Policy & Compliance
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July 30, 2025
Database Administrator Was Employee, Court Told
A former database administrator was misclassified as an independent contractor, he alleged in a proposed class and collective action in New York federal court against companies including Express Scripts and Cigna, saying he was effectively an employee.
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July 29, 2025
Fed. Circ. Backs Rejection Of Man's HPV Vaccine Claims
A man who claimed vaccines he received as a teen, including one meant to guard against HPV, caused him to develop inflammatory bowel disease will receive no payments under the National Vaccine Injury Compensation Program, the Federal Circuit ruled on Tuesday, affirming a determination that his theory that vaccines caused his illness is unsupported.
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July 29, 2025
Ambulance Co. Can't Undo $2.3M Verdict In Wash. Crash Case
A Washington Court of Appeals panel has affirmed an ambulance operator's $2.3 million trial court loss in a patient's family's wrongful death case over a crash, rejecting the company's argument that its crew was shielded from liability by a state law that protects first responders providing emergency medical services.
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July 29, 2025
Trump Says High Court Rulings Undermine Wash. Halt On EOs
Recent decisions by the U.S. Supreme Court undermine a Washington federal judge's finding that portions of two executive orders concerning gender-affirming care and transgender identity likely violate the Constitution, the Trump administration argued in recent filings.
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July 29, 2025
9th Circ. Won't Renew Suit Over Wash. Ban On 'DIY' Rape Kits
A Ninth Circuit panel on Tuesday refused to revive a constitutional challenge to Washington state's ban on self-administered DNA evidence collection kits for sexual assault survivors, concluding that the plaintiff company failed to show the law illegally restricts commercial speech.
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July 29, 2025
DOD Expands Tricare's Clinical Trial Benefit
The U.S. Department of Defense has issued a final rule that makes health insurance coverage for clinical trials aimed at treating and preventing COVID-19 and other infectious diseases permanent for military personnel, retirees and their families.
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July 29, 2025
Detroit Casino Can't Beat Denied Vaccine Exemption Suit
A dozen former supervisors at a Detroit casino can proceed to trial on claims that their employer refused to accommodate their religiously motivated requests to skip the COVID-19 vaccine, a Michigan federal judge has ruled.
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July 29, 2025
9th Circ. Rescinds Ruling On Wash. Abortion Coverage Law
A Ninth Circuit panel has walked back a published March opinion rejecting a Christian church's challenge to a Washington state law mandating employer health coverage of abortion services, saying in a Tuesday order that the federal appeals court would issue a new ruling following additional oral arguments.
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July 29, 2025
RFK Jr. Slams Vaccine Injury Program: 3 Things To Know
U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. is taking aim at the national program that compensates people for vaccine injuries, calling it a "heartless" system that he intends to fix.
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July 29, 2025
Travelers Gets Trim Of Ex-Worker's Tobacco Health Fee Suit
A Minnesota federal judge pared down claims Tuesday from a former Travelers worker's suit alleging the insurance and financial services company unlawfully imposed a surcharge on the health plans of employees who disclosed they were tobacco users and thereby violated nondiscrimination provisions in federal benefits law.
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July 29, 2025
UnitedHealth Urges 6th Circ. To Affirm ERISA Preemption
UnitedHealth Group Inc. urged the Sixth Circuit to affirm the dismissal of a man's claims that UnitedHealth defrauded him into reimbursing the health insurance giant for $25,000, arguing that the Employee Retirement Income Security Act of 1974 completely preempts such claims brought under state law.
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July 29, 2025
Organ Procurement's Dilemma: How Do You Diagnose Death?
A Kentucky man nearly had his organs removed for donation despite showing signs of life. Now a federal investigation is putting a spotlight on how doctors diagnose death prior to organ transplants.
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July 29, 2025
FDA Recommends Federal Restrictions On Kratom Extract
The U.S. Food and Drug Administration announced Tuesday that it recommends placing federal restrictions on 7-Hydroxymitragynine, or 7-OH, an opioid-like alkaloid compound derived from the kratom leaf that the agency said had a strong potential for abuse.
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July 29, 2025
Attys Blast 'Chilling Message' Of Judge Shopping Sanctions
Three attorneys sanctioned for judge shopping while challenging an Alabama statute that criminalizes gender-affirming care have asked the Eleventh Circuit to clear their names, castigating the process that led to their censure as "so extraordinary as to approach unprecedented."
