Policy & Compliance
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July 02, 2025
9th Circ. Upholds Sutter Health's Win In Doc's Kickback Suit
The Ninth Circuit refused to revive a gastroenterologist's constitutional challenge against Sutter Health alleging the nonprofit paid kickbacks to its physicians to refer low-income patients to other hospitals, ruling Wednesday the appellant lacks evidence of purported kickbacks and doesn't address how the alleged injury to those patients harmed him.
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July 02, 2025
ACA Changes Will Result In Mass Coverage Loss, Suit Claims
Doctors for America, the Main Street Alliance and a trio of cities urged a Maryland federal court to vacate recently finalized changes to Affordable Care Act regulations, arguing they will cause at least 1.8 million people to lose their healthcare coverage.
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July 02, 2025
Veterans Sue Air Force For Disability Review Failures
Three former service members hit the U.S. Air Force with a proposed class action challenging the lawfulness of a screening process used to determine if people should be retained or referred to a formal disability evaluation process.
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July 02, 2025
DOJ, HHS Form New False Claims Act Enforcement Group
Lead attorneys at the U.S. Department of Health and Human Services and the Justice Department will head a working group focused on enforcement of the False Claims Act, government officials announced Wednesday.
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July 02, 2025
Pa. Hospital Co. To Pay $2.75M Over Drug Theft Suit
Pennsylvania healthcare company Lehigh Valley Hospital Network Inc. has agreed to pay the federal government $2.75 million to settle claims that it ran afoul of controlled substance laws when one of its pharmacy technicians allegedly stole medication on multiple occasions.
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July 02, 2025
6th Circ. Backs Cigna's Win In Emergency Room Billing Suit
The Sixth Circuit has ruled that Cigna did not have to face an unjust enrichment lawsuit brought against it by two Tennessee hospitals alleging the insurer underpaid them for out-of-network emergency services, backing a lower court's dismissal order.
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July 02, 2025
Wisconsin High Court Narrowly Blocks 1849 Abortion Ban
The Wisconsin Supreme Court on Wednesday narrowly struck down an 1849 statute criminalizing abortion, finding that the law has been effectively replaced by more modern legislation regulating the procedure.
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July 01, 2025
5 Healthcare Enforcement Actions You Don't Want To Miss
A healthcare fraud operation announced by the Justice Department targeting $14.6 billion in potential false claims wasn't the only enforcement action making waves in the industry this past week.
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July 01, 2025
Texas Goes Big On New Healthcare Laws
It may be mid-summer, but Texas lawmakers are sending doctors and lawyers back to school for a course on what constitutes a "medical emergency" for the purpose of a legal abortion. Law360 Healthcare Authority looks at that statute and other legislation becoming law in the Lone Star State.
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July 01, 2025
State AGs Sue Gov't To Halt Medicaid Data Sharing With ICE
A California-led coalition of nearly two dozen state attorneys general is pushing a federal court to stop the U.S. Department of Health and Human Services from giving immigration officials "unfettered access" to Medicaid recipients' personal health information, arguing that the sharing flouts decades of policy and practice.
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July 01, 2025
Iowa Judge Halts Law Targeting Pharmacy Benefit Managers
A federal judge in Des Moines has temporarily blocked an Iowa law regulating pharmacy benefit managers, delivering a significant victory to a coalition of local businesses that argued the statute overstepped federal authority and infringed on free speech.
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July 01, 2025
Lighting Co. Can't Escape 401(k) Forfeiture, Health Fee Suit
An Illinois federal judge narrowed a proposed federal benefits class action against an automotive lighting company from an ex-worker, but allowed allegations to proceed to discovery alleging the company misspent 401(k) forfeitures and failed to properly notify workers about a health plan tobacco surcharge.
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July 01, 2025
High Court Ruling Puts Limits On Medicaid Enforcement
The U.S. Supreme Court ruling that bars a Medicaid beneficiary from suing over her right to choose a medical provider could make more states comfortable following South Carolina’s lead and cutting off Medicaid funding for disfavored providers.
