Policy & Compliance

  • April 16, 2025

    Wyo. Justices Skeptical Of State Abortion Bans' Legality

    The Wyoming Supreme Court on Wednesday seemed poised to side with a lower court judge that recent abortion bans violate the state's constitution, hinting that the Legislature doesn't have the authority to determine when life begins and thus cannot establish a compelling interest for the laws. 

  • April 16, 2025

    UnitedHealthcare Owes $1M Medicare Shortfall, Hospital Says

    UnitedHealthcare owes Connecticut's Danbury Hospital more than $1 million after bungling local Medicare Advantage cost calculations and refusing to correct its payment errors after the hospital provided notice of the problem, the healthcare facility alleged in a state court lawsuit.

  • April 15, 2025

    DC Asks Judge To Narrow Nursing Home Ruling

    The District of Columbia urged a D.C. federal judge on Tuesday to narrow an injunction requiring it to do more to help disabled nursing home residents transition into the community, arguing the order reaches beyond the class of plaintiffs and is too vague.

  • April 15, 2025

    Food Service Co. Can't Escape Tobacco Surcharge Suit

    A food service company can't dodge a proposed class action alleging it unlawfully charges tobacco users an additional fee to obtain health insurance, an Illinois federal judge ruled Tuesday, rejecting the company's assertion that federal benefits law doesn't require retroactive reimbursement for completing a cessation program.

  • April 15, 2025

    FDA Drug Rules Under Fire in Pharma Free Speech Fight

    Vanda Pharmaceuticals says it spent years establishing that one of its flagship, FDA-approved products is an effective and safe treatment for jet lag. But after being denied agency approval for that use, the company launched a novel First Amendment challenge meant to dismantle federal rules for “off-label” drug promotion.

  • April 15, 2025

    39 AGs Urge Congress To Ban PBM Pharmacy Ownership

    A bipartisan coalition of attorneys general have urged congressional leadership to pass legislation banning pharmacy benefit managers, their parent companies and affiliates from owning and operating pharmacies in order to boost competition and fairness.

  • April 15, 2025

    UBH Can't Nix Class Status In Coverage Guidelines Suit

    United Behavioral Health can't unwind class certification in a lawsuit claiming it unlawfully imposed overly restrictive guidelines for coverage of residential mental health treatments, a California federal judge ruled, saying the group's parameters could be adjusted to meet a recent Ninth Circuit standard.

  • April 15, 2025

    Anthem Strikes Deal To End Mental Health Class Action

    Anthem agreed to settle a class action from participants in employee health plans the insurer administered who alleged that coverage denials for inpatient mental health and substance use disorder treatments violated federal benefits and metal health parity laws, the parties told a New York federal court Tuesday.

  • April 15, 2025

    Minn. Couple Accused Of $15M Healthcare Fraud Scheme

    A Minnesota couple whose company was hit with a default civil judgment last year now face an indictment alleging they carried out a $15 million scheme to defraud Medicare, Medicaid and insurance companies by overbilling for neurofeedback therapy and other medical services.

  • April 15, 2025

    Legislation Roundup: States Consider Slew Of Abortion Bills

    Nearly three years after the U.S. Supreme Court's Dobbs decision upended federal abortion access protection, dozens of abortion-related bills are moving through state legislatures this year.

  • April 15, 2025

    Ga. Woman Says Baby 'Ripped Away' After Embryo Mix-Up

    A South Carolina fertility clinic has been hit with a lawsuit from a former patient alleging that its doctors placed the wrong embryo inside her — a fact she discovered only when she, a white woman, gave birth to a Black boy — only to have the baby "ripped away from her" by his biological parents after months of raising him as her own.

  • April 15, 2025

    McGuireWoods Immune From Defamation Case, NC Panel Told

    McGuireWoods LLP and a former partner have told a North Carolina state appeals court that they have absolute privilege over allegedly defamatory statements made in connection with an investigation into the former CEO of a managed care organization, arguing that the trial court should have granted them a pretrial win.

  • April 15, 2025

    Pa. Man To Plead Guilty In Harvard Body Parts Theft Case

    A Pennsylvania man will plead guilty to a federal charge for transporting body parts that were allegedly stolen from cadavers by the manager of Harvard Medical School's morgue, according to a Tuesday filing.

