Policy & Compliance

  • June 11, 2026

    Stop & Shop Parent Pays $40M On Inflated Drug Price Claims

    Stop & Shop's parent company will pay $40 million to resolve allegations it violated the False Claims Act by failing to report discounted prescription drug prices as "usual and customary" in claims submitted to federal Medicare, Medicaid and TRICARE programs, which resulted in overcharges, the U.S. Department of Justice announced Wednesday.

  • June 11, 2026

    HHS OIG Reports 'Concerning' Medicare Advantage Denials

    A pair of reports released by the inspector general for the U.S. Department of Health and Human Services on Thursday found that UnitedHealth Group, Humana and CVS Health logged some of the highest prior authorization denial rates among their Medicare Advantage peers for post-acute care.

  • June 11, 2026

    Braidwood Files New Challenge To ACA Birth Control Mandate

    For-profit healthcare company Braidwood Management and several individuals sued the government in Texas federal court to challenge no-cost contraception coverage requirements under the Affordable Care Act, arguing that the court should enjoin enforcement of the policy because it burdened their faith in violation of federal religious freedom law.

  • June 10, 2026

    Morgan & Morgan Atty Again Blocked From Harvard Suit

    A Massachusetts judge rebuffed a Morgan & Morgan PA attorney's second attempt to appear in a lawsuit over the theft of body parts from a Harvard Medical School morgue, saying he would not reconsider his earlier decision to bar the attorney over an incident in a separate court involving fake AI-generated case citations.

  • June 10, 2026

    Judge Won't Certify Class Of Health Workers In No-Poach Suit

    An Illinois federal judge on Wednesday refused to certify a class of former healthcare employees claiming that their wages were suppressed by alleged no-poach agreements among DaVita, UnitedHealth Group's Surgical Care Affiliates and Tenet Healthcare Corp. unit United Surgical Partners International, ruling that the proposed class is too diverse.

  • June 10, 2026

    Abbott Offered Faulty Health Plan Option, Ex-Worker Says

    Abbott Laboratories violated federal benefits law by offering a health plan option with higher premiums and lower deductibles without disclosing that participants would always pay less if they chose a high-deductible plan, according to a proposed class action filed Wednesday in Illinois federal court.

  • June 10, 2026

    NJ High Court Says Nonprofit Hospital Gets Limited Immunity

    The New Jersey Supreme Court unanimously concluded Wednesday that a nonprofit federally qualified health center isn't immune from a patient's negligence suit under a statute shielding nonprofits organized "exclusively" for charitable or educational purposes, reversing a lower court's finding to the contrary.

  • June 10, 2026

    Insurance Cos. Score Dismissal Of Zepbound Coverage Case

    A D.C. federal judge Wednesday agreed to toss a proposed class action against CVS Caremark and CareFirst BlueCross BlueShield from a worker who challenged coverage denials for Zepbound to treat sleep apnea, holding an exclusion in his employee health plan that the companies administered complied with federal benefits law.

  • June 10, 2026

    Lab To Pay $4.9M To Settle AGs' COVID Test Pricing Suit

    Eighteen states' attorneys general have entered into a $4.87 million settlement with GS Labs to resolve claims that the defunct testing company overcharged consumers for COVID-19 tests, according to statements issued Wednesday.

  • June 10, 2026

    Houston Hospital System Settles Retirement Fee, Fund Fight

    A Texas hospital system agreed to settle a proposed class action from ex-workers alleging the healthcare nonprofit failed to curb excessive recordkeeping fees and remove underperforming funds from its $2.8 billion employee retirement plan, after a magistrate judge recommended denying its motion to dismiss an amended complaint in May.

  • June 09, 2026

    Novartis, AbbVie Lose Bid To Halt Wash. 340B Pharmacy Law

    A Washington federal judge declined Tuesday to block a state law passed to protect prescription drug access for low-income and uninsured patients, rejecting arguments from AbbVie and Novartis that the new measure illegally adds to pharmaceutical manufacturers' obligations under the federal 340B Drug Pricing Program.

  • June 09, 2026

    Trans Care In Court: 7th Circ. Appeal, Atty Discipline And More

    Law360 Healthcare Authority looks at an emergency request related to the American Academy of Pediatrics, a Rhode Island judge's referral of Justice Department attorneys to a disciplinary committee, and other top news of the past week.

