Policy & Compliance
-
August 20, 2025
State AGs Sidelined From Sandoz Price-Fixing Deal
A group of over 40 states and territories cannot intervene in a $275 million settlement resolving generic-drug price-fixing claims against Sandoz because they only have a nominal interest in the suit that fails to confer standing, a Pennsylvania federal judge said.
-
August 20, 2025
$2.8B BCBS Antitrust Deal Approved With $759M For Attys
An Alabama federal judge has approved a $2.8 billion settlement between Blue Cross Blue Shield and a class of medical providers in a landmark antitrust case, with $759 million going to Whatley Kallas LLP and other law firms for attorney fees and costs.
-
August 20, 2025
Insurers Say Gov't Misusing FCA To Get Medicare Cost Cap
Insurers accused of paying brokers to steer customers to their Medicare Advantage plans asked a Massachusetts federal judge to dismiss a False Claims Act lawsuit, saying the government is mischaracterizing legal payments for marketing as kickbacks in an attempt to impose caps it has thus far been unable to obtain.
-
August 20, 2025
CVS PBM Overbilling Judgment Trebled To $290M
A Pennsylvania federal judge has increased threefold a judgment against CVS Caremark from $95 million to $290 million for overbilling Medicare Part D-sponsored drugs.
-
August 19, 2025
Tenn. Judge Trims Healthcare Contract TRAP Suit
A Tennessee federal judge dismissed Fair Labor Standards Act claims brought by operating room technicians claiming their ex-employer, SpecialtyCare, unlawfully required them to repay tens of thousands of dollars for specialty training, plus interest, if they quit within three years, but the judge greenlit their Truth in Lending Act claims.
-
August 19, 2025
Losses Mount For Medicare Drug Negotiation Challengers
Big Pharma's losses in challenges to Medicare drug price negotiations are piling up. But don't think the industry is ready to wave the white flag.
-
August 19, 2025
High Court Seeks State Input on Health Sharing Ministry Case
The U.S. Supreme Court is showing interest in a challenge to state regulatory authority over health care sharing ministries. The nonprofit groups, which offer a cheaper alternative to traditional insurance, are expected to see more demand under major changes coming to the insurance marketplace.
-
August 19, 2025
Novo Nordisk Gets Forfeiture Claims Cut From 401(k) Suit
A New Jersey federal judge on Tuesday dismissed workers' allegations that Novo Nordisk unlawfully used forfeited funds in its $2.3 billion 401(k) plan for its own benefit and kept a shoddy fund on its investment roster, leaving an excessive fee claim in play.
-
August 19, 2025
Panel Weighs Ga. High Court Ruling In Sham Donor Suit
Customers who accused a sperm bank of selling sperm without disclosing the true medical and criminal histories of donors urged the Georgia Court of Appeals to revive their lawsuits Tuesday, arguing the dismissals were based on a misreading of a 2020 decision from the state's high court.
-
August 19, 2025
CMS Defeats 'Hair's Breadth' Star Rating Challenge
Insurance companies challenging the "star" system for rating Medicare Advantage organizations have lost another round in court, with a Texas federal judge saying Elevance Health failed to show federal officials violated the law when rounding down scores.
-
August 19, 2025
Judge Backs Deal To Overhaul NY Kids' Mental Healthcare
A New York federal judge has given the green light to allow the state to revamp its Medicaid mental health services for children to expand greater in-home and crisis care to prevent the institutionalization of kids.
-
August 19, 2025
Hawaii Abortion Drug Fight: 3 Things To Know
The drug mifepristone has emerged as a key flash point in legal battles over state abortion restrictions, drug prescribing rules and the legalities of sending abortion medications across state lines. This week, a federal court in Hawaii will hear arguments in a challenge to the FDA's changes to the drug safety review process.
-
August 19, 2025
Trump's 'Abnormal' Use Of FCA Could Get Tricky In Court
The Trump administration is wielding the False Claims Act in unusually narrow ways to drive policies on social and cultural issues — including gender-affirming care and diversity, equity and inclusion programs — but the government's potential theories of liability under the federal law remain largely untested and might not hold up in court, experts say.
-
August 18, 2025
Most Ozempic, Wegovy Claims Survive MDL Dismissal Bid
Eli Lilly & Co. and Novo Nordisk will have to face most of a multidistrict litigation accusing them of misleading consumers over the risks and benefits of popular weight loss drugs like Ozempic and Trulicity, after a Pennsylvania federal judge only trimmed a few of the dozen claims the drugmakers tried to have tossed.
