Policy & Compliance

  • March 13, 2026

    4th Circ. Brings Back Allergan Medicaid Overcharging Suit

    A split Fourth Circuit panel on Friday revived a whistleblower suit accusing an Allergan Sales LLC predecessor of overcharging Medicaid by more than $680 million, saying the whistleblower plausibly alleged the company knowingly improperly aggregated discounts into "best prices" for drugs.

  • March 13, 2026

    Sandoz Appealing Ruling Over Amgen's Enbrel Biosimilar

    Sandoz Inc. is appealing after a Virginia federal court ruled it should have brought claims accusing Amgen of blocking competition for the Enbrel biosimilar in a previous patent dispute, according to a Friday notice. 

  • March 13, 2026

    Texas Justices Clear Way For State's Trans Care Probe

    An LGBTQ+ advocacy organization must produce documents as part of an investigation from the Texas attorney general's office into transgender treatments for minors, the Texas Supreme Court ruled on Friday, saying that the state's ban on gender-affirming care for minors is the law and must be followed. 

  • March 13, 2026

    EPA Aims To Lift Biden-Era Ethylene Oxide Limits

    The U.S. Environmental Protection Agency on Friday proposed rolling back limits on emissions of ethylene oxide, a carcinogenic chemical used in the sterilization of medical devices.

  • March 12, 2026

    Ariz. Docs Ink $4.75M FCA Deal Over Unnecessary Treatment

    An Arizona-based physician group that offers cardiology and vascular services has inked a $4.75 million settlement to resolve False Claims Act allegations they performed unnecessary vein ablations and submitted claims for payment to government healthcare programs for reimbursement, the U.S. Department of Justice said Thursday.

  • March 12, 2026

    Top Texas Court Upholds Death Sentence For ICU Nurse

    The Texas Court of Criminal Appeals on Thursday affirmed the death sentence of a former cardiovascular nurse convicted of intentionally murdering patients recovering from operations, finding that Texas prosecutors' accusation that defense counsel engaged in "misdirection and deception" was "mild."

  • March 12, 2026

    Wash. Justices OK Jury Instruction In TB Malpractice Case

    The Washington State Supreme Court declined Thursday to flip a family's loss in a case blaming an Evergreen State doctor for failing to address signs of an intestinal tuberculosis infection that led to a patient's death, rejecting a challenge to a jury instruction on the physician's exercise of judgment.

  • March 12, 2026

    Colo. Panel Clarifies Workers Comp Law On Maintenance Care

    In interpreting the Colorado Workers' Compensation Act, the Colorado Court of Appeals ruled for the first time Thursday that employers and their insurers cannot limit maintenance medical benefits to any specific treatment in a final admission of liability.

  • March 12, 2026

    US Chamber Report Warns Of Risks To IP Protection

    While the U.S. has ranked at the top of the U.S. Chamber of Commerce's list measuring how countries worldwide are enforcing intellectual property laws, the group said problems with free trade agreements and efforts to reduce pharmaceutical prices could cause problems on the horizon domestically.

  • March 12, 2026

    Doc's Hands Aren't Property, Texas Panel Rules In Death Suit

    A state-employed doctor's hands are not "tangible personal property," a Texas appeals court ruled Thursday, dismissing a wrongful death suit from the family of a patient who contracted a fatal infection during her hospital stay. 

  • March 11, 2026

    New Wyoming Abortion Law Faces Familiar Legal Challenge

    Just a day after it was signed into law, Wyoming's new anti-abortion law triggered a legal challenge from the same health clinic that successfully sued over the state's previous abortion limits.

  • March 11, 2026

    La. Fights Dismissal Bid In Abortion Regulation Dispute

    The state of Louisiana urged a federal court to deny motions by GenBioPro Inc. and Danco Laboratories seeking dismissal of its suit challenging federal regulation on mail-order abortion drugs, arguing it has established harms stemming from the regulations.

  • March 11, 2026

    Ohio Hospital Defeats DaVita's Dialysis Discrimination Suit

    An Ohio hospital and its health benefit plan did not discriminate against patients with end-stage renal disease by eliminating in-network coverage for dialysis, a federal court ruled, finding that dialysis provider DaVita Inc. failed to show the plan intended to harm participants.