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July 01, 2025
Rural Clinics Win Reprieve For Telehealth Funds At High Court
Thousands of rural healthcare clinics that rely on federal subsidies to provide telehealth services to millions of patients secured a major win when the U.S. Supreme Court ruled that the funding for a key Federal Communications Commission program is not unconstitutional.
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July 01, 2025
Top Personal Injury, Med Mal News: 2025 Midyear Report
A U.S. Supreme Court ruling over whether personal injury claims can be brought under a RICO statute and a $7.4 billion settlement reached with the Sackler family and Purdue Pharma are among Law360's top personal injury and medical malpractice cases from the first six months of 2025.
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July 01, 2025
Dentons Adds Career Arnold & Porter Litigator In DC
A career Arnold & Porter LLP attorney who spent more than 20 years with his former firm representing clients in False Claims Act litigation and other forms of commercial litigation has joined Dentons' Washington, D.C., office as a partner, the firm announced Tuesday.
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July 01, 2025
Anthem Inks $13M Deal To End Mental Health Class Action
Anthem has agreed to pay about $12.9 million to end a proposed class action alleging the insurer's coverage denials for inpatient mental health and substance use disorder treatments violated federal benefits and mental health parity laws, according to New York federal court filings.
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July 01, 2025
RI Judge Orders Halt To HHS Layoffs, Reorganization
A Rhode Island federal judge on Tuesday blocked the Trump administration from carrying out mass layoffs at the U.S. Department of Health and Human Services, finding the reorganization usurped congressional spending authority and likely violated the Administrative Procedure Act.
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June 30, 2025
Texas Panel Says Suit Challenging Abortion Travel Is Unripe
A split Texas appeals court panel found Monday that several anti-abortion groups lack standing to sue the city of San Antonio for allegedly earmarking money to pay for out-of-state abortion travel, saying the money had not gone out yet and the groups' claims were not ripe.
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June 30, 2025
Justices Won't Disturb 10th Circ. Oklahoma PBM Law Ruling
The U.S. Supreme Court on Monday declined to hear the state of Oklahoma's challenge to a Tenth Circuit decision that found parts of a recently enacted law regulating pharmacy benefit managers were preempted by federal benefits laws and Medicare Part D, cementing an industry group's win in the case.
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June 30, 2025
DOJ Says Over 300 Charged In $14.6B Healthcare Fraud Sting
A healthcare fraud operation conducted by federal and state law enforcement groups netted more than 300 defendants in a slew of schemes amounting to $14.6 billion in potential false claims, the Justice Department announced Monday.
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June 30, 2025
High Court Turns Away Fired Christian Workers' Vax Bias Case
The U.S. Supreme Court on Monday declined to review a Third Circuit ruling that shuttered Christian workers' suits claiming a healthcare system illegally fired them for opposing its COVID-19 vaccine mandate, despite the workers' assertions that the opinion improperly constricted their religious rights.
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June 30, 2025
Trump Administration Says Harvard Violated Civil Rights Law
The Trump administration on Monday informed Harvard University that it had run afoul of federal civil rights law by failing to protect Jewish and Israeli students on campus from harassment, and threatened to cut all funding from the nation's oldest university.
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June 30, 2025
Justices Undo Patients' Win In Gender-Affirming Care Fight
The U.S. Supreme Court on Monday struck down a Fourth Circuit decision that preserved access to gender-affirming care under two state-run health plans, telling the lower court to consider a recent decision by the justices that upheld a Tennessee law limiting treatments for young transgender people.
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June 27, 2025
Feds Prevail Over J&J In Another 340B Rebate Dispute
A D.C. federal judge granted a summary judgment win Friday to the U.S. Health Resources and Services Administration over Johnson & Johnson, finding the agency acted within its discretion when it rejected the company's program to offer rebates instead of discounts in a decades-old drug pricing program.
