Policy & Compliance

  • June 17, 2025

    9th Circ. Backs Class Cert. In Suit Over Diabetes Drug Risk

    The Ninth Circuit refused to disband a class of third-party payors who claim Takeda Pharmaceutical and Eli Lilly & Co. hid their anti-diabetes drug's bladder cancer risks, finding no issue with a lower court's analysis of expert evidence showing prescriptions fell after the risks were disclosed.

  • June 17, 2025

    Healthcare Worker's Wage Collective 'Amorphous,' HCA Says

    A respiratory therapist's proposed collective is far too expansive and "amorphous" and is based on scant evidence that HCA Healthcare Inc. illegally manipulated workers' time sheets, the company told a North Carolina federal court, urging it to deny certification. 

  • June 17, 2025

    Trump's Abortion Guidance U-Turn Sparks Legal Risks

    Now that the Trump administration has pulled guidance telling doctors they must perform abortions in emergency situations, healthcare attorneys are warning their clients to diligently document their decisions, especially when they find themselves caught in the middle of conflicting federal and state law.

  • June 17, 2025

    'A Warning Shot?' Experts Eye Surge In Drug Ad Enforcement

    Despite its recent staff cuts and leadership changes, the U.S. Food and Drug Administration has launched a burst of enforcement activity targeting prescription drug promotion, singling out a "sex pill" post on Instagram and an exhibit panel touting a diuretic.

  • June 17, 2025

    Medical AI Co. Calls Rival's Suit A Ploy To Kill Competition

    A Canadian artificial intelligence company focusing on medical information has asked a Massachusetts federal judge to toss out a recent trade secrets lawsuit, saying the complaint is an attempt to thwart competition based solely on speculation.

  • June 16, 2025

    Life Spine Accuses Ex-CEO Of Stealing Money, Trade Secrets

    Spinal device maker Life Spine slapped its founder with a civil suit in Illinois state court Friday accusing him of embezzling millions of dollars from the company through fraudulent credit card charges for motorsports, a lavish Mexico vacation for his family, customized golf clubs, jewelry and a Porsche for his wife. 

  • June 16, 2025

    Ohio Tells 6th Circ. PBM Case Doesn't Target Federal Work

    Ohio urged the Sixth Circuit to send its case accusing Express Scripts and Prime Therapeutics of driving up prescription drug prices through rebate schemes back to state court, arguing the case doesn't target any federal government work by the pharmacy benefit managers.

  • June 16, 2025

    HIV, AIDS Patients Denied Class Cert. In CVS Bias Fight

    A California federal judge has refused to certify a proposed class of HIV and AIDS patients alleging CVS Pharmacy Inc. violated federal disability bias protections by making their medication harder to access, finding the proposed group failed to meet the commonality standards under federal law. 

  • June 16, 2025

    Mass. Judge Blocks NIH Grant Cuts, Points To 'Discrimination'

    A Massachusetts federal judge on Monday blocked the National Institutes of Health from cutting hundreds of grant programs to universities, hospitals and other organizations, saying that in his 40 years on the bench he had never seen such "palpable" racial and LGBTQ discrimination from the government.

  • June 16, 2025

    Justices Turn Away Merck's Bone Drug Warning Label Row

    The U.S. Supreme Court on Monday rejected Merck Sharp & Dohme Corp.'s request to review a Third Circuit decision that more than 1,000 failure-to-warn claims over its osteoporosis drug Fosamax can continue despite the company's assertion that the litigation is barred by federal law.

  • June 16, 2025

    Justices Take Up NJ Anti-Abortion Group's Subpoena Fight

    The U.S. Supreme Court on Monday agreed to review the Third Circuit's dismissal of an anti-abortion pregnancy center's federal lawsuit challenging a subpoena from the New Jersey attorney general demanding information about its donors.

  • June 13, 2025

    Injunction Sought After J&J Unit's Catheter Antitrust Loss

    Innovative Health is seeking a permanent injunction that would ban Johnson & Johnson health tech unit Biosense Webster from conditioning the provision of cardiac mapping services on purchases of cardiac catheters, after Innovative Health netted a $442 million trial win on its antitrust claims.