  • March 11, 2026

    VA, DOJ Cut Deal To Make Attys Mental Health Guardians

    Under a new initiative, attorneys at the U.S. Department of Justice will serve as legal guardians for some homeless veterans, the Trump administration announced on Wednesday, though some veterans advocates expressed concern that the new program could involuntarily coerce veterans experiencing mental health issues into institutional care.

  • March 11, 2026

    Aetna Will Pay $117.7M To Resolve False Billing Suit

    Aetna Inc. has agreed to pay $117.7 million to settle claims that the company violated the False Claims Act by submitting, and failing to correct, false diagnosis codes for its Medicare Advantage plan customers in order to boost cash flow from the federal insurance program, the U.S. attorney's office in Philadelphia said Wednesday.

  • March 10, 2026

    A Look At The Real Impact Of The FTC's PBM Settlements

    It may all come down to the details in a landmark settlement between the Federal Trade Commission and one of the biggest pharmacy benefit managers in the U.S., as delayed timelines and a key carveout provision threaten to dampen sweeping changes to the larger system.

  • March 10, 2026

    5th Circ. Revives J&J Sales Rep's Wage Dispute

    A Texas federal court did not take into consideration relevant factors to determine whether a former Johnson & Johnson sales representative's failure to retain local counsel in his wage and hour suit represented excusable neglect, the Fifth Circuit ruled on Tuesday.

  • March 10, 2026

    Sanofi Says Judge Botched Insulin Device Patent Listings

    Sanofi-Aventis sparred with drug wholesalers over a Massachusetts federal magistrate judge's pronouncements that the parties should go to trial on claims the pharmaceutical giant used improper insulin device patent listings to anticompetitively protect the blockbuster Lantus insulin pen from competition.

  • March 10, 2026

    Lab's Aetna Payment Suit Survives, But With Deep Cuts

    A Connecticut federal judge ruled Aetna and its parent company, CVS Health Corp., must face a pared down lawsuit from a medical laboratory alleging it is owed $20.6 million in unpaid invoices.

  • March 10, 2026

    Wash. To Set Its Own Vaccine Schedule Under New State Law

    Washington Gov. Bob Ferguson has signed legislation that requires health plans to cover vaccines and other preventive care recommended by the state rather than the federal government, joining a movement toward states setting their own recommendations.

  • March 10, 2026

    4th Circ. Backs W.Va.'s Trans Care Coverage Exclusion

    The Fourth Circuit said Tuesday that West Virginia's Medicaid coverage exclusion for gender-affirming care passes constitutional muster and does not discriminate based on sex, basing its conclusion on a U.S. Supreme Court ruling that upheld Tennessee's ban on gender-affirming care for minors.

  • March 10, 2026

    CVS Can't 'Relitigate' Price-Gouging Class Cert.

    A Rhode Island federal judge refused to narrow the certified classes of health plans alleging CVS schemed with pharmacy benefit managers to overcharge insured health plans for generic drugs, finding that PBM Express Scripts' refusal to produce its contracts changes nothing about how the classes will be assessed.

  • March 10, 2026

    2nd Circ. Revives Geico's Suit Over Acupuncture Referrals

    A lower court erred in granting summary judgment to Geico after the insurer sued over reimbursements to an acupuncturist involved in what Geico said was a kickback scheme, the Second Circuit ruled Tuesday, finding the district court misinterpreted a state law detailing requirements for referrals and no-fault payments. 

  • March 10, 2026

    Minn. Medicaid Funds Case A Test For CMS Tactic

    Minnesota’s fight over $243 million in Medicaid funding frozen by the Trump administration sets up an unusual, politically tinged legal clash that may shape the government’s anti-fraud tactics in other states.

  • March 10, 2026

    Wyoming Abortion Ruling Sets Off Lawmaker Backlash

    Lawmakers in Wyoming won't let judges have the final word on abortion and have considered slashing judicial security funding and shrinking the top court. This week, the governor signed a new "heartbeat" abortion ban likely to see new legal challenges.

