Policy & Compliance

  • May 01, 2025

    PBMs Tell 6th Circ. Ohio's Pricing Case Belongs In Fed Court

    Express Scripts and Prime Therapeutics urged the Sixth Circuit to undo a district court order returning a lawsuit from Ohio's attorney general alleging they drove up prescription drug prices to state court, arguing Wednesday an after-the-fact disclaimer of federal program-based claims isn't enough to sever a federal law connection.

  • May 01, 2025

    J&J Talc Unit Says New Doc 'Key' To Talc Study Libel Suit

    A Johnson & Johnson talc unit has asked a New Jersey federal court to reinstate its libel suit over a scientific article linking talcum powder to mesothelioma, arguing that newly discovered evidence shows statements in the article are false.

  • May 01, 2025

    Payment Math Dooms Sandoz Price-Fixing Deal With Florida

    A Connecticut federal judge on Thursday refused to put a bow on the deal the state of Florida struck with Sandoz AG and related defendants in three generic drug price-fixing lawsuits, ruling from the bench in Hartford that the settlement agreement "as written" would lead to exorbitant supplemental payments in the event that other states also reach deals to release their claims.

  • May 01, 2025

    Ex-Conn. State Employee Cops To $1.8M Medicaid Scam Role

    A former Connecticut government employee admitted to playing a part in a $1.8 million scheme to defraud the Constitution State's Medicaid program by fraudulently billing services for children with autism that her company never provided, acting U.S. Attorney Marc H. Silverman has announced.

  • May 01, 2025

    Rehab Center To Pay $19.75M To Resolve FCA Case

    A New Jersey drug and alcohol rehabilitation center will pay $19.75 million to resolve claims that it violated the False Claims Act by concealing it had no license from state regulators and billed the Veterans Health Administration and Medicaid for its services.

  • April 30, 2025

    DOJ Urges 11th Circ. To Restore FCA Whistleblower Provision

    The U.S. Department of Justice told the 11th Circuit on Wednesday that a Florida federal judge was wrong to rule that the provision of the False Claims Act that lets whistleblowers bring suits on the government's behalf was unconstitutional, arguing that the judge erred in saying whistleblowers were an unappointed part of the federal workforce.

  • April 30, 2025

    SuperValu Fights New Trial Bid In Whistleblower Drug Case

    SuperValu urged an Illinois federal judge Tuesday not to overturn its defense win on whistleblower claims of systematic prescription overbilling, saying the whistleblowers are now making "kitchen sink arguments" with little basis.

  • April 30, 2025

    Atlanta Home Health Service Faces Overtime Class Action

    An Atlanta home healthcare service was hit with a proposed class action Wednesday over allegations it failed to pay certified nursing assistants proper overtime compensation.

  • April 30, 2025

    DOL, HHS Seek Nix Of Bid To Halt DOGE's Access To Systems

    The U.S. Department of Labor and the U.S. Department of Health and Human Services challenged a bid to halt agencies from giving Elon Musk's Department of Government Efficiency access to sensitive systems, telling a D.C. federal judge that a group of unions didn't show personal information would be leaked.

  • April 30, 2025

    Kratom Cos. Get False Ad, Addiction Suit Tossed

    A California federal judge has dismissed a proposed class action alleging Thang Botanicals and FTLS Holdings LLC mislead consumers about addictive qualities of their kratom products after the plaintiffs failed to file an amended complaint on time.

  • April 29, 2025

    Gilead Will Pay $202M In DOJ Deal Over Drug Kickbacks

    Gilead agreed to pay $202 million to the federal government and some states to resolve claims it made improper payments to high-volume prescribers of its HIV drugs, New York federal prosecutors announced Tuesday.

  • April 29, 2025

    Omnicare Hit With $136M Jury Verdict For Bilking Feds

    A New York federal jury on Tuesday returned a verdict finding that CVS Health Corp. subsidiary Omnicare illegally billed the federal government to the tune of $135.6 million, one of the largest jury verdicts in a False Claims Act case, according to a statement from the U.S. Department of Justice.

  • April 29, 2025

    Ohio Justices Reinstate Trans Care Limits During AG's Appeal

    The Ohio Supreme Court on Tuesday reinstated state law limits on gender-affirming care for transgender youths pending Ohio Attorney General Dave Yost's appeal of what he called "radical constitutional views" of an Ohio state appeals court that last month blocked the restrictions.