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July 29, 2025
22 States Sue To Block Defunding Of Planned Parenthood
California and more than 20 other states on Tuesday launched their own legal challenge to budget legislation that halts federal Medicaid funding for Planned Parenthood, alleging the measure illegally targets the organization and violates its First Amendment rights.
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July 29, 2025
Ark. Law Banning PBM-Owned Pharmacies Put On Ice
Arkansas can't enforce a law banning pharmacy benefit managers from owning pharmacies in the state, a federal judge ruled, saying that CVS, Express Scripts, Optum and a trade group are likely to succeed on their claims that the statute unlawfully restricts interstate commerce.
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July 29, 2025
9th Circ. Clarifies Kickback Boundaries For Referral Bonuses
A Ninth Circuit opinion affirming a California man's fraud conviction provides some clarity — and a warning — to the owners of medical testing laboratories wondering what sales tactics are allowed under a 2018 kickbacks law.
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July 29, 2025
Meet Josh Craddock, Fetal Personhood Advocate Joining DOJ
President Donald Trump has named a former BigLaw attorney and outspoken proponent of the fetal personhood legal doctrine to serve as deputy assistant attorney general at the legal arm of the U.S. Department of Justice.
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July 28, 2025
PBMs Can't Escape NY State Law Claims In Opioid MDL
Two UnitedHealth subsidiaries cannot escape claims that they exacerbated the opioid crisis by providing data analytics and consulting services to drugmakers, a federal judge overseeing the multidistrict litigation ruled on Monday, saying the New York state municipalities have adequately alleged RICO by claiming they were part of the same criminal conspiracy.
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July 28, 2025
Express Scripts, Prime Urge Court To Toss Mich. Price-Fix Suit
Two pharmacy benefit managers sought to shake allegations of price-fixing brought by Michigan Attorney General Dana Nessel, arguing Friday that her antitrust suit suffers from several fatal legal flaws, including that the state does not have standing to sue on pharmacies' behalf.
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July 28, 2025
DOJ Probes NewYork-Presbyterian Over Antitrust Allegations
The U.S. Department of Justice has opened an investigation into NewYork-Presbyterian Healthcare System for allegedly violating antitrust laws by cutting deals with insurance companies that have led to rising healthcare costs, according to a subpoena viewed by Law360.
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July 28, 2025
Judge Again Cites Bias In NIH Fund Freeze As Gov't Appeals
A Massachusetts federal judge on Monday reiterated his conclusion that the Trump administration's freeze of $783 million worth of National Institutes of Health grants was based on "palpable" gender and racial discrimination, as he acknowledged a pending request by the government to the U.S. Supreme Court to stay his order that the money be released.
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July 28, 2025
Judge Says Trump Admin Can't Defund Planned Parenthood
A Massachusetts federal judge on Monday blocked President Donald Trump's administration from denying Medicaid reimbursements to Planned Parenthood clinics, expanding an earlier ruling that had applied only to those that do not provide abortions or that receive minimal federal support.
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July 25, 2025
Utah Docs Say Billing Expert's Report Rife With AI Falsehoods
Utah anesthesiologists facing a False Claims Act suit are moving to bar the testimony of a medical billing expert they say used artificial intelligence to draft a report riddled with errors and fake citations, calling it an extraordinary example of AI gone wrong.
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July 25, 2025
Hospital Giant To Pay $3.5M Over Nurse Training Repayments
HCA Healthcare Inc., a major U.S. hospital operator, has agreed to pay roughly $3.5 million to settle claims that it unlawfully trapped new nurses in agreements requiring them to repay training costs if they left their jobs within two years, according to a trio of state attorneys general.
Expert Analysis
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When Banks Unknowingly Become HIPAA Biz Associates
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.
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The Regulatory Headwinds Facing Lab-Developed Tests
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.
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3 High Court Rulings May Shape Health Org. Litigation Tactics
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.
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A New Way Forward For COVID Vaccine Lawsuit Immunity
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.
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Why DOJ's Whistleblower Program May Have Limited Impact
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.
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How Cos. With Chinese Suppliers Should Prep For Biotech Bill
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.
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FTC's Drug Middlemen Probe Highlights Ongoing Scrutiny
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.
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What Cos. Should Note In DOJ's New Whistleblower Pilot
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.
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Motion To Transfer Venue Considerations For FCA Cases
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.
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A Primer On EU's Updated Human Substance Regulations
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.
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CFPB's Medical Debt Proposal May Have Side Effects
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.
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15 Areas That Would Change Under Health Data Rule Proposal
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.
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3 Healthcare FCA Deals Provide Self-Disclosure Takeaways
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.