Policy & Compliance

  • June 24, 2026

    Doc's Defamation Claim Against Cigna Barred By ERISA

    In a precedential opinion dealing with an issue of first impression, the Third Circuit on Wednesday held that the Employee Retirement Income Security Act preempts a doctor's defamation claim against Cigna because the statements stemmed from the administration of his patients' health plans.

  • June 24, 2026

    11th Circ. Urged To Toss Convictions In $1.4B Hospital Fraud

    Two brothers convicted in a $1.4 billion scheme to bill insurers inflated rates for drug tests told the Eleventh Circuit on Wednesday that there was insufficient evidence to support their convictions and that they should have been allowed an evidentiary hearing after potential juror misconduct emerged following the trial.

  • June 24, 2026

    3rd Circ. Extends Lenient Retaliation Test To ADA, FMLA Suits

    The Third Circuit declared Wednesday that the long-standing, worker-friendly standard used to evaluate Title VII retaliation claims also applies to analogue allegations under the Americans with Disabilities Act and the Family and Medical Leave Act, kickstarting a former Marine's suit over a leaner-than-expected bonus and pay raise.

  • June 24, 2026

    UnitedHealthcare Turns Blame On MassHealth In Fraud Case

    UnitedHealthcare said it plans to defend itself against accusations that it overcharged Massachusetts for senior care, claiming the state's Medicaid program was not properly administered as it moved the case to federal court. 

  • June 23, 2026

    Kaiser Owes LA County Hospital $82M In Out-Of-Network Suit

    Kaiser Permanente's health coverage arm must pay more than $82 million to Pomona Valley Hospital Medical Center to cover unreimbursed emergency medical services, a California state judge ordered Tuesday, after a state appeals court backed a jury's verdict concerning payment for roughly 4,000 disputed medical service claims.

  • June 23, 2026

    Texas Woman Says ERs Violated EMTALA Amid Miscarriage

    A Texas woman urged the U.S. Centers for Medicare & Medicaid Services to investigate two providers over their alleged violations of the Emergency Medical Treatment and Labor Act, or EMTALA, when she sought treatment for a miscarriage, arguing her case "is not an isolated incident."

  • June 23, 2026

    What To Know About State-Level PBM Reform

    Healthcare attorneys are keeping a close eye on new laws focused on the vertical integration of pharmacy benefit managers.

  • June 23, 2026

    FTC Tells 4th Circ. Court Got It Wrong In J&J Stelara Case

    The Federal Trade Commission has told the Fourth Circuit that a Virginia federal court messed up when it ruled in an antitrust suit against Johnson & Johnson that the company bringing the suit needed to show specific intent in order to prop up a monopolization claim over the immunosuppressive drug Stelara.

  • June 23, 2026

    What To Know About The Missouri Abortion Law Ruling

    Nearly two years after Missouri residents enshrined reproductive rights into the state constitution, a judge ruled that more than three dozen state laws conflicted with the 2024 ballot amendment. Law360 Healthcare Authority looks at the case and what it means for abortion law in the Show-Me State.

  • June 23, 2026

    BCLP Health Atty Talks False Claims Act, Move From DOJ

    A former leader of False Claims Act enforcement at the U.S. Department of Justice has joined Bryan Cave Leighton Paisner LLP. Susan Carney Lynch spoke to Law360 Healthcare Authority about the move and trends in FCA enforcement.

  • June 23, 2026

    UnitedHealth Trims But Can't Escape 401(k) Forfeiture Suit

    UnitedHealth Group won dismissal of some claims in a proposed class action alleging the company mismanaged its employee 401(k) and profit sharing plan by misallocating forfeitures, but couldn't escape allegations that the way the company spent the funds breached fiduciary duties and caused transactions prohibited by federal benefits law.

  • June 23, 2026

    Judge Flags Flaws In Rule Capping Health Student Loans

    A D.C. federal judge appeared to agree with health worker organizations challenging new federal student loan caps that there were problems with how the U.S. Department of Education defined "professional degrees" in a recent rulemaking, but suggested that "taking over the job" of the department would be inappropriate.