  • April 29, 2025

    Trans Care In Court: DOJ Memo, Ohio Ban And Insurer Loss

    Ohio's highest court is allowing the state to enforce a law banning the use of puberty blockers and hormones for minors seeking to medically transition while the state's attorney appeals a ruling that portions of the law are unconstitutional.

  • April 29, 2025

    Justices Wary Of Issuing 'Advisory' Ruling In Class Cert. Row

    The U.S. Supreme Court's latest attempt to address a pressing question about class certification standards may be doomed by a procedural hiccup, with a majority of justices expressing concern Tuesday that they didn't have the authority to wade into a dispute over approval of a class that contains uninjured members.

  • April 29, 2025

    DC Judge Worries About 340B Rebate Program Without 'Teeth'

    The D.C. federal judge tasked with deciding dueling summary judgments in litigation accusing the government of blocking drugmakers' efforts to reshape the way they do rebates seemed skeptical of endorsing a vision of the program that could have "potentially devastating consequences."

  • April 29, 2025

    HHS Inspector Nominee A Partisan Outlier For Watchdog Role

    President Donald Trump's pick to lead the Office of Inspector General at the U.S. Department of Health and Human Services has a particularly partisan background for a role viewed as nonpolitical.

  • April 29, 2025

    GenBioPro Can Defend FDA Approval In Mifepristone Suit

    A Texas federal judge has allowed drugmaker GenBioPro to join a legal fight over access to the abortion drug mifepristone, finding that the company has a distinct interest in defending federal approval of the generic version of the medication.

  • April 29, 2025

    HHS Legal Staff Cuts Will Impair Abuse, Neglect Enforcement

    A massive overhaul underway at the U.S. Department of Health and Human Services will wipe out the roles filled by more than 100 attorneys and other staff at offices in six states. Among the enforcement areas being hit are federal efforts led by regional HHS legal teams combating elder abuse and neglect at nursing homes.

  • April 29, 2025

    Companies Are Increasing Security Coverage For GCs, Execs

    UnitedHealth Group has disclosed it spent nearly $1.9 million on security for its executives and their families in 2024, including over $213,000 for chief legal officer Christopher Zaetta, and a new study shows more corporations are following suit.

  • April 29, 2025

    Opioid MDL Judge Won't Recuse Over Ex Parte Allegations

    An Ohio federal judge will not step aside from multidistrict opioid litigation after the plaintiffs' attorney, who had alleged the judge "regularly communicates" with other lawyers involved in the litigation, testified that there was no such communication after all, the judge ruled Tuesday.

  • April 29, 2025

    BCBS Wants Hospital Sanctioned For 'Cat-And-Mouse' Tactics

    Blue Cross Blue Shield of North Carolina asked a federal judge to sanction a hospital company and its related entities for their purported "evasion, obfuscation, misdirection and outright misrepresentation" during discovery in a $32 million billing dispute that has gone on for seven years.

  • April 29, 2025

    High Court Backs HHS In Hospital Pay Formula Dispute

    The U.S. Supreme Court on Tuesday sided with federal health officials in a challenge over a formula used to calculate billions of dollars in annual payments to hospitals treating indigent patients, saying that those entitled to Supplemental Security Income should be collecting cash payments before they're counted in the formula.

  • April 28, 2025

    Gov't Reverses Position On Surgery For Trans Prisoners

    The Trump administration is rejecting the federal government's previous stance that prison officials are constitutionally required to provide gender confirmation surgery to incarcerated people with gender dysphoria who request the treatment, noting the shift in recent statements to a Georgia federal court.

  • April 28, 2025

    NC Dentist Acquitted Of $3M Fraud, Tax Evasion Charges

    A North Carolina dentist was acquitted of wire fraud and tax evasion charges on the fourth day of a federal jury trial in which prosecutors had alleged the dentist submitted false loan applications to the Small Business Administration and failed to pay income taxes.

Expert Analysis

  • Strategies To Defend Against Healthcare Nuclear Verdicts

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    The healthcare industry is increasingly the target of megaclaims, particularly those alleging medical malpractice, but attorneys representing providers can use a few tools to push back on flimsy litigation and reduce the likelihood of a nuclear verdict, says LaMar Jost at Wheeler Trigg.