Expert Analysis
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In The CFPB Playbook: Making Good On Bold Promises
The U.S. Supreme Court's decision upholding the Consumer Financial Protection Bureau's funding structure in the second quarter cleared the way for the bureau to resume a number of high-priority initiatives, and it appears poised to charge ahead in working toward its aggressive preelection agenda, say Andrew Arculin and Paula Vigo Marqués at Blank Rome.
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Critical Questions Remain After High Court's Abortion Rulings
The U.S. Supreme Court's decisions in two major abortion-related cases this term largely preserve the status quo for now, but leave federal preemption, the Comstock Act and in vitro fertilization in limbo, say attorneys at Jenner & Block.
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Navigating FDA Supply Rule Leeway For Small Dispensers
As the November compliance deadline for the U.S. Food and Drug Administration's new pharmaceutical distribution supply chain rules draws closer, small dispensers should understand the narrow flexibilities that are available, and the questions to consider before taking advantage of them, say attorneys at Faegre Drinker.
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1st Gender Care Ban Provides Context For High Court Case
The history of Arkansas' ban on gender-affirming medical care — the first such legislation in the U.S. — provides important insight into the far-reaching ramifications that the U.S. Supreme Court's decision in U.S. v. Skrmetti next term will have on transgender healthcare, says Tyler Saenz at Baker Donelson.
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6 Lessons From DOJ's 1st Controlled Drug Case In Telehealth
Following the U.S. Department of Justice’s first-ever criminal prosecution over telehealth-prescribed controlled substances in U.S. v. Ruthia He, healthcare providers should be mindful of the risks associated with restricting the physician-patient relationship when crafting new business models, says Jonathan Porter at Husch Blackwell.
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After Chevron: Scale Tips Favor Away From HHS Agencies
The loss of Chevron deference may indirectly aid parties in challenging the U.S. Department of Health and Human Services' interpretations of regulations and could immediately influence several pending cases challenging HHS on technical questions and agency authority, say attorneys at Ropes & Gray.
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After Chevron: FDA Regulations In The Crosshairs
The U.S. Supreme Court's overturning of the Chevron doctrine is likely to unleash an array of challenges against the U.S. Food and Drug Administration, focusing on areas of potential overreach such as the FDA's authority under the Federal Food, Drug and Cosmetic Act, say attorneys at Debevoise.
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USPTO Disclaimer Rule Would Complicate Patent Prosecution
The U.S. Patent and Trademark Office's proposed changes to terminal disclaimer practice could lead to a patent owner being unable to enforce a valid patent simply because it is indirectly tied to a patent in which a single claim is found anticipated or obvious in view of the prior art, say attorneys at Sterne Kessler.
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Navigating Scrutiny Of Friendly Professional Corps. In Calif.
In light of ongoing scrutiny and challenges to private equity participation in the California healthcare marketplace, particularly surrounding the use of the friendly professional corporation model, management services organizations should consider implementing four best practices, say attorneys at Holland & Knight.
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Takeaways From New HHS Substance Use Disorder Info Rules
A new U.S. Department of Health and Human Services rule continues the agency's efforts to harmonize complex rules surrounding confidentiality provisions for substance use disorder patient records, though healthcare providers will need to remain mindful of different potentially applicable requirements and changes that their compliance structures may require, say attorneys at Ropes & Gray.
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Calif. Banking Brief: All The Notable Legal Updates In Q2
The second quarter of 2024 in California, which saw efforts to expand consumer protection legislation and enforcement actions in areas of federal focus like medical debt and student loans, demonstrated that the state's role as a trendsetter in consumer financial protection will continue for the foreseeable future, say attorneys at Sheppard Mullin.
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How Cannabis Rescheduling May Affect Current Operators
The U.S. Drug Enforcement Agency's proposal to reschedule marijuana to Schedule III provides relief in the form of federal policy from the stigma and burdens of Schedule I, but commercial cannabis operations will remain unchanged until the federal-state cannabis policy gap is remedied by Congress, say Meital Manzuri and Alexis Lazzeri at Manzuri Law.
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Air Ambulance Ruling Severely Undermines No Surprises Act
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.