Policy & Compliance

  • December 01, 2025

    Judge Upholds Mich. MedMal Cap, Cuts $8.5M Verdict

    A Michigan federal judge has slashed the $8.5 million a jury awarded to the estate of a cancer patient suing over his doctor's treatment decisions to about $615,000, ruling that a state law limiting noneconomic damages in medical malpractice cases is constitutional. 

  • November 26, 2025

    Up Next At High Court: ISP Liability & State Subpoena Suits

    The U.S. Supreme Court will return Monday for the first week of its December oral argument session, during which the justices will consider whether internet service providers can be held liable for contributing to their customers' infringing activity online and whether the subjects of state subpoenas are required to first challenge them in state court. 

  • November 26, 2025

    Nurse For App-Based Health Co. Can't Revive Retaliation Suit

    A Washington appeals court refused to revive a nurse's suit claiming she was fired from an app-based medical provider for complaining that it underpaid and overworked independent contractors, ruling she failed to show her termination was because of her concerns rather than reports that she was unprofessional.

  • November 25, 2025

    UnitedHealth Gets OptumRx Antitrust Suit Sent To Arbitration

    A group of independent pharmacies must arbitrate their proposed class claims that UnitedHealth-owned OptumRx gatekeeps its network of Medicare prescription patients by imposing unfair fees, a Washington federal judge said Tuesday, concluding the pharmacies haven't shown the arbitration clauses in question are unenforceable.

  • November 25, 2025

    Mich. Pharmacist Gets 46 Months For $4M Fraud Scheme

    A former Michigan pharmacist who pled guilty to orchestrating a $4 million Medicare scam was sentenced by a federal judge to 46 months in prison and ordered to pay restitution and forfeit property as part of a plea deal, the U.S. Department of Justice announced.

  • November 24, 2025

    9th Circ. Clarifies FTC's Sanction Power In Backing $7M Win

    The Ninth Circuit affirmed Monday a $7.3 million compensatory sanction and asset-freeze injunction against executives behind the "Success By Health" pyramid scheme, rejecting their argument, among others, that the justices' AMG v. FTC ruling requires the Federal Trade Commission to hold administrative proceedings before suing over rule violations.

  • November 24, 2025

    Teamsters Health Plan Wants Data Breach Suit Tossed

    A Massachusetts federal judge should toss a proposed class action accusing a Teamsters healthcare plan of failing to protect plan participants' personal information, the plan argued, seeking dismissal of a suit that seeks to hold the plan liable for an August data breach.

  • November 24, 2025

    Mass. Judge Says States Can Fight Planned Parenthood Cuts

    A Massachusetts federal judge on Monday chided a Trump administration lawyer for continuing to argue that a coalition of states lacks standing to seek to block what it says is the effective defunding of Planned Parenthood, even as it only just received a lengthy list of new requirements for Medicaid reimbursement.

  • November 24, 2025

    Mich. Christian Health Group Claims Right To Deny Trans Care

    A Christian health system urged a federal court to permanently prohibit Michigan from enforcing a state civil rights law barring discrimination based on sexual orientation and gender identity, arguing the statute unconstitutionally hampers its ability to make faith-based hiring and policy decisions.

  • November 24, 2025

    Wash. Hits Regence BlueShield With Transparency Fine

    Washington's insurance commissioner slapped Regence BlueShield with a $550,000 fine, the state announced Monday, for purportedly violating reporting requirements under a federal law that says health insurers must provide the same level of coverage for mental health care as general medical care.

  • November 24, 2025

    ND Justices Reverse Ruling That Struck Down Abortion Ban

    North Dakota's near-total ban on abortion is back in effect after the state's top court narrowly reversed a lower court decision by failing to reach the supermajority required to declare the law unconstitutional.

  • November 24, 2025

    Hi-Tech Pharma CEO Beats Most Of Feds' Fraud Case

    A Georgia federal jury acquitted Hi-Tech Pharmaceuticals' chief executive on the bulk of the conspiracy, fraud and money laundering charges leveled against him, rejecting allegations that he cheated his customers by drawing up bogus quality certificates.

