Policy & Compliance
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August 26, 2025
Split 9th Circ. Upholds Oregon Pharmaceutical Reporting Law
A split Ninth Circuit panel on Tuesday vacated a lower court's order blocking an Oregon law requiring drug manufacturers to report information related to certain prescription drugs to the state, ruling that the law is indeed constitutional under both the First and Fifth amendments.
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August 26, 2025
DC Circ. Backs HHS In Low-Income Patient Payment Dispute
The D.C. Circuit has delivered a blow to a group of hospitals in a recent decision finding they had challenged a key component of their Medicare reimbursements too early, despite hospital associations' warnings that such a ruling could slow healthcare providers' ability to seek review and "ultimately harm" patients.
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August 26, 2025
Mich. AG Lambasts UMich For Halting Trans Youth Care
Michigan's attorney general publicly warned the University of Michigan Tuesday that her office was "considering all of our options" after the university's hospital system said it would cease providing gender-affirming care to minors under pressure from the Trump administration.
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August 26, 2025
Maine Medicaid Cuts, Medicare Radiation Ruling And More
A Maine federal court turned down a family planning organization's request to temporarily block a congressional mandate withdrawing Medicaid funds to abortion providers. In South Carolina, Planned Parenthood filed a new complaint challenging a state policy kicking the provider out of the state's Medicaid program for providing abortions.
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August 26, 2025
Doctors Press 5th Circ. To Reverse Surprise Billing Ruling
Three physician trade associations urged the full Fifth Circuit to reverse a panel's ruling on how qualifying payments are calculated under the No Surprises Act, writing that the current decision harms underserved communities by narrowing provider networks.
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August 26, 2025
Cigna Strikes ERISA Ghost Network Suit Settlement Deal
Cigna Health and Life Insurance Co. has agreed to settle a proposed class action alleging the health plan administrator violated federal benefits law by advertising providers as in-network who were out-of-network to participants in employer-sponsored health benefit plans that Cigna administered, according to filings in Illinois federal court.
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August 26, 2025
Frier Levitt Adds FDA Regulation Specialist Duo
New Jersey-based national healthcare law boutique Frier Levitt added a partner and senior counsel pair from a life science law boutique this week to expand its expertise in Food and Drug Administration regulation and compliance and the cannabis and hemp industries.
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August 26, 2025
TikTok Takes State's Addictive App Case To NC Top Court
TikTok and its Chinese parent company are taking the state of North Carolina's lawsuit accusing it of intentionally designing the app to addict young users to the state's highest court after a Business Court judge rejected their early exit bid.
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August 26, 2025
Foley Hoag Adds Healthcare Co-Leader From Manatt
Foley Hoag LLP has hired the former president and CEO of the National Hospice and Palliative Care Organization as the new co-chair of its healthcare department.
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August 25, 2025
DOJ Wants $10.5M From Convicted Nursing Exec For Fraud
U.S. Department of Justice prosecutors asked a Nevada federal judge Friday for a $10.5 million preliminary forfeiture order against a nurse staffing executive convicted of wage-fixing, an amount that matches what he was paid for his staffing company after deceiving the buyer into thinking there was no criminal antitrust investigation.
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August 25, 2025
Greenberg Traurig Adds Healthcare Atty From Baker Donelson
Greenberg Traurig LLP has brought on a shareholder from Baker Donelson Bearman Caldwell & Berkowitz PC at its Tallahassee office, adding an experienced attorney to its healthcare and U.S. Food and Drug Administration practice, the firm announced Monday.
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August 25, 2025
Generic-Drugs Group Asks 9th Circ. To Nix Pay-For-Delay Law
A trade group for generic drugmakers urged the Ninth Circuit to fully scrap a California law banning brand pharmaceutical companies from paying to delay generics competition, in a brief targeting both the law's in-state features upheld by a district court and the extraterritorial reach the state wants revived.
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August 22, 2025
Texas, Fla. Want In On Abortion Medication Challenge
Texas and Florida have asked a Lone Star State federal court to allow them to intervene in litigation challenging federal approvals for the abortion medication mifepristone, arguing that their interests may "no longer be adequately represented" by Missouri, Kansas and Idaho, which are currently leading the suit.
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August 22, 2025
Chicago Feds Create New Healthcare Fraud Section
The U.S. attorney's office in Chicago announced Friday it has created a section within its Criminal Division dedicated solely to prosecuting healthcare fraud, which the U.S. Department of Justice has identified as a fraud enforcement priority.
