Policy & Compliance

  • October 22, 2026

    CMS Hit With Another Broker Suit Over ACA Registration Bar

    The Centers for Medicare & Medicaid Services has been hit with another suit by health insurance brokers alleging the agency is unlawfully blocking them from registering to help individuals find Affordable Care Act marketplace coverage for plan year 2027.

  • October 22, 2026

    'Substantially Impaired' Main Topic Of Medicaid Rule Hearing

    A Massachusetts federal judge pressed the Trump administration Thursday on its argument that Congress intentionally left it with the task of defining who is considered too medically frail to comply with Medicaid work requirements set to take effect in January.

  • October 22, 2026

    Shriners Hospital System Escapes Race Bias Suit

    Shriners Hospitals for Children escaped a suit from a Black and Korean ex-employee who said she faced mistreatment for complaining that she was being held to a higher standard than other workers, with an Illinois federal judge finding a reprimand she received didn't qualify as harassment.

  • October 22, 2026

    ​​DOJ Accuses Ohio State Med School Of Race Discrimination

    The Ohio State University College of Medicine gave a leg up to Black and Hispanic student applicants in violation of civil rights law, the U.S. Department of Justice claimed, alleging the school crafted admissions policies that discounted students' academic achievements.

  • October 21, 2026

    Ill. Judge Questions Bid To Block 340B Drug Discount Law

    An Illinois federal judge seemed hesitant Wednesday to halt a state law barring drugmakers from trying to impose restrictions on pharmacies under contract with a federal drug pricing discount program, saying the state seems to be maximizing public health in an area the statute doesn't address.

  • October 21, 2026

    High Court Lets Block On Prison Gender Care Ban Stand

    The U.S. Supreme Court on Wednesday allowed federal prisons to continue to offer gender transition medical services to incarcerated people.

  • October 20, 2026

    Feds Offer Up-Front Payments For Fraud Whistleblower Tips

    The U.S. Department of Justice on Tuesday announced the creation of a whistleblower incentive program offering up-front monetary awards for tips that lead to criminal fraud charges.

  • October 20, 2026

    Medical Device Co. Beats Investors' Alleged Demand Drop Suit

    A New York federal judge has dismissed a proposed shareholder class action alleging medical device maker Integer Holdings Corp. hid plummeting demand for cardiac devices and misled investors about its overall growth, concluding that the allegations do not suggest its disclosures in 2024 and 2025 were untrue or deceptive.

  • October 20, 2026

    11th Circ. Rejects Ex-3M Worker's COVID Vax Refusal Suit

    The Eleventh Circuit on Tuesday declined to revive a Title VII religious discrimination suit by a former 3M healthcare business division employee who was terminated after refusing to get vaccinated against COVID-19 because of her beliefs, finding that her own statements show that there's no conflict between her beliefs and 3M's policy. 

  • October 20, 2026

    Suits Linking Tylenol To Autism, $400M Sandoz Deal And More

    Law360 Healthcare Authority looks at the Second Circuit's denial of a drugmaker's request for full review of expert testimony for plaintiffs in a case alleging Tylenol causes autism, the preliminary approval of a $400 million settlement between Sandoz and a coalition of states in generic drug price-fixing litigation, and other legal news from the past week.

  • October 20, 2026

    $8.4B Calif. Research Funding Plan Sparks Legal Questions

    Opponents of a California ballot measure that would authorize borrowing $8.4 billion to fund immunology research are raising legal questions about a provision that would dedicate half the money to a single institution.

  • October 20, 2026

    2nd Circ. Won't Block Connecticut Drug Price Cap

    A Second Circuit panel affirmed a lower court's decision Tuesday, refusing to block Connecticut from enforcing a cap on generic and off-patent drug prices while a trade association for drug wholesalers challenges the statute.

  • October 20, 2026

    7th Circ. Rejects Removal Of Hospital Patient Privacy Suits

    The Seventh Circuit on Tuesday joined a host of other appellate courts in determining healthcare providers were not "acting under" the federal government when they created patient web portals, finding actions alleging hospitals improperly shared patient information belonged in state court.