  • November 24, 2025

    Justices Won't Review Doctor's Conviction For Reusing Devices

    The U.S. Supreme Court on Monday rejected a petition from a North Carolina physician seeking to revisit the Fourth Circuit's decision to back her conviction for healthcare fraud.

  • November 21, 2025

    DC Judge Axes Teva Challenge To Drug Price Program

    A D.C. federal judge tossed a challenge by Teva Pharmaceuticals to the Medicare drug price negotiation program, marking the latest in a series of losses by drugmakers and trade groups seeking to upend the program.

  • November 21, 2025

    Fla. Wound Doctor Agrees To Pay $45M For Overbilling Claims

    A Florida doctor and his companies agreed to pay $45 million to settle a suit alleging he submitted fraudulent claims to Medicare for medically unnecessary wound care procedures, the U.S. government said Friday. 

  • November 21, 2025

    Colo. Healthcare System Stiffing Workers, Court Told

    A pair of former workers for a hospital and healthcare facility operator in Colorado have accused their past employer of routinely shortchanging their pay in violation of state and federal wage and hour laws, according to a proposed class action filed in federal court.

  • November 21, 2025

    PBMs Say Gov't Benefits From Drug Rebates FTC Condemns

    Caremark Rx, Express Scripts and OptumRx have been given permission to seek documents they say will show the government benefits from the same type of prescription drug rebating activity that's being targeted by the Federal Trade Commission's insulin pricing case.

  • November 21, 2025

    'No Evidence' New Info Backs J&J Unit's Libel Suit, Court Told

    A doctor being sued by Johnson & Johnson's bankrupt talc subsidiary pushed back on the unit's bid to revive its trade libel claim over a scientific article she wrote linking asbestos in talc to mesothelioma, arguing it failed to cite any evidence that undermines the court's finding that the article was a nonactionable statement of scientific opinion.

  • November 21, 2025

    Rothman Orthopaedics Hit With Pa. Wiretapping Lawsuit

    Rothman Orthopaedics has been hit with a proposed class action in Pennsylvania alleging the company violated state wiretapping laws by intercepting private healthcare information on its website using a third-party tracking pixel.

  • November 21, 2025

    Hyperbaric Chamber Death Suit Not Covered, Insurers Say

    Two Nationwide insurers said they have no duty to defend or indemnify a hyperbaric oxygen therapy center or its employees in a suit over the death of a 5-year-old boy, telling a Michigan federal court that there was no bodily injury or property damage caused by an occurrence, or accident.

  • November 21, 2025

    1st Circ. Clears IT Co. In Suit Over Zoll Patient Data Breach

    An information technology company cannot be held liable for a data breach exposing the health information of patients of a unit of medical device maker Zoll Medical Corp, the First Circuit ruled, because the two companies did not have a business relationship permitting them to hold one responsible for another's conduct.

  • November 20, 2025

    Pharma Cos. Seek Early Win In States' Price-Fixing Lawsuit

    A collection of states failed to prove an overarching conspiracy among 25 separate pharmaceutical companies to fix the prices of generic drugs, most of them dermatology formulations, the drugmakers argued Wednesday in support of a bid for an early win on one element of dozens of antitrust claims.

  • November 20, 2025

    5th Circ. Seeks Interpretation Of Miss. Health Decisions Law

    A Fifth Circuit panel asked the Mississippi Supreme Court on Thursday to clarify an "ambiguous" state law that sets out which family members can act as surrogates and make healthcare decisions for relatives without the capacity to decide for themselves.

  • November 20, 2025

    Ala. County Must Face Inmate Death Claim, 11th Circ. Rules

    An Eleventh Circuit panel ruled Thursday that no Alabama state law prevents a county from facing liability for an incarcerated person's death after substandard healthcare from a third-party medical provider the county hired. 

  • November 20, 2025

    Blue Shield Of California, Magellan Sued Over 'Ghost Network'

    Blue Shield of California and Magellan Health maintain a "ghost network" directory of mental health providers who don't exist or don't accept new patients, leading customers to hit a dead end or desperately resort to expensive out-of-network providers, according to a proposed class action filed Wednesday in California federal court. 

