Policy & Compliance

  • March 23, 2026

    Health Insurers Can't Force Conn. ERISA Row Into Arbitration

    Elevance Inc. can't compel arbitration of a union health plan's allegations the insurer caused it to pay excessive administrative fees and medical costs, a Connecticut federal judge ruled, finding the insurer and its subsidiaries waived that right by seeking to dismiss the proposed class action.

  • March 23, 2026

    High Court Won't Hear Mich. Newborn Blood Testing Case

    The U.S. Supreme Court on Monday declined to hear a petition from parents seeking to revive claims that the way newborn blood samples are collected and stored in a Michigan health screening program violates their rights to make medical decisions for their children.

  • March 23, 2026

    Justices Won't Review Lab Owner's Kickback Conviction

    The U.S. Supreme Court on Monday declined to review the conviction of a former California biotech president sentenced to eight years in prison for lying about the efficacy of his company's COVID-19 and allergy testing and conducting a $70 million Medicare fraud scheme. 

  • March 23, 2026

    High Court Won't Hear Calif. Border Hospital Medicaid Fight

    The U.S. Supreme Court said Monday it would not consider a case challenging California's exclusions of hospitals in neighboring states from supplemental federal payments going to providers that serve Medi-Cal beneficiaries.

  • March 20, 2026

    Feds Rip Ex-NFL Player's New Trial Bid Over Medicare Scheme

    The federal government opposed a new trial bid by Keith Gray, a former NFL player and Texas laboratory owner convicted in a $328 million scheme involving billing for unnecessary cardiovascular genetic testing for Medicare beneficiaries, arguing Thursday he lacks any valid basis to "disturb the jury's sound verdict."

  • March 20, 2026

    EPA's Ethylene Oxide Plan May Hinder Other Air Toxics Regs

    A new proposal from the U.S. Environmental Protection Agency to weaken emission standards for a medical sterilizer could have broader implications for the agency's power to tighten air pollution limits when new science becomes available.

  • March 20, 2026

    Pa. Hospital Must Pay $109M For Brain Injury During Birth

    Jefferson Health and its subsidiary Einstein Healthcare Network have been hit with a nearly $109 million verdict by a Philadelphia jury in a lawsuit accusing them of negligence leading to debilitating brain injuries sustained by a child delivered at one of their hospitals.

  • March 20, 2026

    Mich. BCBS Unit Gets Health Plans' Claims Fight Transferred

    A federal judge granted Blue Cross Blue Shield of Michigan's request to transfer a proposed class action alleging the insurance company violated federal benefits law by mismanaging claims in self-funded employee healthcare plans it administered, given that a similar, earlier-filed action was proceeding in an adjacent district.

  • March 20, 2026

    Eye On ERISA: A Chat With King & Spalding's Darren Shuler

    Increased scrutiny of health plans and the high costs of care are fueling a litigation uptick that's coming not just from plan participants but also from employers frustrated with their third-party administrators, said Darren Shuler, a partner at King & Spalding LLP. Here, Shuler speaks with Law360 about litigation trends involving the Employee Retirement Income Security Act.

  • March 19, 2026

    HHS Can't Block Trans Care Under Kennedy Edict, Court Says

    A coalition of 21 states and the District of Columbia prevailed on Thursday in their challenge to a Trump administration move to cut access to gender-affirming care for minors when an Oregon federal judge agreed to void a policy statement from Health and Human Services Secretary Robert F. Kennedy Jr.

  • March 19, 2026

    Pharma Group Can't Halt Colo. Law Over Drug Discount Rules

    A Colorado federal judge denied a bid by the Pharmaceutical Research and Manufacturers of America seeking to halt enforcement of a state law guarding providers' ability to contract with pharmacies to distribute discounted drugs under the federal 340B program.

  • March 19, 2026

    Legislative Update: Cannabis And Psychedelics Bill Roundup

    Virginia lawmakers last week gave final approval to legislation that would tax and regulate the sale of adult-use cannabis, Georgia legislators passed a dramatic expansion of the state's medical cannabis program, and Iowa lawmakers approved a bill to designate kratom as a Schedule I substance. Here are the major moves in cannabis and psychedelics legislation from the past week.

  • March 19, 2026

    11th Circ. Partially Reopens Aetna Twin Birth Coverage Fight

    The Eleventh Circuit on Thursday undid Aetna's escape from a worker's coverage dispute over an extended hospital stay for her newborn twins, agreeing with the lower court that allegations failed to state a claim for violating federal benefits law but holding that an amended complaint should have been allowed.

  • March 19, 2026

    Calif. Families Sue Rady Health Over Move To End Trans Care

    Four families have asked a state judge to prevent California's largest pediatric health system from cutting off gender-affirming care for minors, alleging the move would violate state antidiscrimination laws and leave them scrambling to find new providers, some more than 100 miles away.