  • April 15, 2025

    Medicare Advantage 'Upcoding' In Federal Crosshairs

    Dr. Mehmet Oz and others have called for a crackdown on fraud and waste in privately run Medicare plans. But addressing "upcoding" won't be easy, and healthcare attorneys are watching to see whether the increased attention translates into actual enforcement.

  • April 15, 2025

    Abortion Bans At Wyo. High Court: 3 Things To Know

    Wyoming’s highest court is set to hear arguments over whether two near-total abortion bans violate the state Constitution and its guarantee of personal choice in healthcare.

  • April 14, 2025

    9th Circ. Says $24M Punitive Damages In Jail Death Too Steep

    A jury correctly determined that a healthcare contractor was liable for the death of a woman in custody in a Washington jail, a split Ninth Circuit panel ruled Monday, but its $24 million award for punitive damages was excessive.

  • April 14, 2025

    Ark. PBM Regulation Violates ERISA, Teamsters Fund Says

    An Arkansas insurance regulation forcing health plans to turn over information about reimbursement rates negotiated by pharmacy benefit managers, or PBMs, conflicts with federal benefits law, a Teamsters healthcare fund claimed, urging an Illinois federal court to block the state from enforcing the rule.

  • April 14, 2025

    Judge Threatens Penalties Over Late Report In Fla. Fee Suit

    A Florida federal judge threatened parties in a federal proposed class action over excessive fees charged to maintain retirement savings plans, warning there will be sanctions if they do not respond to an order to show why they failed to timely file a case management report.

  • April 14, 2025

    Quinn Emanuel, King & Spalding Rep Harvard In Trump Letter

    Harvard University on Monday turned to a pair of high-powered lawyers from Quinn Emanuel Urquhart & Sullivan LLP and King & Spalding LLP as the school pushed back on the Trump administration's policy demands linked to nearly $9 billion in federal funding — a move that prompted the government to freeze more than $2 billion in grants for the school.

  • April 14, 2025

    FTC Joins DOJ In Targeting Anticompetitive Regulations

    The Federal Trade Commission launched a public inquiry Monday to look into reducing regulations that are hindering competition, following a similar move by the U.S. Department of Justice last month.

  • April 14, 2025

    Takeda Gets Actos Case Paused For Class Cert. Review

    A New York federal court has paused a lawsuit accusing Takeda Pharmaceuticals of inflating the price of its diabetes treatment, Actos, by delaying the entry of generic alternatives, and took a scheduled July trial off the calendar, as the company appeals a class certification ruling.

  • April 14, 2025

    Healthcare Duo Joins Carlton Fields From Mass. Boutique

    Carlton Fields announced Monday that a pair of experienced healthcare attorneys joined the firm's Los Angeles and Tampa, Florida, offices after a stint with Massachusetts boutique Kajko Weisman & Colasanti LLP.

  • April 14, 2025

    Sandoz Sues Amgen Over Enbrel Biosimilar

    Sandoz accused Amgen of illegally blocking biosimilar competition to its blockbuster Enbrel drug for arthritis and other inflammatory diseases, alleging that the company used strategic acquisitions and illegal patent extensions to fend off challengers in the space and inflate U.S. prices for its drug.

  • April 11, 2025

    Amgen Can't Ditch Regeneron's Bundling Antitrust Suit

    A Delaware federal judge on Thursday denied Amgen's bid to toss antitrust litigation brought by Regeneron accusing its rival of using a bundling scheme to increase the sales of its cholesterol drug Repatha and push competitors out of the market.

  • April 11, 2025

    Express Scripts Judge Asks If Khan's FTC Exit Affects Suit

    The Missouri federal judge overseeing Express Scripts' lawsuit accusing the Federal Trade Commission of defaming it with a report excoriating the pharmacy benefits manager for allegedly inflating drug costs asked the parties Friday if new leadership at the commission affects the case that significantly targets former Chair Lina Khan.

Expert Analysis

  • Air Ambulance Ruling Severely Undermines No Surprises Act

    Author Photo

    A Texas federal court's recent decision in Guardian Flight v. Health Care Service — that the No Surprises Act lacks a judicial remedy when a health insurer refuses to pay the amount established through an independent review — likely throws a huge monkey wrench into the elaborate protections the NSA was enacted to provide, says Mark DeBofsky at DeBofsky Law.

