Policy & Compliance

  • July 23, 2026

    UnitedHealth's $5M Demand Challenged By Wash. Dental Co.

    A dental practice is urging a Washington federal court to stop UnitedHealth from withholding future reimbursements, saying the insurer has failed to fully explain its assertion that it overpaid the practice more than $5 million for past claims, in a lawsuit filed Wednesday.

  • July 23, 2026

    Okla. Chiropractor Convicted Of $30M Medical Fraud Scheme

    A Florida federal jury convicted an Oklahoma chiropractor of attempting to bilk $30 million from federal health insurance programs, finding him guilty of a fraud conspiracy charge after he obtained patient information to produce fake doctors' orders for unnecessary medical equipment, according to the U.S. Department of Justice.

  • July 23, 2026

    Texas Panel Overturns Abortion Injunction Against Midwife

    A Texas appellate court overturned a temporary injunction against a licensed Houston-area midwife accused by state prosecutors of violating Texas' abortion ban, finding Thursday a trial court wrongly admitted probable-cause affidavits from a related criminal case.

  • July 22, 2026

    Late Emails Undercut BCBS Pricing Suit, Walgreens Says

    Walgreen Co. is urging an Illinois federal judge to again sanction a Blue Cross Blue Shield insurer and its subsidiary for allegedly failing to produce key email evidence the pharmacy retailer says "upends" the insurers' 6-year-old claim that it intentionally overcharged them for prescription drugs.

  • July 22, 2026

    Target Beats ERISA Suit Over Tobacco Health Surcharge

    A Minnesota federal judge on Wednesday tossed a proposed class action alleging that a tobacco fee on Target workers' health plan violated nondiscrimination provisions in federal benefits law, agreeing with the retail giant that the suit failed to state a claim.

  • July 22, 2026

    Cambia Health Hit With FCA Suit Over Medicare Fraud Claims

    Cambia Health Solutions Inc. stole millions of dollars from the federal Centers for Medicare & Medicaid Services over more than a decade by submitting fraudulent diagnostic information to the government, according to a whistleblower's False Claims Act lawsuit unsealed by a Seattle federal judge this week.

  • July 22, 2026

    Insurer Sanctioned For Destroying Opioid Coverage Evidence

    An Illinois federal court Wednesday sanctioned an insurer in a drug wholesaler's suit seeking coverage for underlying opioid litigation, finding that the carrier intentionally destroyed key emails and underwriting records in order to deprive the wholesaler of that information.

  • July 22, 2026

    Ex-Players Seek $4M In Legal Fees In NFL Race-Norming Fight

    Ex-NFL players who settled a suit over racially discriminatory assessments made by the league's disability and retirement plans are asking a Maryland federal judge for over $4 million in legal fees.

  • July 22, 2026

    Trump Says 100% Tariff On Generic Drugs Coming In 2028

    Generic drugs imported into the U.S. will be hit with a tariff of 100% in 2028 and 200% in later years in an attempt to drive manufacturing into the country, President Donald Trump said on social media.

  • July 22, 2026

    9th Circ. Won't Reopen Vax Bias Suit Against Wash. Officials

    The Ninth Circuit upheld a Washington state agency's win in a suit alleging it unlawfully fired over a dozen employees rather than accommodate their religious objections to the COVID-19 vaccine, ruling they hadn't shown the agency was purposely hostile toward religion.

  • July 22, 2026

    DOL Proposes E-Delivery Rule For Employer Health Plans

    The U.S. Department of Labor's employee benefits arm unveiled a proposal Wednesday that would provide more opportunities for electronic delivery of employer-provided health plans' mandatory disclosures.

  • July 21, 2026

    DC Circ. Affirms HHS Authority Over 340B Rebate Plans

    The D.C. Circuit on Tuesday upheld a lower court's finding that U.S. Department of Health and Human Services has the authority to block or approve drugmakers' efforts to implement rebates instead of discounts under the 340B drug-pricing program.

  • July 21, 2026

    Economist Concedes Opioid Stats' Limits In Albertsons Trial

    Despite testifying that Albertsons pharmacy records suggest some opioids dispensed in Washington state had "red flags" for potential diversion from legitimate use, an economist for the Evergreen State conceded Tuesday that he can't point to "even a single pill dispensed by Albertsons" that was actually improperly diverted. 