  • March 19, 2026

    CVS, Caremark Pocket Money Meant For Rebates, Suit Claims

    CVS charges drug manufacturers "exorbitant" fees in exchange for pushing their products, then pockets the money instead of funneling it toward customer rebates as it promises, a federal lawsuit alleges, accusing the company of collecting billions of dollars at customers' expense and violating the anti-racketeering statute.

  • March 18, 2026

    Key Details As 3rd Circ. Ponders FCA's Fate, $1.6B J&J Fine

    Third Circuit judges Wednesday explored divergent views of the False Claims Act's constitutionality and a record fraud verdict against Johnson & Johnson, expressing little eagerness to gut the FCA's whistleblower mechanism, and voicing uncertainty about evidence and jury instructions underpinning the drug promotion punishment.

  • March 18, 2026

    SelectQuote Looks To Escape Investors' Kickback Probe Suit

    SelectQuote has asked a New York federal judge to dismiss a proposed class action accusing it of harming investors by concealing a kickback scheme, which is currently the subject of a suit by the U.S. Department of Justice, arguing the existence of the government's suit is not enough to show the shareholders were damaged.

  • March 18, 2026

    UnitedHealth Customers Denied Class Cert. In PrEP Suit

    Two UnitedHealthcare customers can't turn their Affordable Care Act lawsuit against a company subsidiary into a class action, a Minnesota federal judge ruled Wednesday, denying the pair's bid to represent thousands of customers in litigation accusing the subsidiary of failing to approve full coverage for PrEP.

  • March 18, 2026

    Ed. Dept. Flouting Mental Health Funding Order, States Claim

    The U.S. Department of Education is flouting orders that it fund K-12 mental health grants given to public schools by only partially funding the grants and threatening to withhold remaining funds, a group of state attorneys general told a Washington federal court.

  • March 18, 2026

    Doctor Gets 6½ Years For Healthcare Fraud, Tax Evasion

    An Anchorage, Alaska, physician was sentenced to six and a half years in prison for committing over $16 million in healthcare fraud and tax evasion as part of a scheme that injected sick patients with the wrong medications or dosages, the federal government said Wednesday. 

  • March 18, 2026

    ADA Challenge to Oregon Psilocybin Law Can Proceed

    An Oregon federal judge Tuesday rejected the state's health regulator's bid for a favorable judgment in a suit brought under federal antidiscrimination law, seeking to broaden access for homebound patients to the state's regulated psilocybin program.

  • March 18, 2026

    Health Litigator Rejoins Holland & Knight From In-House Role

    A former Holland & Knight LLP attorney has returned to the firm in Jacksonville, Florida, after a 10-year stint in-house at Florida Blue, a subsidiary of GuideWell Mutual Holding Corp.

  • March 18, 2026

    FDA Can't 'Refuse To File' Tobacco Applications, Suit Says

    The maker and a seller of Zone nicotine pouches are suing the U.S. Food and Drug Administration in Texas federal court, alleging the agency stalled and eventually refused to file their marketing application, despite federal law requiring the FDA to either approve or deny such applications.

  • March 17, 2026

    The Legal Reasoning That Put RFK's Vax Panel On Ice

    The legal reasoning behind a Massachusetts court's decision to freeze major changes to national vaccine policy is simpler than you might expect.

  • March 17, 2026

    9th Circ. Backs Rare FCA Theory In Huge Drug Prices Program

    In a novel and potentially far-reaching decision, the Ninth Circuit on Tuesday revived a major hospital chain's False Claims Act suit accusing large pharmaceutical companies of massive overcharges in a prominent drug discount program where pricing disputes are common.

Expert Analysis

  • 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.

  • 6 Issues That May Follow The 340B Rebate Pilot Challenge

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    Though the Health Resources and Services Administration withdrew a pending case to reconsider the controversial 340B rebate pilot program, a number of crucial considerations remain, including the likelihood of a rework and questions about what that rework might look like, say attorneys at Spencer Fane.

  • 2026 State AI Bills That Could Expand Liability, Insurance Risk

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    State bills legislating artificial intelligence that are expected to pass in 2026 will reshape the liability landscape for all companies incorporating AI solutions into their business operations, as any novel private rights of action authorized under AI-related statutes signal expanding exposures, say attorneys at Wiley.

  • How 11th Circ.'s Zafirov Decision Could Upend Qui Tam Cases

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    Oral argument before the Eleventh Circuit last month in U.S. ex rel. Zafirov v. Florida Medical Associates suggests that the court may affirm a lower court's opinion that the qui tam provisions of the False Claims Act are unconstitutional — which could wreak havoc on pending and future qui tam cases, say attorneys at Morgan Lewis.

  • Key Trends For Life Sciences Cos. To Watch In 2026

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    Following a year of drastic change at the U.S. Food and Drug Administration, two themes are likely to drive the coming year — a commitment to lowering the cost of drugs and an inherent tension between the priorities of the health agencies and the broader administration, say attorneys at Sheppard Mullin.