Policy & Compliance

  • November 18, 2025

    Eye Doc's Hospital Competition Lawsuit Gets NC Panel Trial

    Five years after being denied “certificate of need” application for an eye surgery center, a North Carolina doctor was in court Tuesday challenging a state law that has been on the books in some form since the Carter administration.

  • November 18, 2025

    Feds Look To 'False Certification' FCA Strategy

    Prosecutors shifted strategy in a kickback case against a biotech giant. FCA attorneys are closely watching the Regeneron case for clues on how the DOJ will establish causation in a growing number of states implicated by recent circuit court rulings.

  • November 18, 2025

    McGuireWoods Is Delaying Defamation Case, NC Justices Told

    The former CEO of a managed care organization who alleges McGuireWoods and one of its ex-partners defamed him during a press conference more than seven years ago has told North Carolina's top court not to take up the case, panning their petition as yet another stalling tactic.

  • November 18, 2025

    Massage Therapist Prevails In Fla. Health Dept. License Saga

    Florida health officials' yearslong effort to revoke a massage therapist's license resulted in a notable appeals court decision that found a licensing board wrongly disregarded an administrative law judge's findings. 

  • November 17, 2025

    DC Circ. Mulls If Gov't Can Say No To 340B Rebate Program

    The D.C. Circuit is set to decide "who's the decision-maker" in a fight brought by drugmakers over the federal government's efforts to reshape the way they do drug rebates after spending more than an hour and a half Monday morning hearing out all sides.

  • November 17, 2025

    2 Execs Found Guilty In $233M ACA Fraud Scheme

    A Florida federal jury returned a guilty verdict on Monday against a marketing company CEO and insurance brokerage executive who were accused of submitting fraudulent enrollments to fully subsidized Affordable Care Act insurance plans to get millions in commission payments from insurers.

  • November 17, 2025

    B. Braun Unit Inks $38.5M Deal To End FCA Knee Implant Case

    The U.S. Department of Justice on Monday announced a $38.5 million False Claims Act settlement with a subsidiary of German medical device giant B. Braun Melsungen AG resolving accusations it sold a knee replacement implant allegedly known to fail prematurely after surgery.

  • November 17, 2025

    2nd Circ. Questions Experts' Rejection In Tylenol Autism Suits

    A Second Circuit panel on Monday appeared skeptical of a lower-court order that barred every expert witness set to testify for families who allege that patients taking Tylenol while pregnant can cause autism or attention deficit hyperactivity disorder in their children.

  • November 17, 2025

    Hospital Inks $335K Deal To End EEOC Gender Bias Suit

    A Kentucky federal judge signed off Monday on a $335,000 settlement to end a U.S. Equal Employment Opportunity Commission suit claiming a hospital system fired its chief nursing officer after she complained that she lost a promotion due to her gender.

  • November 17, 2025

    Mass. Justices Say Panel Overstepped In Sepsis Death Suit

    Massachusetts' highest court on Monday reinstated medical malpractice claims against a nurse practitioner over a patient's sepsis death, saying a tribunal had stepped beyond its role in vetting an offer of proof by the man's widow.

  • November 17, 2025

    9th Circ. Strikes Down Trans Patients' Win In ACA Bias Case

    The Ninth Circuit upended a win Monday for patients who challenged Blue Cross Blue Shield of Illinois' administration of their employer-provided health plans containing gender-affirming care exclusions, ordering a lower court to reexamine the case in light of intervening authority from the U.S. Supreme Court.

  • November 17, 2025

    Corporate Pilot Fired For Flagging Safety Concerns, Suit Says

    The former head of aviation for an oral surgery management services company in North Carolina says he was canned because of his age and hearing disability and for allegedly reporting flight scheduling practices that he said flouted federal safety laws.

  • November 17, 2025

    No High Court Review For FDA Fast-Track Denial

    The U.S. Supreme Court on Monday said it would not consider whether federal drug regulators went astray in denying fast-track review for a digestive disorder medication being developed by Vanda Pharmaceuticals.