  • June 23, 2026

    BioNTech Accused Of Firing Nurse Over Drug Trial Concerns

    A former senior clinical trial manager at BioNTech US Inc. told a North Carolina federal court Monday that she was wrongfully fired after complaining to higher-ups about an "epidemic of safety issues and protocol deviations" in clinical trials.

  • June 23, 2026

    Feds Tout AI's Role In $6.5B Healthcare Fraud Crackdown

    Federal authorities said Tuesday that artificial intelligence and sophisticated data analysis helped them detect and prosecute healthcare fraud as part of a national crackdown that resulted in charges against 455 defendants.

  • June 23, 2026

    ACA Ruling May Forecast Future Trouble For CMS Changes

    Recent pushback by a Baltimore federal judge on Affordable Care Act changes made through agency rulemaking could presage more legal defeats for the Trump administration.

  • June 22, 2026

    FTC Requires Fix For Aurobindo's $250M Lannett Deal

    The Federal Trade Commission is allowing Aurobindo Pharma Ltd. to move ahead with its planned $250 million acquisition of Lannett Co. Inc., after the pharmaceutical company agreed to unload four generic drug products to prevent potential overlaps.

  • June 22, 2026

    Sodexo Can't Wipe Out Worker's Nicotine Fee Suit

    A California federal judge refused to toss a Sodexo worker's proposed class action alleging the global food services company wrongly charged nicotine-using employees $1,200 more a year for health insurance, opening discovery on allegations that a wellness program implementing the surcharge didn't meet all federal requirements.

  • June 18, 2026

    RFK Jr. Urges 1st Circ. To Reinstate His Vaccine Advisers

    U.S. Health Secretary Robert F. Kennedy Jr. told the First Circuit a Boston federal judge's decision to freeze his vaccine committee appointments lacks a legal foundation and has left the government paralyzed when it comes to vaccine policy.

  • June 18, 2026

    Gibson Dunn Hires Ropes & Gray Health Regulatory Atty In DC

    Gibson Dunn & Crutcher LLP has hired a former Ropes & Gray LLP partner who works on a myriad of health regulatory and drug pricing matters, advising pharmaceutical manufacturers, investors and other entities on those issues, the firm announced Thursday.

  • June 18, 2026

    5 Big ERISA Litigation Developments From 2026's First Half

    The U.S. Supreme Court's acceptance of a petition challenging Intel's 401(k) investment lineup and a Fourth Circuit ruling unraveling a class of Genworth Financial retirement plan participants headlined the court developments that caught benefits attorneys' attention in the first six months of 2026. Here, Law360 looks at those and other noteworthy ERISA decisions.

  • June 18, 2026

    Health System Strikes Deal To End Tobacco Fee Suit

    Nonprofit health system Advocate Aurora Health reached a deal to close a proposed class action claiming it hit workers with an unlawful fee through their health plan if they used tobacco, according to a filing in Illinois federal court.

  • June 18, 2026

    High Court Bars Federal Review Of State Court Appeals

    The U.S. Supreme Court ruled Thursday that a legal doctrine designed to curtail duplicative litigation prevents parties who lose in state court from appealing in federal district court even if the state case is still pending.

  • June 17, 2026

    Mental Health Co. To Face Wage Class Damages Trial

    A North Carolina federal judge ruled Wednesday that the mental healthcare company JMJ Enterprises LLC must face a second-phase damages trial after a jury found in February in favor of a collective of employees claiming that the company willfully broke federal and state wage laws by underpaying workers at group homes.

  • June 17, 2026

    DC Judge Halts Prison Bureau's 'Near Total' Trans Care Ban

    A Washington, D.C., federal judge blocked the Bureau of Prisons from enforcing a "near total ban" on gender-affirming care for trans incarcerated people, ruling Wednesday the policy was "reverse engineered" to fit the Trump administration's directive barring funding of such care in prisons, violating the Administrative Procedure Act. 

  • June 17, 2026

    Sen. Committee Clears Drug Disclosure, Biosimilar Bills

    The U.S. Senate Committee on Health, Education, Labor and Pensions on Wednesday cleared two bills for full Senate review, tackling the gap between health and patent oversight agencies, and the need for more interchangeable biosimilars.

