Policy & Compliance

  • 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.

  • September 18, 2025

    Senate Confirms Trump's Pick To Lead DOL Benefits Arm

    The Senate confirmed fiduciary liability insurance expert Daniel Aronowitz on Thursday to lead the U.S. Department of Labor's employee benefits division, which oversees regulation and enforcement of employer-provided health and retirement plans.

  • September 18, 2025

    Couple Slam NC Defense Attys In Hospital Negligence Appeal

    A couple pursuing negligence claims against a local hospital scoffed at the idea that they were lurking on the sidelines waiting to cash in on a favorable outcome in a similar case, telling the North Carolina appeals court to ignore an amicus brief by defense attorneys arguing as much.

  • September 18, 2025

    1st Circ. Won't Lift Block On HHS Job, Program Cuts

    The First Circuit on Wednesday rejected a bid by the Trump administration to let it move ahead with cutting 10,000 jobs and end a number of programs at the U.S. Department of Health and Human Services while it appeals a Rhode Island federal judge's order temporarily barring the plan.

  • September 18, 2025

    Withheld Email Not Enough To Revive Doc's Retaliation Suit

    A psychiatrist failed to convince the Second Circuit to reinstate his suit claiming a New York City-area hospital system forced him out because he raised patient safety concerns, with the appeals court saying he couldn't show the hospital's omission of an email during discovery was purposeful.

  • September 17, 2025

    J&J Whistleblowers Defend $1.6B False Claims Act Win

    Whistleblowers filed a brief Wednesday in the Third Circuit in a closely watched False Claims Act appeal involving a $1.6 billion judgment against Johnson & Johnson unit Janssen as well as the constitutionality of the FCA's "qui tam" whistleblower provisions, arguing that the act's lawfulness has been settled by its "unbroken 162-year history."

  • September 17, 2025

    FDA Says Vape Manufacturer Lying About Marketing Approval

    The U.S. Food and Drug Administration on Tuesday sued manufacturers of flavored vapes in New Jersey federal court to seek an end to their sales, saying that they are falsely representing that their products had received marketing approval.

  • September 17, 2025

    3rd Circ. Weighs Limits On NJ Medical Aid In Dying Act

    The Third Circuit on Wednesday considered whether a Delaware woman with terminal cancer can challenge New Jersey's residency requirement for medical aid in dying, even though she has yet to be certified as having six months or less to live.

  • September 17, 2025

    Hospital Agrees To End Retirement Plan Fee, Investment Suit

    A New York hospital system told a federal court Wednesday it will end a proposed class action alleging it failed to remove underperforming investment options from its retirement plan and keep an eye on administrative costs, losing millions of dollars of employees' savings.

  • September 17, 2025

    Ex-CDC Head Says RFK Jr. Urged Vax Schedule Rubber Stamp

    Susan Monarez, the former head of the Centers for Disease Control and Prevention, told federal lawmakers on Wednesday she was abruptly fired just weeks into her tenure for "holding the line on scientific integrity."

  • September 16, 2025

    Dr.'s COVID Falsehoods Are Free Speech, Wash. Panel Says

    A Washington state appeals court unanimously ruled Tuesday that the Washington Medical Commission overstepped its authority by punishing a doctor for COVID-19 falsehoods he published to his blog, but affirmed the commission's decision to discipline him for prescribing ivermectin to COVID-19 patients.

  • September 16, 2025

    Harborview Nurses In Ga. Score Collective Status In OT Suit

    A pair of nurses who worked at Harborview Health Systems' facility in Rome, Georgia, brought enough evidence to show they and other similarly situated nurses were subjected to pay practices that shorted them on overtime wages to proceed as a collective action, a New York magistrate judge said Tuesday.

  • September 16, 2025

    Merck Says Vaccine Case 'Poor Vehicle' For Antitrust Review

    Merck & Co. told the U.S. Supreme Court to reject a bid from physicians looking to revive antitrust claims over submissions the pharmaceutical giant made to federal regulators concerning its mumps vaccine, arguing that the case is "an exceptionally poor vehicle" for review.

