Policy & Compliance

  • June 11, 2025

    Children's Healthcare Nonprofit Settles Retirement Fee Suit

    A Florida-based nonprofit children's healthcare network and ex-workers who alleged their employee retirement savings were dragged down by excessive fees told a Florida federal court Wednesday they'd worked out a class action settlement of the dispute after mediation.

  • June 11, 2025

    Ga. Hospice Provider Pays $9.2M To End Kickback Case

    A Georgia hospice care provider and its CEO forked over $9.2 million to settle claims that they violated federal fraud laws by participating in a kickback scheme with medical directors who referred hospice patients to the group, prosecutors announced Wedesnday.

  • June 11, 2025

    Aetna Resolves Lipedema Patients' Coverage Class Action

    Aetna has agreed to end a class action alleging it unlawfully refused to cover liposuction as a treatment for over two dozen patients afflicted with a rare chronic condition called lipedema, according to a Wednesday filing in California federal court.

  • June 11, 2025

    Cigna Accused Of Misusing $17M In 401(k) Forfeitures

    Retirement plan participants and beneficiaries at Cigna say the company violated the Employee Retirement Income Security Act by using up to $17 million given up by participants who quit early to reduce the company's matching contributions, rather than using it to pay for the plan's administrative costs.

  • June 11, 2025

    Conn. Orthopedic Practice Faces Data Breach Class Claims

    A March 2 data breach at a Connecticut orthopedic practice exposed the personal information and health data of an unknown number of patients to online hackers, a patient alleged in a proposed class action.

  • June 11, 2025

    Health Network Strikes Deal In Retirement Plan Forfeiture Suit

    A Pennsylvania health system has settled a suit claiming it failed to tamp down on unnecessary expenses in its $1.1 billion retirement plan and used forfeited funds to cover its own contributions to the plan instead of using the abandoned cash to reduce fees.

  • June 10, 2025

    Ga. Justices Consider Tolling In Tongue Amputation Case

    The Georgia Supreme Court on Tuesday considered whether the state's two-year statute of limitations applies to a lawsuit against Regency Hospital Co. and one of its nurses over claims that they neglected an allegedly incapacitated patient to the point that her tongue had to be amputated. 

  • June 10, 2025

    IT Co. Urges 1st Circ. To Affirm It's Blameless For Data Breach

    An information security technology company urged the First Circuit on Tuesday to affirm that it isn't liable for a 2018 data breach that exposed confidential information of more than 277,000 of the medical device maker's patients, arguing that the insurer assignee of the device maker had no valid points.

  • June 10, 2025

    Amazon Can't Duck Suit Over Non-FDA Approved Supplements

    Amazon must face a proposed class action alleging it sells non-FDA approved supplements touting health-related claims without mandatory disclaimers, after a Washington federal judge rejected the company's argument the plaintiffs lack standing to pursue claims over supplements they never bought, finding the plaintiffs allege a uniform, systematic marketing practice.

  • June 10, 2025

    Ala. Judge Orders Trans Health Org. To Publish Training Vids

    In a case challenging Alabama's ban on gender-affirming care for youths, a federal judge this week ordered a trans health organization to publish video recordings of the group's conferences and a medical training course, after the group had sought to protect the content's confidentiality. 

  • June 10, 2025

    9th Circ. Skeptical Oregon Hospital Merger Law Is Too Vague

    A Ninth Circuit panel on Monday appeared skeptical of a hospital association's challenge to an Oregon law that grants a state agency broad power to block proposed healthcare consolidations to ensure equitable access to healthcare, with two of the three judges questioning whether federal law could limit the state's authority.

  • June 10, 2025

    Attys Field Provider Fears, Queries On CMS Trans Care Probe

    A new federal push to obtain a broad swath of clinical and financial data from hospitals providing gender-affirming care is triggering a wave of concerns that the Trump administration's enforcement approach will have a chilling effect on care delivery.

  • June 10, 2025

    Pandemic Law Doesn't Protect Mich. Hospital In Bedsore Case

    A Michigan appellate court has revived a lawsuit filed by the estate of an 88-year-old woman who died after developing a bedsore during the COVID-19 pandemic, finding that a state law shielding hospitals from pandemic liability didn't apply because the woman wasn't treated for the virus.