  • Class Actions At The Circuit Courts: June Lessons

    Author Photo

    In this month's review of class action appeals, Mitchell Engel at Shook Hardy considers two recent decisions from the Third and Tenth Circuits, and identifies practice tips around class action settlements and standing in securities litigation.

  • How Congress Is Tackling The US Healthcare Shortage

    Author Photo

    With healthcare shortages continuing across the U.S. despite industry efforts to improve patient access to care, increased Medicare support for graduate medical education could be a crucial component of the solution, say Sarah Crossan and Miranda Franco at Holland & Knight.

  • The Current State Of Healthcare Transaction Reviews In Calif.

    Author Photo

    As of April, certain healthcare transactions in California have been subject to additional notification compliance requirements, and complying with these new rules could significantly delay and discourage some deals, says Andrew Demetriou at Husch Blackwell.

  • High Court's Abortion Pill Ruling Shuts Out Future Challenges

    Author Photo

    The U.S. Supreme Court's unanimous ruling in U.S. Food and Drug Administration v. Alliance for Hippocratic Medicine maintains the status quo for mifepristone access and rejects the plaintiffs' standing theories so thoroughly that future challenges from states or other plaintiffs are unlikely to be viable, say Jaime Santos and Annaka Nava at Goodwin.

  • Orange Book Warnings Highlight FTC's Drug Price Focus

    Author Photo

    In light of heightened regulatory scrutiny surrounding drug pricing and the Federal Trade Commission's activity in the recent Teva v. Amneal case, branded drug manufacturers should expect the FTC's campaign against allegedly improper Orange Book listings to continue, say attorneys at Ropes & Gray.

  • A Plaintiffs-Side Approach To Cochlear Implant Cases

    Author Photo

    As the number of cochlear implants in the U.S. continues to grow, some will inevitably fail — especially considering that many recalled implants remain in use — plaintiffs attorneys should proactively prepare for litigation over defective implants, says David Shoop at Shoop.

  • Inside Antitrust Agencies' Rollup And Serial Acquisition Moves

    Author Photo

    The recent request for public comments on serial acquisitions and rollup strategies from the Federal Trade Commission and U.S. Justice Department mark the antitrust agencies' continued focus on actions that fall below premerger reporting thresholds, say attorneys at Paul Weiss.

  • Short-Term Takeaways From CMS' New Long-Term Care Rules

    Author Photo

    The Centers for Medicare & Medicaid Services' new final rule on nursing home staffing minimums imposes controversial regulatory challenges that will likely face significant litigation, but for now, stakeholders will need to prepare for increased staffing expectations and more specialized facility assessments without meaningful funding, say attorneys at Morgan Lewis.

  • FDA's Data Monitoring Guidance Reveals Future Expectations

    Author Photo

    As the world of clinical research grows increasingly complex, the U.S. Food and Drug Administration's recent draft guidance on the use of data monitoring committees in clinical trials reveals how the agency expects such committees to develop, say Melissa Markey and Carolina Wirth at Hall Render.

  • FDA Warning Indicates Scrutiny Of Regenerative Health Cos.

    Author Photo

    The U.S. Food and Drug Administration's recent warning letter to Akan Biosciences is a quintessential example of the agency's enforcement priorities for certain products involving human cells and tissues, and highlights ongoing scrutiny placed on manufacturers, say Dominick DiSabatino and Cortney Inman at Sheppard Mullin.

  • 2 Regulatory Approaches To Psychedelic Clinical Trials

    Author Photo

    Comparing the U.S. and Canada's regulatory frameworks for clinical trials of psychedelic drugs can be useful for designing trial protocols that meet both countries' requirements, which can in turn help diversify patient populations, bolster data robustness and expedite market access, say Kimberly Chew at Husch Blackwell and Sabrina Ramkellawan at AxialBridge.

  • 'Food As Health' Serves Up Fresh Legal Considerations

    Author Photo

    The growth of food as medicine presents a significant opportunity for healthcare organizations and nontraditional healthcare players to improve patient outcomes and reduce costs, though these innovative programs also bring compliance considerations that must be carefully navigated, say attorneys at McDermott.