Expert Analysis

  • Mapping Philly US Atty's White Collar Enforcement Push

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    Attorneys at Blank Rome discuss the U.S. Attorney for the Eastern District of Pennsylvania David Metcalf’s commitments and priorities, survey early results from his first year, and suggest practical action items for companies operating under the office's jurisdiction.

  • How The Coming Months Will Shape State Drug Price Boards

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    The future of state prescription drug affordability boards may be determined in the next few months, between an upcoming court decision in a challenge against state authority to set drug prices, and pending state decisions about whether to use federal Medicare maximum fair prices as reference, say Michael Kolber, Steven Chen and Kelechi Ezealaji at Manatt.

  • Steps To Consider As DOJ Launches Fraud Division

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    The establishment this month of the National Fraud Enforcement Division within the U.S. Department of Justice is a significant reorganization that suggests an increase in enforcement activity involving federally funded programs but leaves a number of important questions unanswered, say attorneys at Crowell & Moring.

  • Court's HRSA Policy Reversal Leaves 340B Rules Murky

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    A D.C. federal court's recent decision in Premier v. U.S. Department of Health limits the Health Resources and Services Administration's ability to enforce long-standing Section 340B interpretations through subregulatory guidance, leaving open core statutory questions about purchasing models, inventory classification and program oversight, says Martha Cramer at Hooper Lundy.

  • Fresenius Ruling May Shift Anti-Kickback Enforcement

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    The Ninth Circuit's recent decision in Fresenius v. Bonta suggests that businesses have a First Amendment right to donate to certain charities, even if those donations are motivated by economic self-interest, potentially calling into question years of Anti-Kickback Statute proceedings against pharmaceutical manufacturers for making similar donations, says Jonah Knobler at Patterson Belknap.

  • The Challenge Of Stabilizing Rural Hospitals On The Brink

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    The outlook for rural hospitals has grown more concerning, as recent policy and regulatory developments are decreasing hospital revenues and increasing the cost of uncompensated care, which may result in additional hospital closures, service reductions, or mergers and acquisitions, say Omur Celmanbet, Kristy Piccinini and Sabiha Quddus at FTI Consulting.

  • Fraud Enforcement, Sentencing Face Unusual Convergence

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    The Trump administration’s newly created task force to eliminate fraud and the U.S. Sentencing Commission’s recent proposals to scale back certain elements of the federal sentencing framework seem to point in opposite directions, creating a collision of policy priorities that may reshape how fraud cases are charged, negotiated and sentenced for years to come, says David Tarras at Tarras Defense.

  • Peptide Policy Is Shifting Toward Sanctioned Compounding

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    The policy landscape for peptides is undergoing a significant shift under the Trump administration, moving toward a complex system of verified compounding and complementary enforcement that will likely bring peptides firmly back into the sphere of legitimate consumer products, say attorneys at Sheppard.

  • Trump Order Signals Tougher Benefits Fraud Probes

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    A recent order from President Donald Trump establishing a federal taskforce for addressing fraud in federally funded benefit programs emphasizes interagency information sharing, potentially affecting a broad range of areas including government contracts, administrative law considerations and False Claims Act cases, say attorneys at Morgan Lewis.

  • The Evolution Of States' Workplace Violence Prevention Laws

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    Utah's new law requiring hospitals to implement comprehensive workplace violence reporting systems continues a broader trend of state efforts to expand workplace protections in the absence of sufficient federal regulations, say attorneys at Ogletree.

  • FDA Guidance May Move Goalposts For Form 483 Responses

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    New draft guidance from the U.S. Food and Drug Administration provides formal insight on how drug manufacturers are expected to respond to Form 483s, raising some concerns about the agency's timelines and expectations, say attorneys at Cooley.

  • 2 Strands Of Patent Law In High Court's 'Skinny Label' Case

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    Amarin v. Hikma, which is set for oral argument in the U.S. Supreme Court this month, highlights the distinction between two different strands of intellectual property law — analogizing a patent to either a property deed or a home, says Jonas McDavit at Spencer West.

  • A Check-Up On HHS' Push To Implement AI Infrastructure

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    The U.S. Department of Health and Human Services has made some headway in its efforts to implement artificial intelligence across its agencies, but will have to overcome a number of near-term tests in order to be successful, says Theodore Thompson at Stinson.