Policy & Compliance
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November 05, 2025
Pharmacy Groups Urge 8th Circ. To Back Ark. PBM Limits
A pair of pharmacy trade groups is urging the Eighth Circuit to allow Arkansas to enforce a law barring pharmacy benefit managers from owning pharmacies, arguing the law is a rational response to "abusive" PBM practices.
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November 05, 2025
Judge Demands Facts In Pa. Medicaid-Paid Abortion Ban Case
A Pennsylvania Commonwealth Court judge on Wednesday repeatedly asked healthcare providers at oral arguments to show her facts on why a statewide ban on Medicaid-funded abortions was unconstitutional, often remarking that the case was short on evidence to support making changes to the coverage exclusion.
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November 05, 2025
Worker Can Keep OT Claim Against Health Care Co.
A worker's overtime claim can proceed against a healthcare company that provides services through the U.S. Department of Labor to individuals who have suffered injuries while working at nuclear facilities, a South Carolina federal judge ruled Wednesday, while tossing other wage- and benefits-related claims.
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November 05, 2025
Mich. AG Urges State High Court To OK Insulin Price Probe
The Michigan Supreme Court weighed overturning two of its prior rulings on consumer protection law Wednesday as the state's attorney general sought the court's blessing for an insulin price-gouging investigation.
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November 04, 2025
5th Circ. Judge Says FCA Illegally Steps On Executive Power
Fifth Circuit Judge James C. Ho says his court should reconsider what he called "serious constitutional problems with the qui tam provisions of the False Claims Act," arguing that whistleblowers who sue under the law "are neither appointed by, nor accountable to, the president," and that conflicts with presidential authority.
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November 04, 2025
Judges Wade Into Abortion Pill Access And Rx Pricing Fights
In a flurry of recent legal activity, courts across the country have been drawn into the nation's most contentious healthcare debates over access to medication abortions and efforts to cap the cost of prescription medications.
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November 04, 2025
Meet The Attys Behind Drugmakers' Conn. Price Cap Suit
Attorneys from Goodwin Procter LLP and Wiggin and Dana LLP are teaming up to represent the Association for Accessible Medicines in its challenge to a Connecticut drug price cap set to take effect at the start of 2026.
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November 04, 2025
NY Court Splits On Emotional Damage From Fatal Birth Injury
New York’s highest court handed a loss to legal advocates who had hoped a mother’s suit over the ramifications of the death of her newborn baby would help overturn a 20-year-old precedent on prenatal torts. A dissenting judge called a legal barrier to emotional damage recovery “contrary to common sense.”
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November 04, 2025
Gov't Subpoena Powers Face Reckoning In Healthcare Battles
The judicial deference given to the government's power to issue investigative subpoenas is facing an unprecedented challenge in transgender care cases. Willingness by judges to question motives could lead to more subpoena challenges or impede worthy government investigations.
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November 04, 2025
Fed. Circ. Denies VA Surgeon's Wrongful Termination Appeal
The Federal Circuit on Tuesday affirmed the U.S. Merit Systems Protection Board's decision to uphold the firing of a general surgeon by the U.S. Department of Veterans Affairs after he raised concerns about compromised patient care.
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November 04, 2025
9th Circ. Revives Ore. Right To Life Suit: 3 Things To Know
A divided Ninth Circuit panel sided with an Oregon anti-abortion group last week and reinstated its lawsuit challenging a state law that requires health plans to cover abortion and contraceptives.
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November 04, 2025
HHS Watchdog Puts Failing Nursing Home Program On Blast
Hefty fines aren’t enough to turn around the nation's worst nursing homes, a government watchdog has concluded. The findings illustrate the need for new enforcement strategies that promote staffing and other improvements meant to last.
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November 04, 2025
End Payors Seek $66M In Atty Fees In Generic Drug MDL
End payors in a generic drug price-fixing multidistrict litigation are seeking a Pennsylvania federal court's approval for a $66 million award of attorney fees, representing one-third of the $200 million settlement between the classes and Sun Pharmaceutical Industries Inc. and Taro Pharmaceuticals USA Inc.
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November 03, 2025
Pharmacies Seek Cert. In Cholesterol Drug Price-Fixing MDL
A group of indirect reseller plaintiffs urged a Pennsylvania federal judge on Friday to certify a nationwide class of thousands of pharmacies that indirectly purchased the cholesterol medication pravastatin in sprawling multidistrict litigation over alleged price-fixing in the generic drug industry.
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November 03, 2025
FDA Official Quits As Aurinia Sues Over 'Personal Vendetta'
Aurinia Pharmaceuticals on Sunday launched a lawsuit accusing Dr. George Tidmarsh, who that same day resigned as head of the U.S. Food and Drug Administration's drug division, of falsely claiming the biotech's lupus nephritis drug doesn't work amid his "longstanding personal vendetta" against the company's board chair and investor.
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November 03, 2025
Judge Denies New Trial In SuperValu Whistleblower Drug Case
An Illinois federal judge has refused to grant a new trial to whistleblowers who said grocery chain SuperValu systematically overbilled the government for prescription drugs, finding there was no issue with jury instructions on causation.