  • July 21, 2026

    $152M Health Marketing Ban, $62M Drug MDL Deal And More

    Law360 Healthcare Authority looks at the Federal Trade Commission's $152 million deal resolving allegations against a pair of health insurance marketers, a $62 million deal releasing Pfizer Inc. and other drugmakers from multidistrict litigation over generic-drug prices, and other key resolutions in healthcare litigation over the last week.

  • July 21, 2026

    Air Ambulance Co. Fights To Keep 'No Surprises' Suit Alive

    An air ambulance service looking to collect unpaid transport bills from Blue Cross Blue Shield's parent company argued Tuesday that its lawsuit should proceed because court enforcement is its only hope for combating the insurer's practice of ignoring the No Surprises Act's otherwise tight payment deadlines.

  • July 21, 2026

    Chamber Asks 2nd Circ. To Back Toss Of Pepsi Smoking Suit

    A New York federal judge rightly tossed allegations that Pepsi violated federal benefits law by making employees who smoke pay more for health insurance, the nation's largest business lobby argued in an amicus brief, urging the Second Circuit to affirm dismissal of the suit.

  • July 21, 2026

    What To Know: FDA Compounding Panel Weighs Peptides

    A panel advising the U.S. Food and Drug Administration will weigh in this week on a push to expand legal access to seven peptides that are touted by wellness influencers to treat injuries and other conditions.

  • July 21, 2026

    Class Cert. In Avandia MDL Undone For Lacking Stats

    The Third Circuit undid class certification for a group of health plans claiming GlaxoSmithKline deceptively marketed its diabetes drug Avandia, with a panel majority ruling Tuesday the plans needed stronger statistical analysis to show links between the marketing, the revelation of side effects and a drop in sales.

  • July 21, 2026

    States Dispute Drugmakers' Bid To Toss GLP-1 Antitrust Case

    The attorneys general of Texas and Louisiana pushed back on Tuesday against a bid from Novo Nordisk and Eli Lilly to duck a specialty pharmacy's antitrust case accusing the companies of blocking competition for GLP-1 medications.

  • July 21, 2026

    Novo's False Ad Suit Against Eli Lilly Ramps Up GLP-1 Rivalry

    Pharmaceutical giant Novo Nordisk Inc. slapped rival Eli Lilly & Co. with a false advertising suit in New Jersey federal court Tuesday, calling a marketing campaign for the rival's weight loss drugs "deceptive" for "withholding critical scientific evidence" about newer GLP-1 formulations.

  • July 21, 2026

    Imaging Co. Faces Consolidated Data Breach Cases In NC

    A North Carolina federal judge consolidated three proposed class actions against diagnostic imaging provider Lumexa Imaging Inc. over an alleged patient data breach earlier this year, tapping attorneys from Kopelowitz Ostrow PA and Milberg PLLC to serve as interim co-lead counsel.

  • July 21, 2026

    Hospitals Say Saul Ewing Atty's Board Role Taints FCA Suit

    A Saul Ewing LLP attorney should be disqualified from leading a whistleblower suit over a nurse's alleged diversion of prescription narcotics, as the former Heritage Valley Health System in western Pennsylvania said he was previously a member of its board of directors.

  • July 21, 2026

    CMS Withholds $1B In Medicaid From Calif., Minn., Citing Fraud

    The Centers for Medicare & Medicaid Services is withholding more than $1 billion in Medicaid dollars from California and Minnesota because the agency suspects healthcare fraud in those states, officials announced Tuesday.

  • July 21, 2026

    Research Or Crime? Feds Eye Scientists Crossing Borders

    At U.S. airports and border crossings, scientists returning from trips abroad are getting a closer look from law enforcement agents. More smuggling and paperwork violations that might once have been overlooked are turning into criminal cases.

  • July 21, 2026

    2nd Circ. Tylenol Expert Call Sows Admissibility Confusion

    A circuit court decision on expert admissibility in a dispute over an alleged link between Tylenol and autism is raising legal experts' concerns that the panel will sow confusion among judges trying to weed out unreliable medical opinions.

Expert Analysis

  • High Court's Hikma Decision Reshapes 'Skinny Label' Suits

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    The U.S. Supreme Court's decision in Hikma v. Amarin marks a significant victory for generic drug manufacturers, but rather than putting an end to so-called skinny label inducement claims, it narrows and refocuses them, say attorneys at Sterne Kessler.