  • June 09, 2026

    Calif. Judge Blocks DOJ's Bid For Trans Patients' Medical Info

    A California federal judge ordered Stanford Medicine hospital not to disclose medical information belonging to trans adolescents who received gender-related care in response to a Texas grand jury subpoena, and blocked the U.S. Department of Justice from taking further steps to obtain their patient records.

  • June 09, 2026

    Eli Lilly Wins Order Halting Alleged Trulicity Fraud

    A Florida federal judge signed off Tuesday on a preliminary injunction pausing a prescription cost share program purportedly for Church of God in Christ members that pharmaceutical giant Eli Lilly and Co. says is actually a fraud scheme to resell GLP-1 drug Trulicity on the secondary market.

  • June 09, 2026

    Loper Battle Looms For Medicaid Frailty Work Exemption

    New federal work requirements for people on Medicaid take a strict view of who's too sick to work. They're almost certain to face legal challenges contending that the Trump administration went too far.

  • June 09, 2026

    4th Circ. Lets Hartford Unit Off The Hook For Drug Test Fight

    A Hartford unit doesn't owe coverage to a drug testing company accused of reporting false positive drug tests due to substandard quality control, the Fourth Circuit ruled Tuesday, saying the suit is related to an earlier claim that was covered by another insurer.

  • June 09, 2026

    The Law360 400: A Look At The Top 100 Firms

    The race to build the legal industry's largest law firm accelerated in 2025, with major firms leaning on mergers, lateral hiring and strategic expansion to climb the ranks of the Law360 400.

  • June 09, 2026

    Georgia County, Trans Deputy OK End To Surgery Bias Fight

    A Georgia county and a transgender sheriff's deputy who sued over her employee health plan's coverage exclusions for gender-affirming surgery have struck a deal to resolve her case, nine months after the en banc Eleventh Circuit issued a ruling that sided with the county. 

  • June 08, 2026

    Kaiser Member Seeks Class Cert. In Microsoft Site Tracker Suit

    A Kaiser Permanente member has called on a federal judge in Seattle to greenlight a series of national classes and California subclasses in her privacy lawsuit accusing Microsoft and Qualtrics of secretly intercepting millions of patients' private health information through tracking technologies embedded in the healthcare system's website.

  • June 08, 2026

    NC Doctor Avoids Prison For Role In $11M Medicaid Fraud

    A North Carolina doctor received five years of probation with eight months of house arrest for making false statements in an $11 million Medicaid fraud scheme, after a federal judge said he was struggling to balance the need to deter others with unwarranted sentencing disparities.

  • June 08, 2026

    Cleveland Clinic Deal With DOJ Bars Trans Care For Minors

    The Cleveland Clinic Foundation will pay over $2.3 million under agreements with the U.S. Department of Justice and the Ohio attorney general to prohibit the provision of puberty blockers and other forms of medical care for minors going through gender transition.

  • June 08, 2026

    Class Attys Want $11.6M In Fees From $35M Teva Inhaler Deal

    Berman Tabacco, Sperling Kenny Nachwalter LLC, Hilliard Shadowen LLP and five other firms have asked a Massachusetts federal judge for $11.55 million in attorney fees from a $35 million antitrust settlement resolving claims that Teva abused patent protections to delay generic competition for its QVAR asthma inhalers.

  • June 08, 2026

    HCA Unit To Pay $200K In EEOC Promotion Denial Suit

    An HCA Healthcare subsidiary has agreed to pay $200,000 to end a U.S. Equal Employment Opportunity Commission suit claiming it refused to promote a researcher because he was an Asian man in his 50s, the federal agency told a Tennessee federal court.

  • June 08, 2026

    Trump's $100K H-1B Fee Is Unauthorized Tax, Judge Rules

    A Massachusetts federal judge ruled Monday that President Donald Trump's $100,000 H-1B visa payment constitutes a tax that Congress did not authorize the president to impose, declaring the fee unlawful and vacating it in its entirety.

  • June 05, 2026

    HHS Can Issue Medicare Fines Without Jury, 4th Circ. Says

    The Fourth Circuit ruled Friday that the U.S. Department of Health and Human Services can seek monetary penalties from Medicare participants for violating program requirements without a jury trial, rejecting a Maryland nursing home operator's argument that Medicare participants are guaranteed that right.