  • June 13, 2025

    5th Circ. Says No Private Right Of Action In No Surprises Act

    The Fifth Circuit has ruled a pair of flight ambulance providers cannot pursue their lawsuit seeking to enforce out-of-network billing dispute resolution awards against a health insurance company, saying there's no private right of action built into a 2022 law that protects patients from surprise medical bills.

  • June 13, 2025

    Pa. Home Care Agency Owner Gets Prison, $235K Restitution

    The New York-based owner of a Berks County, Pennsylvania, home care agency has been sentenced to spend a month in jail and repay $235,778 in fraudulently billed Medicaid claims, the Pennsylvania Attorney General's Office announced Friday.

  • June 13, 2025

    EEOC Says Henry Ford Ignored Subpoena Over Bias Charge

    Michigan's Henry Ford health system has ignored a subpoena from the U.S. Equal Employment Opportunity Commission seeking information into a worker's bias charge, according to a federal court filing from the agency seeking an order enforcing the request.

  • June 13, 2025

    CVS Wants To Halt Ark. Law Banning PBM-Owned Pharmacies

    CVS urged an Arkansas federal judge to block a new state law from taking effect that would ban pharmacy benefits managers from owning pharmacies in the state, arguing the law shirks the U.S. Constitution by tamping down competition and discriminating against out-of-state businesses.

  • June 12, 2025

    Florida, Sandoz Say They've Fixed Generic Drug Price-Fix Deal

    The Florida Attorney General's Office and Sandoz Inc. have told a Connecticut federal court they've fixed the problems the court identified with a generic drug price-fixing settlement after other states with claims in the case objected to a clause in the deal.

  • June 12, 2025

    'Forum Shopping' Center Stage At 6th Circ. Drug Pricing Args

    As part of an expansive effort to tee up U.S. Supreme Court review, pharmaceutical industry-backed opponents of Medicare's drug price negotiations entered less-than-hospitable territory at the Sixth Circuit, where judges pointedly questioned a local business group's basis for challenging a national healthcare program.

  • June 12, 2025

    Humana, Aetna Underpaid For 340B Drugs, New Suits Say

    Humana and Aetna are facing new claims in a trio of suits filed in North Carolina federal court alleging they underpaid health systems for drugs purchased through the federal 340B drug discount program.

  • June 12, 2025

    11th Circ. Won't Revive Nurses' African Bias, Retaliation Suit

    The Eleventh Circuit on Thursday backed an Atlanta hospital's defeat of a lawsuit claiming it disciplined and fired two nurses who complained that a supervisor made derogatory comments about African employees, saying neither woman could overcome evidence of their misconduct.

  • June 12, 2025

    Fla. Death Damages Row Signals Insurers' Tort Reform Focus

    Florida Gov. Ron DeSantis' veto of a bill that would have repealed limits on noneconomic damages in fatal medical malpractice cases — despite state lawmakers' overwhelming support of the measure — signals broad concerns over how tort reform legislation could impact the insurance industry.

  • June 11, 2025

    Seattle Hospital Hit With Class Suit Over 'Diverted' Pain Meds

    A Seattle-based hospital system has been slapped with a proposed class action in Washington state court over claims that hundreds of patients suffered unwarranted pain and risk of infection because a staff member may have been pocketing painkillers.

  • June 11, 2025

    RFK Jr. Picks Vaccine Critics As Part Of CDC Panel Overhaul

    Robert F. Kennedy Jr., secretary of the U.S. Department of Health and Human Services, announced Wednesday he appointed eight new members to a vaccine advisory panel, just two days after he removed 17 existing members of the panel, which provides advice and guidance on the use of vaccines to the Centers for Disease Control and Prevention.

  • June 11, 2025

    UNC Hospital System Must Face Ex-Resident's Bias Suit

    The University of North Carolina's hospital system must face a discrimination lawsuit filed by a fired surgical resident, a North Carolina federal judge ruled Wednesday, tossing the system's motion to dismiss claims that the discharge decision was motivated by bias against the resident's mental health conditions.