  • October 20, 2026

    Calif. Clinics Grapple With Ballot Measure's Uncertain Impact

    California voters will decide whether to require community clinics to spend at least 90% of revenue on patient care. Opponents and supporters disagree on the measure's likely impact.

  • October 20, 2026

    FTC Gender Care Suit Sparks Latest Judge-Shopping Debate

    The Federal Trade Commission's lawsuit against a transgender health organization in a conservative-friendly Texas district is sparking concerns about judge shopping.

  • October 19, 2026

    Accused In $91M Health Plan Scam Asks To Halt FTC Suit

    A woman accused of running a $91 million fraudulent health benefits scheme with her brother urged a Florida federal court on Monday to pause the Federal Trade Commission's lawsuit against her if related criminal charges proceed in court. 

  • October 19, 2026

    Biz Groups Back Health System's Win In 401(k) Forfeiture Suit

    The U.S. Chamber of Commerce and an employee benefit administrator trade group backed a Louisiana healthcare system's win over a lawsuit challenging its use of forfeited 401(k) funds to cover employer contributions, telling the Fifth Circuit that federal regulations have greenlighted the practice for decades.

  • October 19, 2026

    DOJ Appeals New Trial Order In Ex-NFL Player's Fraud Case

    The U.S. Department of Justice said it's asking the Fifth Circuit to review a Texas federal judge's decision to grant a new trial for a former NFL player convicted in a $328 million Medicare billing scheme.

  • October 16, 2026

    Conduent Inks $80M Breach Deal With 62M Class Members

    Victims of a data breach at Conduent Business Services LLC on Friday asked a New Jersey federal judge to greenlight an $80 million settlement resolving their claims that the company failed to adequately protect sensitive personal and health information of about 62 million people.

  • October 16, 2026

    2nd Circ. Denies Rehearing In Tylenol Autism Suits

    The Second Circuit on Friday denied a bid by Tylenol maker Kenvue and several retailers to reconsider its ruling that a district court improperly excluded expert testimony for plaintiffs who claim prenatal exposure to the over-the-counter pain reliever causes autism and ADHD.

  • October 16, 2026

    Hospital Operator Challenges NC AG's Power Over Merger

    HCA Healthcare is taking another crack at throwing out the North Carolina attorney general's suit alleging HCA broke its promise to maintain a certain level of care at an Asheville hospital it purchased, saying his office lacks the power to enforce a merger between two private parties.

  • October 16, 2026

    Aetna Drops Medical Billing Suit Against Acupuncture Clinic

    Aetna, a Washington acupuncture clinic and a retired doctor have agreed to end the insurer's suit claiming it paid more than $800,000 because of fraudulent billing for medical services, according to a federal court filing.

  • October 16, 2026

    Brokers Sue CMS Over Moratorium On ACA Registration

    A trade group for brokers and other health insurance professionals urged a Maryland federal court to halt the U.S. Center for Medicare and Medicaid Services' moratorium on new registrations of agents and brokers, arguing the policy and a related rule don't comply with administrative procedure.

  • October 16, 2026

    Expect These Post-Midterm Probes If The Hill Changes Hands

    The top investigative priorities of a potentially Democratic-controlled Congress are coming into sharper focus with the midterms weeks away and could impact an array of companies and individuals in technology, finance and energy, experts say.

  • October 15, 2026

    Audiologists Sue RFK Jr. Over Medicare Opt-Out Exclusion

    Audiologists have sued U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. in Texas federal court over a Medicare rule categorically barring them from accepting out-of-pocket payment for treatment services, arguing that violates the due process and equal protection clauses of the U.S. Constitution.

Expert Analysis

  • What DOJ Fraud Division Rule Resolves, And What It Doesn't

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    The U.S. Department of Justice’s recently published final rule answers many outstanding questions about the newly created National Fraud Enforcement Division, but overlapping mandates could result in parallel investigations and diverging viewpoints between multiple sets of prosecutors, say attorneys at Gibson Dunn.