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August 22, 2025
Judge Blocks Most ACA Rule Changes, Lets Others Proceed
A Maryland federal judge Friday largely froze the Trump administration's changes to Affordable Care Act regulations, handing a win to three cities, a coalition of doctors and a small business advocacy group that contend the changes would cause at least 1.8 million people to lose their healthcare coverage.
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August 21, 2025
CVS, Drugmakers Illegally Inflated Insulin Prices, City Claims
Drugmakers Eli Lilly and Co., Novo Nordisk Inc. and Sanofi-Aventis US LLC, pharmacy benefit managers CVS Caremark, Express Scripts and Optum Rx, and others have been hit with civil racketeering and state unfair trade practices law claims by the city of Torrington, Connecticut, over an alleged scheme to inflate insulin prices.
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August 21, 2025
DOJ Gets Backing In Fight Over Public Benefits
A group that fights to restrict immigration into the U.S. is urging a Rhode Island federal court to let the Trump administration narrow noncitizens' access to programs like Head Start, homeless shelters and food banks, arguing Thursday that a coalition of 20 states is trying to obstruct immigration enforcement and give benefits to "illegal aliens."
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August 21, 2025
High Court Allows Trump Admin To Cancel $783M In NIH Grants
The U.S. Supreme Court on Thursday allowed the Trump administration to resume the mass termination of scientific grants, overturning rulings by lower courts that had kept the funds flowing to universities and other recipients.
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August 21, 2025
Feds Claim Fla. Billing Co. Aided $15M Medicare Fraud
The U.S. government urged a Florida federal judge to deny an outsourcing company's motion to toss a $15 million False Claims Act lawsuit, saying the business aided a Miami-based laboratory to fraudulently bill Medicare for genetic tests that weren't used to treat patients.
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August 21, 2025
11th Circ. Backs Health System In Black Worker's Bias Suit
The Eleventh Circuit ruled Thursday that a fired Black worker can't revive her race and disability bias suit against a Georgia health system, saying her failure to provide a proposed date to return from medical time off amounted to an unreasonable request for indefinite leave.
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August 21, 2025
Seton Hall Gets COVID-19 Death Suit Tossed For Good
A New Jersey federal judge wasn't swayed by new arguments brought by parents of a Seton Hall University sophomore who died during a COVID-19 isolation period, saying their contract-related claims failed to establish one existed at all.
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August 21, 2025
Employer Plans In Limbo As Courts Grapple With Trans Care
Despite appellate courts' apparent willingness to allow states to ban gender-affirming care for minors, employers are still waiting for clarity on whether federal anti-discrimination laws require health plans to cover transgender healthcare access, experts say.
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August 20, 2025
17 States, DC Urge FDA To Lift Mifepristone Restrictions
Seventeen states and the District of Columbia Wednesday joined four others in urging the U.S. Food and Drug Administration to lift restrictions on the abortion drug mifepristone, saying that data their health departments collected overwhelmingly back the drug's safety.
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August 20, 2025
Judge Grills Feds On Upending 30-Year Noncitizen Benefits
A Rhode Island federal judge seemed perplexed Wednesday by a government attorney's contention that for nearly 30 years, various administrations across the political spectrum have wrongly interpreted a law the Trump administration now says requires immigration status checks for additional federal benefits.
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August 20, 2025
Ohio Justices Free Bank From $77M Guaranty Disclosure Duty
The Ohio Supreme Court on Wednesday ruled that nothing in state law required Huntington Bank to inform a co-signer of a $77 million loan guaranty about the risks associated with signing the deal with two other partners, one of whom later pled guilty to a check-kiting scheme.
Expert Analysis
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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.
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Takeaways From High Court's Tribal Health Admin Cost Ruling
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.
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FTC Focus: Private Equity Investments In Healthcare
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.
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High Court's Expert Ruling May Help Health Fraud Defendants
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.
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Unpacking HHS' Opinion On Cell Therapy Refund Programs
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.
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DOJ Innovasis Settlement Offers Lessons On Self-Disclosure
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.
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How Orange Book Antitrust Scrutiny Is Intensifying
Pharmaceutical patent holders should be reviewing Orange Book listing practices, as the Federal Trade Commission takes a more aggressive antitrust approach with actions such as the Teva listing probe, and the U.S. Food and Drug Administration calls attention to potentially improper listings, say attorneys at McDermott.
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After Chevron: Slowing Down AI In Medical Research
The U.S. Supreme Court's recent decision overturning the Chevron doctrine may inhibit agencies' regulatory efforts, potentially slowing down the approval and implementation of artificial intelligence-driven methodologies in medical research, as well as regulators' responses to public health emergencies, say Ragini Acharya and Matthew Deutsch at Husch Blackwell.