  • June 10, 2025

    Drug Cos. Face Persistent Scrutiny Over Physician Kickbacks

    Drugmakers continue to become ensnared in — and settle — investigations into illegal payments to healthcare providers for participating in sham speaker programs. These payments raise ethical questions about patient harm and whether they are seen as a cost of doing business.

  • June 10, 2025

    A Federal Preemption Target On State Medical Debt Laws

    The Trump administration changes course on medical debt reporting, putting a new target on a slate of state laws that protect patients from some of the impacts of unpaid medical bills.

  • June 09, 2025

    RFK Jr. Fires CDC's Entire 17-Member Vaccine Advisory Panel

    The U.S. Department of Health and Human Services announced Monday that Secretary Robert F. Kennedy Jr. removed every member of the committee that provides advice and guidance on the use of vaccines to the Centers for Disease Control and Prevention, pledging to replace them with his preferred picks.

  • June 09, 2025

    Trump Orders Targeting DEI, LGBTQ+ Funding Partly Blocked

    A California federal judge Monday blocked portions of President Donald Trump's executive orders targeting diversity and inclusion policies and programs serving the LGBTQ+ community, saying a group of nonprofits is likely to succeed in showing that stripping their federal funding violates their constitutional rights.

  • June 09, 2025

    Gov't Seeks $706M Penalty In FCA Case Against Omnicare, CVS

    The government asked a New York federal judge to impose a collective $706 million in civil penalties on Omnicare Inc. and its parent, CVS Health Corp., after a jury found that they submitted millions of false billing claims for healthcare programs.

  • June 09, 2025

    2nd Circ. Nixes Doc's Power Of Atty Deal In Patient ERISA Suit

    The Second Circuit ruled Monday that a doctor couldn't use a power-of-attorney arrangement to sue on behalf of a patient who said their union's health plan illegally stuck them with a $150,000 medical bill, but directed a trial court to determine if the patient can pursue the case.

  • June 09, 2025

    5th Amendment Can't Shield Ex-Exec, Drugmakers Argue

    Generic-drug makers urged a Pennsylvania court to compel a former executive to sit for a deposition in ongoing price-fixing litigation despite his invocation of the Fifth Amendment, arguing his testimony is crucial to their defense.

  • June 09, 2025

    Sheppard Mullin Adds Perkins Coie IP Trio In DC, Chicago

    Three Perkins Coie LLP intellectual property partners with deep experience representing clients in the pharmaceutical, biotechnology and related industries have jumped to Sheppard Mullin Richter & Hampton LLP.

  • June 09, 2025

    HI Gov. Eyes Veto Of Medical Pot Bill Over Privacy Concerns

    Hawaii Gov. Josh Green has signaled that he intends to veto a bill modifying the state's medical marijuana program, saying that it would impinge the privacy rights of the Aloha State's medical cannabis patients.

  • June 09, 2025

    Worker Says NYC Hospital Network, Co. Skimped On Wages

    NYC Health and Hospitals and a staffing company failed to pay the entirety of wages to employees who worked at emergency response and relief centers where asylum seekers would stay, a former operational site lead said in a suit in New York federal court.

  • June 06, 2025

    J&J Unit's $147M Catheter Antitrust Loss Tripled To $442M

    Johnson & Johnson health tech unit Biosense Webster's bill in an antitrust trial was upped from $147 million to $442 million after a California federal jury found it stifled competition by conditioning the provision of cardiac mapping services on purchases of cardiac catheters.

  • June 06, 2025

    Texas AG Says Trans Care Investigation Is Lawful

    The Texas Attorney General's Office told the state's Supreme Court that a lower court went too far by blocking an investigation into an LGBTQ+ advocacy organization that allegedly had knowledge about outside parties performing gender-affirming care on minors, saying the court undermined the AG's investigative authority.

Expert Analysis

  • Spartan Arbitration Tactics Against Well-Funded Opponents

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    Like the ancient Spartans who held off a numerically superior Persian army at the Battle of Thermopylae, trial attorneys and clients faced with arbitration against an opponent with a bigger war chest can take a strategic approach to create a pass to victory, say Kostas Katsiris and Benjamin Argyle at Venable.