Expert Analysis

  • Federal AI Action Plan Marks A Shift For Health And Bio Fields

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    The Trump administration's recent artificial intelligence action plan significantly expands federal commitments across biomedical agencies, defining a pivotal moment for attorneys and others involved in research collaborations, managing regulatory compliance and AI-related intellectual property, says Mehrin Masud-Elias at Arnold & Porter.

  • Preparing For DEA Rescheduling Of 2 Research Chemicals

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    A recent decision to allow the U.S. Drug Enforcement Administration to reclassify two research psychedelics in Schedule I under the Controlled Substances Act may pose significant barriers to scientific study, including stringent registration requirements, heightened security protocols and burdensome reporting obligations, say Kimberly Chew at Husch Blackwell and Jackie von Salm at Psilera.

  • 9th Circ.'s Kickback Ruling Strengthens A Prosecutorial Tool

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    The Ninth Circuit's decision last month in U.S. v. Schena, interpreting the Eliminating Kickbacks in Recovery Act to prohibit kickback conduct between the principal and individuals who do not directly interact with patients, serves as a wake-up call to the booming clinical laboratory testing industry, say attorneys at Kendall Brill.

  • Fla. Misses Opportunity To Rectify Wrongful Death Damages

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    Florida Gov. Ron DeSantis' recent veto of a bill that would have removed certain arbitrary and unfair prohibitions on noneconomic wrongful death damages in medical negligence cases highlights the urgent need for reforms to current state law, say attorneys at Farah & Farah.

  • A Shifting Trend In FDA Form 483 Disclosure Obligations

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    A New York federal court's Checkpoint Therapeutics decision extends a recent streak of dismissals of securities class actions alleging that pharmaceutical companies failed to disclose U.S. Food and Drug Administration Form 483 inspection reports, providing critical guidance for companies during the FDA approval process, say attorneys at Alston & Bird.

  • The Future Of Lab-Test Regs After FDA Rescinds Rule

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    The U.S. Food and Drug Administration recently rescinded its laboratory-developed tests rule in response to a Texas federal court decision this spring, reinforcing a separation of authority between the FDA and the Centers for Medicare & Medicaid Services, and calling into question the FDA's role in overseeing such tests without congressional action, say attorneys at Venable.

  • Unpacking Ore. Law's Limits On PE Healthcare Investment

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    A recent Oregon law imposes significant restrictions on nonphysicians owning or controlling medical practices, but newly enacted amendments provide some additional flexibility in certain ownership arrangements without scuttling the law's intent of addressing concerns about the rise of private equity investment in healthcare, say attorneys at Debevoise.

  • Criminal Healthcare Fraud Takeaways From 4th Circ. Reversal

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    After the Fourth Circuit reversed a doctor’s postconviction acquittal in U.S. v. Elfenbein last month, defense attorneys should consider three strategies when handling complex criminal healthcare matters, says Jonathan Porter at Husch Blackwell.

  • AG Watch: Texas Embraces The MAHA Movement

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    Attorneys at Kelley Drye examine Texas Attorney General Ken Paxton's actions related to the federal Make America Healthy Again movement, and how these actions hinge on representations or omissions by the target companies as opposed to specific analyses of the potential health risks.

  • How States Are Regulating Health Insurers' AI Usage

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    The absence of a federal artificial intelligence framework positions states as key regulators of health insurers’ AI use, making it important for payors and service providers to understand the range of state AI legislation being passed in California and elsewhere, and consider implementing an AI-focused compliance infrastructure, say attorneys at Ropes & Gray.

  • HHS Plan To Cut Immigrant Benefits Spurs Provider Questions

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    A recent notice from the U.S. Department of Health and Human Services identifying new federal public benefit programs for which nonqualified aliens are not eligible may have a major impact on entities that participate in these programs — but many questions remain unanswered, say attorneys at Foley.

  • Noncompete Forecast Shows Tough Weather For Employers

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    Several new state noncompete laws signal rough conditions for employers, particularly in the healthcare sector, so employers must account for employees' geographic circumstances as they cannot rely solely on choice-of-law clauses, say lawyers at McDermott.

  • Previewing State Efforts To Regulate Mental Health Chatbots

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    New York, Nevada and Utah have all recently enacted laws regulating the use of artificial intelligence to deliver mental health services, offering early insights into how other states may regulate this area, say attorneys at Goodwin.