Policy & Compliance

Expert Analysis

• Feds' Mixed Cues On Medicaid Fraud Signal States To Step Up

  

  While the federal government has recently delivered four distinct and mutually inconsistent messages regarding Medicaid fraud enforcement, states should focus on improving enforcement, regardless of which federal posture proves correct, says Ken Levine at Stone & Magnanini.

• A Shift In How Policymakers Are Approaching PBM Regulation

  

  Recent federal and state legislative and regulatory activity involving pharmacy benefit managers represent a change in focus from transparency to PBM compensation structures, vertical integration and competitive effects, say attorneys at Barclay Damon.

• Workplace Menopause Laws Demand New HR Playbooks

  

  A recent wave of state and local legislation that makes menopause an expressly protected condition in the workplace creates new compliance obligations amid an already ambiguous federal framework, and demands a workplace culture where employees feel safe asking for support, says Elliot Griffin at Ballard Spahr.

• States Should Reconsider Forced PBM Divestiture Laws

  

  State legislatures are attempting to enact policies intended to force pharmacy benefit managers to divest from pharmacies, but these laws would have the practical effect of reducing patient access and competition, potentially violating the U.S. Constitution in the process, says former Utah Attorney General John Swallow.

• Noncompete Laws Show States Focusing On Bans, Healthcare

  

  The first half of 2026 confirms that state legislatures are driving the most consequential changes in noncompete law, including a few state bans and several healthcare-specific laws, making a one-size-fits-all approach increasingly untenable for multistate employers, say attorneys at Faegre Drinker.

• Where The Justices Aligned In Appellate Authority Ruling

  

  The real story of the U.S. Supreme Court’s recent ruling in T.M. v. University of Maryland Medical System Corp., finding that a doctrine designed to curtail duplicative litigation prevents federal district courts from reviewing state court decisions, is in how the justices together revisited an obscure, century-old jurisdictional doctrine, says Alex Dimitrief at Zeughauser Group.

• Rare DOJ Military Bias Suit Shows Peril Of Co. Admissions

  

  Although the government rarely litigates Uniformed Services Employment and Reemployment Rights Act claims against private employers, Opara v. UV Memory Care demonstrates that it will do so when an employer's own admissions build the case, potentially resulting in significant compliance obligations and long-term consequences, says Bradford Kelley at Littler.

• Mass. UHC Fraud Suit Signals States' Medicaid FCA Push

  

  Massachusetts' recently filed False Claims Act suit alleging UnitedHealthcare misrepresented the health status of enrollees in a Medicaid senior care organization plan it managed pushes forward a new phase of state-level scrutiny of managed care data and Medicaid payment mechanisms, say Li Yu at Bernstein Litowitz, Ellen London at London & Naor and Gwendolyn Stamper at Vogel Slade.

• FDA Draft Guidance Maps Payor Strategy For Psychedelics

  

  Recently revised guidance from the U.S. Food and Drug Administration will operationalize a framework permitting drug developers to share product information with insurance companies, giving psychedelic therapeutics developers a road map for building a successful payor infrastructure before approval, says Kimberly Chew at Husch Blackwell.

• Denying Emergency Abortion Care Is A Liability Oversight

  

  Health systems in states with abortion bans should consider that refusing to provide emergency abortion care carries greater legal risk than the risk of prosecution under post-Dobbs laws for providing treatment, say Kimberly Chernoby at FemInEM and Rachel Rebouché at the University of Texas, Austin School of Law.

• Carbon Health Settlement Highlights Why Evidence Is Key

  

  The California Attorney General's Office's first-of-its-kind settlement with Carbon Health, imposing penalties for alleged corporate practice of medicine violations, shows that friendly professional corporation challenges usually hinge not on the parties' management services agreement, but on whether the operational record matches it, says Ben Dubin at VC Expert Services.

• Remote Work Rulings Show ADA Fights Hinge On Process

  

  Two opposite outcomes in recent Fifth Circuit and D.C. federal court cases underscore that the legality of denying employees' disability accommodation requests for remote work depends less on broad policy and more on how it's applied, says Paul Sweeney at Ice Miller.

• How Justices' TPS Ruling Affects Workforce Planning

  

  The U.S. Supreme Court’s recent holding in Mullin v. Doe that courts lack jurisdiction to review temporary protected status determinations greenlights the end of TPS for thousands of Syrian and Haitian nationals, and means employers must reevaluate TPS-designees' employability while avoiding discriminatory document practices, says attorney Richard Herman.