Expert Analysis

  • Texas Med Spas Must Prepare For 2 New State Laws

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    Two new laws in Texas — regulating elective intravenous therapy and reforming healthcare noncompetes — mark a pivotal shift in the regulatory framework for medical spas in the state, which must proactively adapt their operations and contractual practices, says Brad Cook at Munsch Hardt.

  • DOJ-HHS Collab Crystallizes Focus On Health Enforcement

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    The recently announced partnership between the U.S. Department of Justice and U.S. Department of Health and Human Services to combat False Claims Act violations, following a multiyear trend of high-dollar DOJ recoveries, signals a long-term enforcement horizon with major implications for healthcare entities and whistleblowers, say attorneys at RJO.

  • How The Healthline Privacy Settlement Redefines Ad Tech Use

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    The Healthline settlement is the first time California has drawn a clear line in the sand around how website tracking must function in practice, so if your site uses tracking technologies, especially around sensitive content like health or finance, regulators are inspecting your website's back end, not just its banner, say attorneys at Baker Donelson.

  • How Sweeping Budget Bill Shakes Up Health Industry

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    With the recently passed One Big Beautiful Bill Act marking one of the most significant overhauls of federal health policy since the passage of the Affordable Care Act, providers, managed care organizations and life sciences companies must now shift focus from policy review to implementation planning, say advisers at Holland & Knight.

  • New DOJ Penalty Policy Could Spell Trouble For Cos.

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    In light of the U.S. Department of Justice’s recently published guidance making victim relief a core condition of coordinated resolution crediting, companies facing parallel investigations must carefully calibrate their negotiation strategies to minimize the risk of duplicative penalties, say attorneys at Debevoise.

  • A Look At Key 5th Circ. White Collar Rulings So Far This Year

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    In the first half of 2025, the Fifth Circuit has decided numerous cases of particular import to white collar practitioners, which collectively underscore the critical importance of meticulous recordbuilding, procedural compliance and strategic litigation choices at every stage of a case, says Joe Magliolo at Jackson Walker.

  • What US Medicine Onshoring Means For Indian Life Sciences

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    Despite the Trump administration's latest moves to onshore essential medicine manufacturing, India will likely remain an indispensable component of the U.S. drug supply chain, but Indian manufacturers should prepare for stricter compliance checks, says Jashaswi Ghosh at Holon Law Partners.

  • FCA Working Group Reboot Signals EHR Compliance Risk

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    The revival of the False Claims Act working group is an aggressive expansion of enforcement efforts by the Justice Department and the U.S. Department of Health and Human Services targeted toward technology-enabled fraud involving electronic health records and other data, say attorneys at ArentFox Schiff.

  • FDA's Hasty Policymaking Approach Faces APA Challenges

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    Though the U.S. Food and Drug Administration has abandoned its usual notice-and-comment process for implementing new regulatory initiatives, two recent district court decisions make clear that these programs are still susceptible to Administrative Procedure Act challenges, says Rachel Turow at Skadden.

  • The Metamorphosis Of The Major Questions Doctrine

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    The so-called major questions doctrine arose as a counterweight to Chevron deference over the past few decades, but invocations of the doctrine have persisted in the year since Chevron was overturned, suggesting it still has a role to play in reining in agency overreach, say attorneys at Crowell & Moring.

  • A Rapidly Evolving Landscape For Noncompetes In Healthcare

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    A wave of new state laws regulating noncompete agreements in the healthcare sector, varying in scope, approach and enforceability, are shaped by several factors unique to the industry and are likely to distort the market, say attorneys at Seyfarth.

  • Arguing The 8th Amendment For Reduction In FCA Penalties

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    While False Claims Act decisions lack consistency in how high the judgment-to-damages ratio in such cases can be before it becomes unconstitutional, defense counsel should cite the Eighth Amendment's excessive fines clause in pre-trial settlement negotiations, and seek penalty decreases in post-judgment motions and on appeal, says Scott Grubman at Chilivis Grubman.

  • $95M Caremark Verdict Should Put PBMs On Notice

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    A Pennsylvania federal judge’s recent ruling that pharmacy benefits manager CVS Caremark owes the government $95 million for overbilling Medicare Part D-sponsored drugs highlights the effectiveness of the False Claims Act, as scrutiny of PBMs’ outsized role in setting drug prices continues to increase, say attorneys at Duane Morris.