  • September 16, 2025

    FTC Ends Director Overlap In Healthcare Space

    The Federal Trade Commission said three members of Sevita Health's board of directors resigned after enforcers flagged an overlap with the board of a competing provider of specialty healthcare for people with intellectual and developmental disabilities.

  • September 16, 2025

    Oregon Joins Expansion Of '5NP' Acupuncture Practice

    Oregon has joined a number of states that have enacted laws that make it easier for people to get a "five needle" therapy with a raft of mental health benefits, including reduced substance withdrawal symptoms.

  • September 16, 2025

    The Limits On Blue States' Push For Vaccine Policy Control

    Democratic-run states are changing vaccine policies as HHS Secretary Robert F. Kennedy Jr. and other Trump health officials move to restrict vaccine access, creating a new policy patchwork. Those state efforts can only go so far, healthcare experts say.

  • September 16, 2025

    Pharma Tests Drug Price Policies In Court: 3 Cases To Know

    Two circuit courts issued notable rulings over the past week upholding laws aimed at lowering prescription drug prices. Elsewhere, insulin makers are seeking a panel rehearing in a proposed class action targeting discount programs. Here, Law360 Healthcare Authority looks at three key drug pricing cases you may have missed.

  • September 16, 2025

    Wash. Justices Scrutinize Minimum Wage 'Live In' Exclusion

    Washington Supreme Court justices on Tuesday pushed counsel for an adult family home on the stance that its "live in" workers are adequately protected by existing laws and regulations, pointing to testimony its employees are always on call and sometimes at risk of physical assault by residents.

  • September 16, 2025

    Ill. Hospital Nonprofit Must Face Tobacco Fee Suit

    An Illinois federal judge refused to toss the bulk of a proposed class action from an Illinois hospital worker who claimed a fee on the employee health plans of tobacco users was discriminatory and breached fiduciary duties under benefits law, finding most allegations sufficiently backed up to survive dismissal.

  • September 16, 2025

    DC Circ. Asked To Look At ADA Injunction In Segregation Case

    Washington, D.C., wants the D.C. Circuit to narrow an injunction commanding the district to help people in Medicaid-funded nursing homes move out of those facilities and into less restrictive forms of care, as the litigation approaches its 15th birthday.

  • September 16, 2025

    $50B Rural Health Fund: A Primer

    The U.S. Centers for Medicare & Medicaid Services will use a newly created $50 billion rural health fund to entice states to take unhealthy foods out of their food-stamp programs, expand telehealth and embrace other Trump administration priorities.

  • September 16, 2025

    Calif. Healthcare Bills: 4 You Need To Know

    Golden State lawmakers passed a flurry of healthcare bills this legislative session, including measures meant to ease prior authorization requirements on providers and increase oversight of PBMs and PE-backed transactions. Healthcare Authority looks at four bills now on the governor's desk.

  • September 16, 2025

    CVS Caremark Takes $290M Overbilling Judgment To 3rd Circ.

    CVS's pharmacy benefits manager will appeal a judgment against the company that was recently increased from $95 million to $290 million in a suit alleging it overbilled Medicare Part D-sponsored drugs, according to a notice of appeal filed in Pennsylvania federal court.

  • September 16, 2025

    WellSpan Health Elevates Atty To Legal Chief

    Regional healthcare provider WellSpan Health has tapped one of the company's in-house attorneys to lead its law department in its south central Pennsylvania headquarters.

  • September 16, 2025

    For Cahill Atty, Rare Disease Pro Bono Work Is Personal

    John MacGregor of Cahill Gordon & Reindel LLP didn't have any experience in healthcare law before taking on a pro bono client that supports people with a rare form of epilepsy. MacGregor's son is one of them.

Expert Analysis

  • Rank-And-File DOJ Attorneys Will Keep Calm And Carry On

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    Career prosecutors at the U.S. Department of Justice often pride themselves on their ability to remain apolitical in order to ensure consistency and keep the department’s mission afloat, and the incoming Trump administration is unlikely to upend this tradition, says Michael Landman at Bird Marella.