  • The Road Ahead For Florida's Drug Importation Program

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    Though the U.S. Food and Drug Administration approved Florida's drug importation program in January, a series of hurdles — including requisite buy-in from Canada — and potential legal challenges must be addressed before importation can begin, say attorneys at Ropes & Gray.

  • Assessing CDC's Revised Guideline On Opioid Prescriptions

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    Kenneth Weinstein, Nicholas Van Niel and Kate Uthe at Analysis Group look at newly available data to evaluate the impact that the Centers for Disease Control and Prevention's revised opioid monitoring guideline have had on prescription trends in recent years, highlighting both specific and overall decreases.

  • Valeant Ruling May Pave Way For Patent-Based FCA Suits

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    The Ninth Circuit’s recent ruling in Silbersher v. Valeant marks a significant development in False Claims Act jurisprudence, opens new avenues for litigation and potentially raises the stakes for patent applicants who intend to do business with the government, say Joshua Robbins and Rick Taché at Buchalter.

  • Suits Against Insulin Pricing Are Driven By Rebate Addiction

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    A growing wave of lawsuits filed by states, cities and counties against insulin manufacturers and pharmacy benefit managers improperly allocate the blame for rising insulin costs, when in actuality the plaintiffs are partially responsible, says Dan Leonard at Granite Capitol Consulting.

  • When Physician Retirement Arrangements May Be Legal

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    A recent advisory opinion from the Office of Inspector General regarding physician retirement arrangements sheds light on key considerations and mitigating factors that may be useful when attempting to balance healthcare operational needs with statutory conformity, says Magda Rodriguez at Day Pitney.

  • ESG Around The World: Gulf Cooperation Council

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    The Gulf Cooperation Council is in the early stages of ESG policy implementation, but recent commitments by both states and corporations — including increases in sustainable finance transactions, environmental commitments, female representation on boards and human rights enforcement — show continuing progress toward broader ESG goals, say attorneys at Cleary.

  • Navigating ACA Reporting Nuances As Deadlines Loom

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    Stephanie Lowe at Liebert Cassidy walks employers through need-to-know elements of Affordable Care Act reporting, including two quickly approaching deadlines, the updated affordability threshold, strategies for choosing an affordability safe harbor, and common coding pitfalls.

  • Lessons From Rare Post-Verdict Healthcare Fraud Acquittal

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    A Maryland federal court recently overturned a jury verdict that found a doctor guilty of healthcare fraud related to billing levels for COVID-19 tests, providing defense attorneys with potential strategies for obtaining acquittals in similar prosecutions, says attorney Andrew Feldman.

  • ChristianaCare Settlement Reveals FCA Pitfalls For Hospitals

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    ChristianaCare's False Claims Act settlement in December is the first one based on a hospital allegedly providing private physicians with free services in the form of hospital-employed clinicians and provides important compliance lessons as the government ramps up scrutiny of compensation arrangements, say attorneys at Sheppard Mullin.

  • Patent Waiver For COVID Meds Would Harm US Biopharma

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    If the Biden administration backs the World Trade Organization in waiving patent rights on COVID-19 treatments, it would negatively affect the U.S. biopharmaceutical industry and help foreign competitors, without necessarily expanding global access to COVID-19 care, says clinical pathologist Wolfgang Klietmann.

  • New CMS Rule Will Change Nursing Facility Disclosures

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    A new rule from the Centers for Medicare & Medicaid Services significantly expands disclosure requirements for nursing facilities backed by private equity companies or real estate investment trusts, likely foreshadowing increased oversight that could include more targeted audits, say Janice Davis and Christopher Ronne at Morgan Lewis.

  • Skirting Anti-Kickback Causation Standard Amid Circuit Split

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    Amid the federal circuit court split over the causation standard applicable to False Claims Act cases involving Anti-Kickback Statute violations, which the First Circuit will soon consider in U.S. v. Regeneron, litigators aiming to circumvent the heightened standard should contemplate certain strategies, say Matthew Modafferi and Terence Park at Frier Levitt.