  • November 14, 2025

    Texas Judge Rejects Bid To Block Kenvue's $398M Dividend

    Texas can't stop the makers of Tylenol from marketing the drug as safe for children and pregnant women or halt a nearly $400 million payment to shareholders, a state court ruled on Friday, rejecting arguments by Attorney General Ken Paxton's motion.

  • November 14, 2025

    Fla. Pharmacy To Pay $17M To Settle COVID False Claims Case

    A Tampa, Florida, pharmacy has agreed to pay over $17 million to settle allegations that it knowingly filed false Medicare claims for over-the-counter COVID-19 tests that hadn't gone out to recipients.

  • November 14, 2025

    Drug Buyers Defend Class Cert. In 3rd Circ. Generics Case

    Direct purchasers and end-payers in the sprawling multidistrict litigation over alleged price-fixing of generic drugs are fighting requests from Actavis and Mylan to undo class certification in the cases, arguing to the Third Circuit that the litigation is a classic example of a class action matter.

  • November 14, 2025

    10th Circ. Sides With Rehab Facility In Bias, Retaliation Suit

    The Tenth Circuit refused Friday to reopen an occupational therapist's lawsuit claiming she was unceremoniously let go by a Kansas rehabilitation clinic for reporting a colleague's inappropriate behavior toward women, saying she couldn't revive her suit using arguments the trial court never considered.

  • November 14, 2025

    Horizon BCBS To Pay $100M To End NJ AG's Overcharge Suit

    Horizon Blue Cross Blue Shield of New Jersey has agreed to pay the state $100 million to resolve allegations that it fraudulently secured a multibillion-dollar contract to administer public employee health plans and then systematically overcharged taxpayers for years, Attorney General Matthew J. Platkin announced Friday.

  • November 13, 2025

    NC Biz Court Bulletin: Rulings Spotlight Coverage Clashes

    The North Carolina Business Court plowed into the fourth quarter with two big decisions in insurance disputes that involved $50 million in COVID-19-related losses at a chain of outlet malls, and an industrial accident at a Nucor Corp. iron plant in Louisiana.

  • November 13, 2025

    Donor Info Subpoena Chills Speech, Anti-Abortion Org Says

    An organization that operates anti-abortion pregnancy centers told the U.S. Supreme Court on Thursday that New Jersey is undermining its own subpoena power in a bid to avoid constitutional review of its request for information about the group's donors.

  • November 13, 2025

    Weight-Loss Drug MDL In Pa. Grows With 3 New Jersey Cases

    Three New Jersey cases were grouped into multidistrict litigation accusing Eli Lilly & Co. and Novo Nordisk of downplaying alleged side effects of weight loss drugs like Ozempic and Trulicity, according to a transfer order filed in Pennsylvania federal court.

  • November 13, 2025

    Claims Firms Accused Of Misleading Plaintiffs In Pharma MDL

    A Pennsylvania federal judge has been asked to slow down aggressive marketing campaigns from claims recovery firms that are accused of using false and misleading advertising to attract plaintiffs in a multidistrict litigation action against pharmaceutical companies.

  • November 12, 2025

    Valsartan Cancer Expert Blocked, Ending First Injury Trial

    What was set to be the first bellwether case in the sprawling multidistrict litigation over contaminated blood pressure medication Valsartan was decided Monday when a New Jersey federal judge excluded as "pure speculation" the plaintiff's medical expert who testified that the drug caused a patient's liver cancer.

  • November 12, 2025

    Judge Questions Cigna Site Users' Standing In Data Suit

    A Pennsylvania federal judge suggested Wednesday that she may toss a proposed class action alleging Cigna failed to safeguard private health data by tracking plan members' website usage in violation of state wiretapping and federal privacy laws, ordering the plaintiffs to demonstrate that they have standing to sue.

  • November 12, 2025

    Judge Won't Halt Injunction Blocking Trump's Trans Care Ban

    A Washington federal judge rejected the Trump administration's bid to halt a temporary injunction, saying the president took too long to request a pause in the order, which blocks federal officials from withholding federal healthcare funds to hospitals in four states that provide gender-affirming care. 