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November 03, 2025
Colorado Judge Denies AbbVie's Bid To Block State Drug Law
A Colorado federal judge denied AbbVie Inc.'s bid for a preliminary injunction, which would have barred the state from enforcing its laws and penalties surrounding federal 340B drug pricing.
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October 31, 2025
Drugmakers Can't End States' Dermatology Price-Fixing Suits
A Connecticut federal judge on Friday refused to throw out the vast majority of claims in a nationwide antitrust enforcement action accusing a long list of pharmaceutical companies of fixing the prices of generic dermatology drugs, rejecting the companies' argument that the claims were filed too late.
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October 31, 2025
Amgen Again Challenges Colo. Price Cap For Arthritis Drug
Amgen has once again sued Colorado over its price cap for the arthritis drug Enbrel, claiming that the Centennial State's drug price-control statute violates the U.S. Constitution, conflicts with federal patent law and threatens patients' access to lifesaving medications.
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October 31, 2025
Hawaii Judge Declares FDA's Mifepristone Regs Unlawful
The U.S. Food and Drug Administration failed to sufficiently justify restrictions on the abortion drug mifepristone, a Hawaii federal judge ruled in an order declaring the restrictions unlawful under the Administrative Procedure Act.
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October 31, 2025
Aetna Strikes $650K Deal In Lipedema Patients' Coverage Suit
Aetna has agreed to pay up to $650,000 to resolve a class action claiming it unlawfully refused to cover liposuction for over two dozen patients with a rare condition called lipedema, according to a filing in California federal court.
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October 31, 2025
Garnet Health Inks $4.6M Deal In Retirement Fee, Fund Suit
Garnet Health Medical Center has agreed to fork over $4.6 million to end a proposed class action alleging the New York healthcare network mismanaged employee retirement plan fees and investments, according to settlement documents filed by workers Friday in New York federal court.
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October 31, 2025
3 Argument Sessions Benefits Attys Should Watch In Nov.
The Third Circuit will hear a union's appeal in a withdrawal liability battle, a union health plan defends its partial win in a coverage fight at the Ninth Circuit, and pharmacy benefit managers will take a challenge to the Federal Trade Commission's authority to the full Eighth Circuit. Here are three arguments to keep an eye on in November.
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October 31, 2025
NC Attorney General, HCA Duel Over Merger Commitments
The North Carolina Attorney General's Office and HCA Healthcare have offered competing interpretations of a 2019 merger agreement in their efforts to secure a pretrial win in the state's compliance case involving the purchase of an Asheville hospital system.
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October 30, 2025
J&J's Janssen Says 3rd Circ. Should Reverse $1.6B FCA Win
Johnson & Johnson's Janssen Products LP urged the Third Circuit to overturn a $1.6 billion False Claims Act judgment over two of its HIV drugs, arguing the district court allowed whistleblowers to prove fraud based solely on "off-label" marketing rather than any false claim actually submitted to the government.
Expert Analysis
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Unpacking Ore. Law's Limits On PE Healthcare Investment
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.
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Criminal Healthcare Fraud Takeaways From 4th Circ. Reversal
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.
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AG Watch: Texas Embraces The MAHA Movement
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.
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How States Are Regulating Health Insurers' AI Usage
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.
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HHS Plan To Cut Immigrant Benefits Spurs Provider Questions
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.
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Noncompete Forecast Shows Tough Weather For Employers
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.
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Previewing State Efforts To Regulate Mental Health Chatbots
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.
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How DOJ's New Data Security Rules Leave HIPAA In The Dust
The U.S. Department of Justice's recently effective data security requirements carry profound implications for how healthcare providers collect, store, share and use data — and approach vendor oversight — that go far beyond the Health Insurance Portability and Accountability Act, say attorneys at Nelson Mullins.
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Texas Med Spas Must Prepare For 2 New State Laws
Two new laws in Texas — regulating elective intravenous therapy and reforming healthcare noncompetes — mark a pivotal shift in the regulatory framework for medical spas in the state, which must proactively adapt their operations and contractual practices, says Brad Cook at Munsch Hardt.
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DOJ-HHS Collab Crystallizes Focus On Health Enforcement
The recently announced partnership between the U.S. Department of Justice and U.S. Department of Health and Human Services to combat False Claims Act violations, following a multiyear trend of high-dollar DOJ recoveries, signals a long-term enforcement horizon with major implications for healthcare entities and whistleblowers, say attorneys at RJO.
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How The Healthline Privacy Settlement Redefines Ad Tech Use
The Healthline settlement is the first time California has drawn a clear line in the sand around how website tracking must function in practice, so if your site uses tracking technologies, especially around sensitive content like health or finance, regulators are inspecting your website's back end, not just its banner, say attorneys at Baker Donelson.
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How Sweeping Budget Bill Shakes Up Health Industry
With the recently passed One Big Beautiful Bill Act marking one of the most significant overhauls of federal health policy since the passage of the Affordable Care Act, providers, managed care organizations and life sciences companies must now shift focus from policy review to implementation planning, say advisers at Holland & Knight.
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New DOJ Penalty Policy Could Spell Trouble For Cos.
In light of the U.S. Department of Justice’s recently published guidance making victim relief a core condition of coordinated resolution crediting, companies facing parallel investigations must carefully calibrate their negotiation strategies to minimize the risk of duplicative penalties, say attorneys at Debevoise.