-
August 18, 2025
Judge Known For Nixing ACA To Lead Texas' Northern District
A conservative judge known for declaring Obamacare unconstitutional, among other high-profile rulings, took over as chief judge of the U.S. District Court for the Northern District of Texas on Monday, according to an announcement from the court.
-
August 15, 2025
DOJ Backs Small Biz In Gender Dysphoria Coverage Dispute
The U.S. Department of Justice told a New Hampshire federal court Friday that employers are not required under federal anti-discrimination laws to provide medical coverage for gender dysphoria, and that federal religious freedom law protects a turbomachinery company from covering a transgender employee's treatment for the disorder.
-
August 15, 2025
Microsoft Unit Agrees To Pay $8.5M In MOVEIt Hack MDL
A Massachusetts federal judge has preliminarily signed off on an $8.5 million settlement reached between Nuance Communications and more than 1 million patients in multidistrict litigation over a 2023 malware attack that exploited a vulnerability in Progress Software's MOVEIt transfer file tool.
-
August 15, 2025
Wholesalers Want Final OK For $51M AstraZeneca Settlement
Drug wholesalers asked a Delaware federal judge Thursday for the final stamp of approval on a combined $51.4 million in settlements AstraZeneca Pharmaceuticals LP and Handa Pharmaceuticals LLC agreed to pay to resolve allegations AstraZeneca paid off generic-drug makers, including Handa, to protect its brand antipsychotic Seroquel XR.
-
August 15, 2025
AbbVie's Key RICO Claims In Drug Cost Fraud Suit Survive
An Illinois federal judge on Friday ruled that AbbVie could move ahead with the bulk of its racketeering, tortious interference and fraud claims against a behind-the-scenes healthcare company that the drugmaker alleges colluded with pharmacy benefit managers to fraudulently obtain drugs meant for patients in AbbVie's charitable programs.
-
August 15, 2025
Home Chain Got OT Math Wrong For 1,000 Nurses, Court Told
A group of nursing homes operating as one company left shift differentials and bonus pay out of certified nursing assistants' overtime math, a former employee alleged in a suit in Mississippi federal court, saying the violations affected more than 1,000 workers.
-
August 15, 2025
1st Wrongful Death Suit Filed In Deadly Mass. Rest Home Fire
The first of what are expected to be multiple wrongful death lawsuits stemming from a July 13 fire that killed 10 elderly and disabled residents of a Fall River, Massachusetts, assisted living facility was filed late Thursday in state court.
-
August 14, 2025
OptumRx Flags Email Accidentally Sent To Opioid MDL Parties
UnitedHealth subsidiary OptumRx Inc. is seeking a ban on secret communications with the Ohio federal judge overseeing sprawling national opioid litigation after the court-appointed special master accidentally sent the company an email, intended for the judge, celebrating a "gambit" that prevented objections to his decision.
-
August 14, 2025
Calif. Justices Say No Arb. For Nursing Home Death Claim
The California Supreme Court on Thursday reversed a decision sending to arbitration a wrongful death claim by parents who allege their son was neglected at the 24-hour skilled nursing facility he was admitted to.
-
August 14, 2025
Fired Nurse Accused Of Stealing Drugs Can't Revive Bias Suit
The Seventh Circuit declined Thursday to reinstate a fired Salvadoran nurse's suit claiming she was accused of stealing and using opioids at work out of bias for her nationality, stating she failed to put forward evidence that her national origin drove concerns rather than her sluggish behavior.
-
August 14, 2025
20 States Win Injunction Against ICE's Use Of Medicaid Data
A California federal judge has blocked the federal government from using Medicaid information from 20 states for immigration enforcement purposes, marking a partial victory for the coalition of states challenging a new data-sharing arrangement between the U.S. Department of Health and Human Services and the Department of Homeland Security.
Expert Analysis
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
FDA's Multifaceted Role On Display In MDMA Therapy Scrutiny
Ongoing deliberations at the U.S. Food and Drug Administration regarding MDMA-assisted therapy for post-traumatic stress disorder serves as a window into the intricate balance of scientific innovation and patient safety oversight, and offers crucial insights into regulatory nuances, say Kimberly Chew at Husch Blackwell and Kevin Lanzo at Pharmaka Clinical Consulting.
-
Analyzing FDA Draft Guidance On Clinical Trial Diversity
In light of the U.S. Food and Drug Administration's draft guidance on clinical trial diversity action plans, there are several important considerations for sponsors and clinical researchers to keep in mind to prevent delay in a drug or device application, say attorneys at Crowell & Moring.