  • Unpacking Arguments From High Court's Rural Hospital Case

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    During oral arguments in Advocate v. Becerra, the U.S. Supreme Court justices focused questions on the meaning of being "entitled to" supplementary security income assistance, and there's reason for optimism that the likely split decision will break in favor of hospitals, say attorneys at King & Spalding.

  • Health Policy Predictions For Trump's Second Administration

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    As President-elect Donald Trump's nominations for health policy and enforcement heads work their way through the confirmation process, healthcare organizations can look at nominee backgrounds, campaign statements and actions from Trump's previous presidency to predict incoming priorities, say attorneys at McDermott.

  • What Trump's Next Term May Mean For Biz Immigration

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    Leonard D'Arrigo at Harris Beach discusses the employment-based immigration policies businesses can potentially expect during President-elect Donald Trump’s second term, based on policies enacted during his first administration, statements made during his campaign and proposals in Project 2025.

  • Weak Reasoning Underlies Fla. Judge's Bold Qui Tam Ruling

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    U.S. District Judge Kathryn Mizelle's groundbreaking decision in U.S. ex rel. Zafirov v. Florida Medical Associates LLC, holding that qui tam provisions of the False Claims Act are unconstitutional, relies on weak logic to reach a conclusion that differs from every other court that has ruled on the issue, says Ethan Greenberg at Anderson Kill.

  • Medicare Overpayment Rules Are A Mixed Bag For Providers

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    The Centers for Medicare & Medicaid Services' updated rules for handling agency overpayments adopt a more reasonable definition of what it means to have "identified" an overpayment, which is a win for providers, but their new time frame for investigating related overpayments is unrealistic, says Susan Banks at Holland & Knight.

  • Expect More State-Level Scrutiny Of Noncompetes Ahead

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    Despite the nationwide injunction against the Federal Trade Commission’s noncompete ban, and the incoming Republican administration, employers should anticipate that state legislatures will continue to focus on laws that limit or ban noncompetes, including those that target certain salary thresholds or industries, says Benjamin Fryer at FordHarrison.

  • Cos. Should Inventory Issues To Prep For New Congress

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    As the legislative and oversight agendas of the 119th Congress come into sharper focus, corporate counsel should assess and plan for areas of potential oversight risk — from tax policy changes to supply chain integrity — even as much uncertainty remains, say attorneys at WilmerHale.

  • Incoming Admin May Shake Up Life Sciences Regulation

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    Though President-elect Donald Trump has not yet articulated policy priorities regarding the life sciences industry, the sector is positioned to see significant changes that could affect everything from drug exclusivity and generic drug approvals, to the availability of over-the-counter drugs, to laboratory-developed tests and digital health, say attorneys at Morgan Lewis.

  • Navigating DOJ's Patchwork Whistleblower Regime

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    In the past few months, the U.S. Department of Justice and several individual U.S. attorney’s offices have issued different pilot programs aimed at incentivizing individuals to blow the whistle on misconduct, but this piecemeal approach may create confusion and suboptimal outcomes, say attorneys at BakerHostetler.

  • What To Expect Next From Federal Health Tech Regulation

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    Healthcare organizations should pay close attention to federal health information technology regulators' recent guidance concerning barriers to accessing electronic health information, which signals that more enforcement in this area is likely forthcoming, say attorneys at Ropes & Gray.

  • 5 Areas Congress May Investigate After GOP Election Wins

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    With Republicans poised to take control of Congress in addition to the executive branch next year, private companies can expect an unprecedented uptick in congressional investigations focused on five key areas, including cryptocurrency and healthcare, say attorneys at Cahill Gordon.

  • Takeaways From State Votes On Abortion In The 2024 Election

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    Attorneys at Epstein Becker discuss how 10 states voted on ballot initiatives to either protect or restrict access to abortion in the 2024 general election, and analyze overarching trends.