has escaped $25 million in restitution and is also off the hook for the $10.3 million forfeiture of funds tied to the sale of undetectable, performance-enhancement drugs, the Second Circuit said Monday.

  • September 22, 2025

    Family Sues For $100M In Child's Hyperbaric Chamber Death

    The family of a 5-year-old boy who died in a hyperbaric chamber explosion in January sued the center that was treating the child and the manufacturer of the chamber for more than $100 million in damages Monday, alleging the Michigan clinic concealed the dangers of using the chamber. 

  • September 22, 2025

    Anthem's $12.9M ERISA Deal Clears First Hurdle

    A New York federal judge has granted preliminary approval to a nearly $12.9 million settlement resolving claims that Anthem wrongfully denied coverage for residential behavioral health treatment under employer-sponsored health plans.

  • September 22, 2025

    Mayo Clinic Can't Fully Nix Suit Over Withheld Benefits Info

    The Mayo Clinic and its benefits administrator can't entirely escape a worker's suit claiming they pushed her to work with pricey out-of-network providers and wouldn't provide reimbursement estimates, after a Minnesota federal judge said she supported some federal benefits law claims with enough detail to remain in court.

  • September 19, 2025

    Ga. Providers Seek Exit From 'Conspiratorial' BCBS Fraud Suit

    Healthcare consulting firm HaloMD and several providers urged a federal judge Friday to toss a lawsuit from Blue Cross Blue Shield of Georgia accusing them of abusing a federal dispute resolution process for surprise medical bills, arguing the insurer's suit offers little more than "inflammatory, conspiratorial rhetoric."

  • September 19, 2025

    CDC Panel Urges Caution On COVID Vax, Punts On Hep B

    A panel of advisers at the Centers for Disease Control and Prevention on Friday voted unanimously to recommend that people receiving the COVID-19 vaccine this season do so only after discussing it with their health providers.

  • September 18, 2025

    Brothers Blame Associate For $90M HIV Drug Fraud Scheme

    Two Maryland brothers accused of selling $90 million worth of mislabeled HIV drugs told a Florida federal jury on Thursday that their charges stem from an associate hired for his pharmaceutical industry connections, but who instead lied about the medication's black market origins and told them it was purchased legitimately.

  • September 18, 2025

    Mich. Top Court To Weigh Medicare's Role In No-Fault Cases

    Michigan's highest court will weigh whether an injured driver who opted out of personal injury protection due to his Medicare coverage must offset his damages by billing the insurance program for accident-related medical expenses in a no-fault dispute. 

  • September 18, 2025

    HHS Shutters Miami Organ Donor Org. For 'Unsafe' Practices

    Federal health officials have decertified a Miami-based organ procurement organization that arranges organ donations after an investigation found a pattern of "unsafe" practices, marking the first time the federal government has revoked the certification of such a group, according to an announcement Thursday from Health Secretary Robert F. Kennedy Jr. 

  • September 18, 2025

    Elevance Won't Cover Zepbound To Treat Apnea, Patient Says

    Elevance Health, formerly known as Anthem Inc., arbitrarily excludes coverage of FDA-approved Zepbound to treat moderate to severe obstructive sleep apnea and refuses to consider requests for exceptions by maintaining that the medication is for weight loss, alleges a proposed class action filed by an enrollee in Indiana federal court Tuesday.

Expert Analysis

  • Drug Kickback Ruling Will Make FCA Liability Harder To Prove

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    The First Circuit's ruling in U.S. v. Regeneron Pharmaceuticals, requiring the government to prove but-for causation to establish False Claims Act liability based on violations of the Anti-Kickback Statute, raises the bar for FCA enforcement and deepens a circuit split that the U.S. Supreme Court may need to resolve, say attorneys at Baker Donelson.

  • Assessing PE Risk After Mass. False Claims Act Amendments

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    A law recently passed in Massachusetts amends the commonwealth's False Claims Act by dramatically expanding potential liability for private equity firms and investors, underscoring the importance of robust diligence and risk assessments for private equity firms conducting transactions in the commonwealth, say attorneys at Gibson Dunn.

  • What Trump Actions Mean For Federal Research Funding

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    New guidance from the National Institutes of Health represents a massive policy shift regarding federal funding for researchers at institutions of higher education, contributing to a perfect storm of significant resource shortfalls in upcoming years, say attorneys at Arnold & Porter.

  • A Look At Healthcare Transaction Oversight In Oregon

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    Understanding Oregon's enforcement authority and its impact on proposed transactions last year provides a road map to the state's plans to strengthen its processes this year, though enforcement could be challenged by ongoing litigation, say attorneys at Ropes & Gray.

  • Rethinking 'No Comment' For Clients Facing Public Crises

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    “No comment” is no longer a cost-free or even a viable public communications strategy for companies in crisis, and counsel must tailor their guidance based on a variety of competing factors to help clients emerge successfully, says Robert Bowers at Moore & Van Allen.

  • High Court Must Acknowledge US History Of Anti-Trans Laws

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    Despite Justice Amy Coney Barrett's claim to the contrary during oral arguments in U.S. v. Skrmetti, U.S. governments at every level have systematically discriminated against transgender people, and the U.S. Supreme Court must consider this historical context in upcoming cases about transgender issues, says Paisley Currah at the City University of New York.

  • The Fate Of Biden-Era Clinical Study Guidance Under Trump

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    Draft guidance about the study of sex and gender differences in medical product development issued by the outgoing Biden administration currently faces significant uncertainty and litigation potential due to the Trump administration's executive orders and other actions, say attorneys at Arnold & Porter.

  • 10 Issues To Watch In Aerospace And Defense Contracting

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    This year, in addition to evergreen developments driven by national security priorities, disruptive new technologies and competition with rival powers, federal contractors will see significant disruptions driven by the new administration’s efforts to reduce government spending, regulation and the size of the federal workforce, say attorneys at Thompson Hine.

  • Dispelling 10 Myths About Health Provider-Based Compliance

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    Congress appears intent on requiring hospitals to submit provider-based attestations for all off-campus outpatient hospital locations, so now is the time for hospitals to prepare for this change by understanding common misconceptions about provider-based status and proactively correct noncompliance, say attorneys at McDermott.

  • A Look At HHS' New Opinion On Patient Assistance Programs

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    A recent advisory opinion from the U.S. Department of Health and Human Services' Office of Inspector General follows a recent trend of blessing patient assistance program arrangements that implicate the Anti-Kickback Statute, as long as they are structured with appropriate safeguards to minimize the risk of fraud and abuse, say attorneys at Sheppard Mullin.

  • 2 Anti-Kickback Developments Hold Lessons For Biopharma

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    The U.S. Department of Justice's Anti-Kickback Statute settlement with QOL Medical and a favorable advisory opinion from the U.S. Department of Health and Human Services provide a study in contrasts, but there are tips for biopharma manufacturers trying to navigate the vast compliance space between them, says Mary Kohler at Kohler Health Law.

  • Tips For Pharma-Biotech Overlap Reporting In New HSR Form

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    While there’s no secret recipe for reporting overlaps to the Federal Trade Commission in the new Hart-Scott-Rodino Act form, there are several layers of considerations for all pharma-biotech companies and counsel to reflect on internally before reporting on any deal, say attorneys at A&O Shearman.

  • A Look At Drug Price Negotiation Program's Ongoing Impact

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    More than two years after the passage of the Inflation Reduction Act and the rapid implementation of the drug price negotiation program, attorneys at Ropes & Gray discuss how the IRA has influenced licensing strategies, and how maximum fair prices under the law have economically affected certain drugs.