  • Turning To The Courts When PBM Reform Falls Short

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    The effectiveness of state laws intended to regulate pharmacy benefit managers remains uncertain, but litigation — utilizing tried-and-true theories like breach of contract and fair dealing — offers another mechanism through which stakeholders may seek relief from PBMs, say attorneys at Reed Smith.

  • High Court's Abortion Pill Stay Reinforces Appellate Principles

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    The U.S. Supreme Court's recent order in Danco Laboratories v. Louisiana, staying a Fifth Circuit ruling that reinstated an in-person requirement for dispensing the abortion medicine mifepristone, should be seen not as a definitive ruling on reproductive rights, but as an affirmation of a more disciplined jurisdictional reality, says Daniel Nardo at Nardo & Associates.

  • Bracing For Enforcers' Growing Focus On Behavioral Health

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    While recent law enforcement scrutiny of the behavioral health industry has resulted in several settlements, indicating that more enforcement activity is on the way, organizations now have an opportunity to take proactive compliance measures, says Jeffrey Fitzgerald at Polsinelli.

  • DOJ Activity Indicates Rising Antitrust Risk For Hospitals

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    Two civil actions filed by the U.S. Department of Justice against New York-Presbyterian Hospital and OhioHealth, both alleging that the hospital systems used their market power to stifle competition, highlight the government's growing scrutiny of barriers to lower-cost insurance options, say attorneys at Freshfields.

  • Engaging With FDA's New Complete Response Letter Policy

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    A citizen petition filed with the U.S. Food and Drug Administration last month puts renewed focus on the agency's practice of releasing complete response letters in near real time, materially altering the context in which life sciences companies communicate with investors regarding regulatory developments, say attorneys at Debevoise.

  • Trump's Psychedelics EO Creates A Regulatory Collision

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    Sponsors pursuing U.S. Food and Drug Administration approval for psychedelic drug access must tackle how to generate regulatory-grade safety and efficacy data in controlled trials when President Donald Trump's recent executive order on psychedelics mandates uncontrolled access through Right to Try, say Kimberly Chew at Husch Blackwell and Odette Hauke at Odette Alina.

  • AI Regulatory Gaps May Fuel FCA Enforcement Action

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    The intersection of artificial intelligence and False Claims Act enforcement presents legal risk for government contractors across several industries, particularly in the absence of a federal regulatory framework explicitly governing its development and use, say attorneys at O’Melveny.

  • 5th Circ.'s Abortion Pill Order Is Shaky On Multiple Grounds

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    The Fifth Circuit's recent order in Louisiana v. U.S. Food and Drug Administration, reinstating an in-person dispensing requirement for the abortion medication mifepristone, seems to turn federalism upside-down, and is also questionable for several other reasons, says Gregory Curtner at Curtner Law.

  • 5 Takeaways From Justices' Subpoena Fight Ruling

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    The U.S. Supreme Court's recent decision in First Choice v. Davenport fortifies a line of First Amendment associational privacy cases stretching back nearly 70 years, and ensures that organizations subject to government demands for donor information have a meaningful federal forum in which to defend their constitutional rights, say attorneys at DLA Piper.

  • Accelerated Psychedelic Therapy Pathways Require Caution

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    President Donald Trump's new executive order aiming to accelerate the approval of psychedelic drugs for the treatment of mental health disorders will likely bolster investigational psychedelic therapies, but parties within the psychedelic product supply chain will still need to prepare for potentially burdensome compliance requirements, say attorneys at Morgan Lewis.

  • Health Cos. Must Act Quickly To Secure Digital Front Doors

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    A fast-approaching deadline will require health providers to implement digital accessibility standards to their websites, necessitating important compliance steps that will help to ensure equal access to online health services, say attorneys at Holland & Knight.

  • How Oregon Ruling Affects Federal Gender Care Crackdown

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    In a favorable development for healthcare providers, an Oregon federal court recently vacated certain U.S. Department of Health and Human Services restrictions on gender-affirming care for minors, but the government's broader campaign against this care, including proposed rulemaking and agency investigations, leaves significant uncertainty, say attorneys at Arnold & Porter.