Expert Analysis

  • Traditional FCA Enforcement Surges Amid Shifting Priorities

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    The U.S. Department of Justice’s January report on False Claims Act enforcement in fiscal year 2025 reveals that while the administration signaled its intent to expand FCA enforcement into new areas such as tariffs, for now the greatest exposure remains in traditional areas like healthcare — in which the risk is growing, say attorneys at Debevoise.

  • 3 Key Ohio Financial Services Developments From 2025

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    Ohio's banking and financial services sector saw particularly notable developments in 2025, including a significant Ohio Supreme Court decision on creditor disclosure duties to guarantors in Huntington National Bank v. Schneider, and some major proposed changes to the state's Homebuyer Plus program, says Alex Durst at Durst Kerridge.

  • Rescheduling Cannabis Marks New Tax Era For Operators

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    As the attorney general takes steps to move cannabis from Schedule I to Schedule III of the Controlled Substances Act, operators and advisers should prepare by considering the significant changes this will bring from tax, state, industry and market perspectives, says Michael Harlow at CohnReznick.

  • Justices' Med Mal Ruling May Spur Huge Shift For Litigators

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    The U.S. Supreme Court’s recent decision in the medical malpractice suit Berk v. Choy, holding that a Florida procedural requirement does not apply to medical malpractice claims filed in federal court, is likely to encourage eligible parties to file claims in federal court, speed the adjudicatory process and create both opportunities and challenges for litigators, says Thomas Kroeger at Colson Hicks.

  • 5 Drug Pricing Policy Developments To Watch In 2026

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    2026 may prove to be a critical year for drug pricing in the U.S., with potential major shifts including several legislative initiatives moving forward after being in the works for years, and more experimentation on the horizon concerning GLP-1s and Section 340B pricing, say attorneys at Manatt.

  • Regulatory Uncertainty Ahead For Organ Transplant System

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    Pending court cases against a Centers for Medicare and Medicaid Services final rule that introduced a competition-centric model for assessing organ procurement organizations' performance will significantly influence the path forward for such organizations and transplant hospitals, say attorneys at Crowell & Moring.

  • Key False Claims Act Trends From The Last Year

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    The False Claims Act remains a powerful enforcement tool after some record verdicts and settlements in 2025, and while traditional fraud areas remain a priority, new initiatives are raising questions about its expanding application, says Veronica Nannis at Joseph Greenwald.

  • It's Too Soon To Remove Suicide Warnings From GLP-1 Drugs

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    The U.S. Food and Drug Administration's decision this month to order removal of warnings about the risk of suicidal thoughts from GLP-1 weight-loss drugs is premature — and from a safety and legal standpoint, the downside of acting too soon could be profound, says Sean Domnick at Rafferty Domnick.

  • What To Know About DOL's New FLSA, FMLA Opinion Letters

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    The U.S. Department of Labor kicked off 2026 by releasing several opinion letters addressing employee classification, incentive bonuses and intermittent leave, reminding employers that common practices can create significant risk if they are handled inconsistently or without careful documentation, say attorneys at Woods Rogers.

  • What Changed For Healthcare Transaction Law In 2025

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    Though much of the legislation introduced last year to expand state scrutiny of healthcare transactions did not pass, investors should pay close attention to the overarching trends, which are likely to continue in this year's legislative sessions, say attorneys at Ropes & Gray.

  • Expect State Noncompete Reforms, FTC Scrutiny In 2026

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    Employer noncompete practices are facing intensified federal scrutiny and state reforms heading into 2026, with the Federal Trade Commission pivoting to case-by-case enforcement and states continuing to tighten the rules, especially in the healthcare sector, say attorneys at DLA Piper.

  • CMS 2027 Proposal Is Mixed Bag For Medicare Advantage

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    The Centers for Medicare and Medicaid Services' recent proposed rule for the Medicare Advantage and Part D programs gives small organizations reason for optimism, although certain elements may be inconsistent with the Centers' desire to enhance competition, says Christine Clements at Sheppard Mullin.

  • 3 Key Takeaways From Planned Rescheduling Of Cannabis

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    An executive order reviving cannabis rescheduling represents a monumental change for the industry and, while the substance will remain illegal at the federal level, introduces several benefits, including improving state-legal cannabis operators' tax treatment, lowering the industry's legal risk profile, and leaving state-regulated markets largely intact, say attorneys at Dentons.