  • Youth Center Investigation Shows Rising Governance Scrutiny

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    A recent New Hampshire attorney general report following its investigation into the state's Sununu Youth Services Center shows how organizations serving vulnerable populations can face scrutiny of their governance, safety practices and preparedness, even when investigators find no abuse, say attorneys at Morgan Lewis.

  • Target's ERISA Win Doesn't Ax Tobacco Surcharge Questions

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    Though a Minnesota federal court's recent dismissal of a putative class action challenging Target's tobacco surcharge wellness program offers employers a defense road map, courts' differing conclusions about the Employee Retirement Income Security Act versus U.S. Department of Labor requirements leave the legal landscape unsettled, say attorneys at McGuireWoods.

  • How 'Most Favored Nation' Regime Affects Biopharma Deals

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    As M&A activity surges in the biopharma space, companies will need to account for the Trump administration's most-favored-nation pricing proposals — durable in concept, if unsettled in detail — when drafting deals, say attorneys at Gibson Dunn.

  • Where DOJ's Fraud Priorities Memo May Actually Matter

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    The U.S. Department of Justice’s recently released memo outlining priorities for its newly created fraud division will shape how cases are identified, staffed and sequenced, meaning white collar defense work must begin earlier, say David Tarras at Tarras Defense and Trevor Jones at Dynamis.

  • DOJ Healthcare Declination Offers Self-Disclosure Checklist

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    The U.S. Department of Justice's declination of criminal charges against Campus Eye Management signals that its new self-disclosure policy provides a real path for healthcare companies to avoid criminal exposure, but that path is paved with speed, transparency and operational remediation, says Jonathan Porter at Husch Blackwell.

  • Correctional Healthcare Requires Clearer Legal Standards

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    As the correctional healthcare industry increasingly faces financial instability due to litigation, the U.S. Bureau of Prisons should develop clear standards for constitutionally adequate care for incarcerated patients, says Susanne Moore at Blackstone Trial Group.

  • How Home Infusion Providers Can Adapt To Enrollment Pause

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    Recent Centers for Medicare & Medicaid Services moratoria on new enrollments of home health agencies, medical equipment companies and hospices make home infusion providers' compliance obligations more complex and ambiguous, requiring new careful consideration of specific enrollment requirements and limitations, say attorneys at Quarles & Brady.

  • AI Data Mining Is Changing FCA Enforcement

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    With False Claims Act investigations increasingly emerging from statistical anomalies identified by data miners, companies need to consider what conclusions an outsider armed with artificial intelligence might draw from public-facing data and be ready to explain any anomalies if questions arise, say attorneys at Cohen & Gresser.

  • Lessons From 5 Months Of DOJ Corporate Policy Deals

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    Recent declinations and prosecution agreements between the U.S. Department of Justice and corporations since the March unveiling of the corporate enforcement and voluntary disclosure policy provide takeaways for management considering how to respond to corporate misconduct, says Brendan Quigley at Baker Botts.

  • A New Era Of Scrutiny For China-Linked Pharma Deals

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    As Congress considers bipartisan legislation that would heighten regulatory scrutiny for life sciences deals involving Chinese biotech entities, companies should reassess the risks and due diligence requirements that will come with using heavily China-dependent pipelines, says Jen Maki at Ankura.

  • Justices' FTC Ruling Weakens Qui Tam's Constitutional Base

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    The U.S. Supreme Court’s holding in Trump v. Slaughter, expanding presidential control over those exercising executive power, suggests that courts may be receptive to arguments challenging the constitutional foundations of the False Claims Act’s qui tam mechanism, says Daniel Passeser at Wiggin.

  • Calif. Drug Ruling Affirms Defect-Centric Liability Framework

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    The California Supreme Court's decision in Gilead Tenofovir Cases this week rejects a novel duty-to-innovate theory of negligence that could have reshaped product liability exposure well beyond the pharmaceutical industry, instead signaling that negligence claims premised on nondefective products are unlikely to succeed, say attorneys at Dechert.