Expert Analysis

  • What 2024 Tells Us About Calif. Health Transaction Reviews

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    Looking back at the California Office of Health Care Affordability's first year accepting notices for material healthcare transactions reveals critical lessons on what the OHCA's review process may mean for the future of covered transactions in the state, say attorneys at Ropes & Gray.

  • Updated HIPAA Rule Is A Necessary Step For Data Protection

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    The U.S. Department of Health and Human Services' updated rules addressing cybersecurity threats in healthcare will necessitate significant investment in technology, training and compliance infrastructure, but are an essential evolution in safeguarding data in an increasingly digital world, say attorneys at Clark Hill.

  • Courts Must Curb The Drug Price Negotiation Program

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    The Inflation Reduction Act's drug price negotiation program upends incentive structures that drive medical innovation, and courts must act appropriately to avoid devastating consequences for American healthcare and the pharmaceutical industry, says Jeff Stier at the Consumer Choice Center.

  • The OIG Report: Preparing For Oversight In 2025

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    Across sectors, Office of Inspector General work plans and challenge reports for 2025 provide a trove of information on the issues and industries that will likely be the focus of government oversight in the year to come, says Diana Shaw at Wiley.

  • 5 Drug And Device Developments That Shaped 2024

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    The last year saw significant legal developments affecting drug and device manufacturers, with landmark decisions and regulatory changes that require vigilance and agility from the industry, say attorneys at Faegre Drinker.

  • How New Fraud Enforcement Tool Affects Gov't Contractors

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    Government contractors will likely face greater scrutiny under the recently enacted Administrative False Claims Act, which broadens federal agencies' authority to pursue low-dollar fraud claims, but contractors may also find the act makes settlement of such claims easier to negotiate, say attorneys at Wiley.

  • Consultants Should Be Aware Of DOJ's Potential New Reach

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    The U.S. Department of Justice's recent first-of-its-kind settlement with McKinsey & Co. indicates not only the DOJ's more aggressive stance toward businesses' potential criminal wrongdoings, but also the benefits of self-disclosure and cooperation when wrongdoing becomes apparent, says Dom Caamano at Kibler Fowler.

  • Health Tech Regulatory Trends To Watch In 2025

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    With an upcoming change in administration and the release of some long-awaited rules, the healthcare industry should prepare for shifting trends, including a growing focus on health data and interest in technology-enabled delivery of healthcare, say attorneys at Orrick.

  • 10 Noteworthy CFPB Developments From 2024

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    In a banner year for consumer finance regulation, the Consumer Financial Protection Bureau made significant strides in its efforts to rein in Big Tech and nonbank financial firms, including via rules regarding open banking, credit card late fees, and buy now, pay later products, say attorneys at Wiley.

  • The Future Of GLP-1 Policy After Drug Shortage Ends

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    If and when the U.S. Food and Drug Administration determines that GLP-1 RA drugs are no longer in short supply, regulators will face questions of how to balance access to GLP-1 RAs with statutory and policy considerations applicable to compounded drugs, say attorneys at Skadden.

  • Top 10 Whistleblowing And Retaliation Events Of 2024

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    From a Florida federal court’s ruling that the False Claims Act’s qui tam provision is unconstitutional to a record-breaking number of whistleblower tips filed with the U.S. Commodity Futures Trading Commission, employers saw significant developments in the federal and state whistleblower landscapes this year, say attorneys at Proskauer.

  • How White Collar Defense Attys Can Use Summary Witnesses

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    Few criminal defense attorneys have successfully utilized summary witnesses in the past, but several recent success stories show that it can be a worthwhile trial tactic to help juries understand the complex decision-making at issue, says Jonathan Porter at Husch Blackwell.

  • Nutraceutical Patent Insights As Market Heats Up

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    Companies entering the expanding nutraceutical market and seeking patents to protect their innovations should evaluate successful nutraceutical claim language and common patent challenges in this field, say attorneys at Sterne Kessler.