  • June 11, 2025

    Children's Healthcare Nonprofit Settles Retirement Fee Suit

    A Florida-based nonprofit children's healthcare network and ex-workers who alleged their employee retirement savings were dragged down by excessive fees told a Florida federal court Wednesday they'd worked out a class action settlement of the dispute after mediation.

Expert Analysis

  • 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.

  • Motion To Transfer Venue Considerations For FCA Cases

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    Several recent decisions highlight the importance for practitioners of analyzing as early as possible whether a False Claims Act case warrants a change of venue, and understanding how courts weigh certain factors for defendants versus whistleblowers, say Ellen London at London & Stout, and Li Yu and Corey Lipton at DiCello Levitt.

  • A Primer On EU's Updated Human Substance Regulations

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    The European Union's updated standards regarding quality and safety of substances of human origin meant for human application carry significant implications for companies that work with cells and tissues, and U.S. companies active in the EU market should pay particular attention to the import and export rules, say Geneviève Michaux and Georgios Symeonidis at King & Spalding.

  • CFPB's Medical Debt Proposal May Have Side Effects

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    The Consumer Financial Protection Bureau’s recent proposal to prevent medical debt information from appearing on consumer reports and creditors from basing lending decisions on such information may have initial benefits for some consumers, but there are potential negative consequences that should also be considered, say attorneys at Cooley.

  • 15 Areas That Would Change Under Health Data Rule Proposal

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    If finalized, the Office of the National Coordinator for Health Information Technology's proposed rule will significantly progress its efforts to advance interoperability, respond to stakeholder concerns and clarify compliance with the health IT certification program, say attorneys at Ropes & Gray.

  • 3 Healthcare FCA Deals Provide Self-Disclosure Takeaways

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    Several civil False Claims Act settlements of alleged healthcare fraud violations over the past year demonstrate that healthcare providers may benefit substantially from voluntarily disclosing potential misconduct to both the U.S. Department of Justice and the U.S. Department of Health and Human Services, say Brian Albritton and Raquel Ramirez Jefferson at Phelps Dunbar.

  • Takeaways From High Court's Tribal Health Admin Cost Ruling

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    The U.S. Supreme Court's recent determination that the government must reimburse two Native American tribes for administrative healthcare costs will help tribes maintain equal footing with the Indian Health Service when administering programs, and continues a pattern of how the current court aligns on tribal concerns, say attorneys at Lewis Roca.

  • FTC Focus: Private Equity Investments In Healthcare

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    As the Federal Trade Commission is tightening its scrutiny of private equity investment in healthcare, the agency is finding novel grounds to challenge key focus areas, including rollup acquisitions, the flip-and-strip approach and minority investments in rival providers, say attorneys at Proskauer.

  • High Court's Expert Ruling May Help Health Fraud Defendants

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    The U.S. Supreme Court's decision in Diaz v. U.S. appears to give the government a powerful new tool in calling its own agents as expert witnesses, but it could also benefit defense counsel in criminal healthcare fraud and other white collar criminal cases that arise in complex legal or regulatory environments, say attorneys at Holland & Knight.

  • Unpacking HHS' Opinion On Cell Therapy Refund Programs

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    A recent advisory opinion from the U.S. Department of Health and Human Services, determining that a biopharma company's refund program for its cell therapy will not be penalized, indicates an encouraging willingness to engage, but the regulator's assumptions about the program's limited term warrant a closer look, says Mary Kohler at Kohler Health.

  • DOJ Innovasis Settlement Offers Lessons On Self-Disclosure

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    The recent $12 million settlement with Innovasis and two of its executives demonstrates the U.S. Department of Justice's continued prioritization of Anti-Kickback Statute enforcement amid the growing circuit split over causation, and illustrates important nuances surrounding self-disclosure, say Denise Barnes and Scott Gallisdorfer at Bass Berry.