  • What Drug Cos. Must Know About NY Price Transparency Law

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    Drug manufacturers must understand the contours of New York's recently implemented law requiring self-reporting of drug price increases, as well as best practices for compliance and challenges against similar laws in other states, say Elizabeth Bierut and Angie Garcia at Friedman Kaplan.

  • Whistleblowers Must Note 5 Key Differences Of DOJ Program

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    The U.S. Department of Justice’s recently unveiled whistleblower awards program diverges in key ways from similar programs at other agencies, and individuals must weigh these differences and look first to programs with stronger, proven protections before blowing the whistle, say Stephen Kohn and Geoff Schweller at Kohn Kohn.

  • The Licensure Landscape For Psychedelics Manufacturers

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    As the need for bulk manufacturing of psychedelic substances grows, organizations aiming to support clinical trials or become commercial suppliers must navigate a rigorous and multifaceted journey to obtaining a license from the U.S. Drug Enforcement Administration, say Kimberly Chew at Husch Blackwell and Jaime Dwight at Promega Corp.

  • OSHA Workplace Violence Citation Highlights Mitigation Steps

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    The Occupational Safety and Health Administration's recent citation against behavioral health company Circles of Care sheds light on the enforcement risks companies may face for failing to prevent workplace violence, and is a reminder of the concrete steps that can help improve workplace safety, say attorneys at Benesch.

  • When Banks Unknowingly Become HIPAA Biz Associates

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    There appears to be significant confusion regarding the application of the Health Insurance Portability and Accountability Act to financial institutions when serving healthcare-related clients, so these institutions should consider undertaking several steps as a starting point in the effort to achieve compliance, say attorneys at Vorys.

  • The Regulatory Headwinds Facing Lab-Developed Tests

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    Though the U.S. Food and Drug Administration's final rule regarding regulation of laboratory-developed tests outlines a four-year plan for ending enforcement discretion, and though this rule is currently being challenged in courts, manufacturers should heed compliance opportunities immediately as enforcement actions are already on the horizon, say attorneys at Kirkland & Ellis.

  • 3 High Court Rulings May Shape Health Org. Litigation Tactics

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    Three separate decisions from the U.S. Supreme Court's most recent term — Loper Bright, Corner Post and Jarkesy — will likely strengthen healthcare organizations' ability to affirmatively sue executive agencies to challenge regulations governing operations and enforcement actions, say attorneys at McDermott.

  • A New Way Forward For COVID Vaccine Lawsuit Immunity

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    As Public Readiness and Emergency Preparedness Act protections for COVID-19 vaccines wane, adding those vaccines to coverage by the National Vaccine Injury Compensation Program would bolster defenses for administrators and manufacturers while also providing stronger remedies for those injured by vaccines, says Altom Maglio at MCT Law.

  • Why DOJ's Whistleblower Program May Have Limited Impact

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    The U.S. Department of Justice’s new whistleblower pilot program aims to incentivize individuals to report corporate misconduct, but the program's effectiveness may be undercut by its differences from other federal agencies’ whistleblower programs and its interplay with other DOJ policies, say attorneys at Milbank.

  • How Cos. With Chinese Suppliers Should Prep For Biotech Bill

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    A proposed bill to prohibit government-affiliated life sciences companies from contracting with Chinese biotech companies of concern may necessitate switching to other sources for research and supplies, meaning they should begin evaluating supply chains now due to the long lead times of drug development, say John O'Loughlin and Christina Carone at Weil Gotshal.

  • FTC's Drug Middlemen Probe Highlights Ongoing Scrutiny

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    The Federal Trade Commission's interim staff report on its inquiry into pharmacy benefit managers suggests that the industry will remain under an enforcement microscope for the foreseeable future due to concerns about how PBMs affect drug costs and accessibility, say attorneys at Arnold & Porter.

  • What Cos. Should Note In DOJ's New Whistleblower Pilot

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    After the U.S. Department of Justice unveiled a new whistleblower pilot program last week — continuing its efforts to incentivize individual reporting of misconduct — companies should review the eligibility criteria, update their compliance programs and consider the risks and benefits of making their own self-disclosures, say attorneys at Skadden.